The Task before Psychiatry Today Redux: STSPIR

Abstract

This paper outlines six important tasks for psychiatry today, which can be put in short as: Spread and scale up services;Talk;Science,Psychotherapy;Integrate; andResearch excellence.As an acronym, STSPIR. Spread and scale up services: Spreading mental health services to uncovered areas, and increasing facilities in covered areas:Mental disorders are leading cause of ill health but bottom of health agenda;Patients face widespread discrimination, human rights violations and lack of facilities;Need to stem the brain drain from developing countries;At any given point, 10% of the adult population report having some mental or behavioural disorder;In India, serious mental disorders affect nearly 80 million people, i.e. combined population of the northern top of India, including Punjab, Haryana, Jammu and Kashmir, Uttarakhand and Himachal Pradesh;Combating imbalance between burden of demand and supply of efficient psychiatric services in all countries, especially in developing ones like India, is the first task before psychiatry today. If ever a greater role for activism were needed, this is the field;The need is to scale up effective and cost-effective treatments and preventive interventions for mental disorders.Talk: Speaking to a wider audience about positive contributions of psychiatry: Being aware of, understanding, and countering, the massive anti-psychiatry propaganda online and elsewhere;Giving a firm answer to anti-psychiatry even while understanding its transformation into mental health consumerism and opposition to reckless medicalisation;Defining normality and abnormality;Bringing about greater precision in diagnosis and care;Motivating those helped by psychiatry to speak up;Setting up informative websites and organising programmes to reduce stigma and spread mental health awareness;Setting up regular columns in psychiatry journals around the globe, called ‘Patients Speak’, or something similar, wherein those who have been helped get a chance to voice their stories.Science: Shrugging ambivalence and disagreement and searching for commonalities in psychiatric phenomena; An idiographic orientation which stresses individuality cannot, and should not, preclude the nomothetic or norm laying thrust that is the crux of scientific progress.The major contribution of science has been to recognize such commonalities so they can be researched, categorized and used for human welfare.It is a mistake to stress individuality so much that commonalities are obliterated.While the purpose and approach of psychiatry, as of all medicine, has to be humane and caring, therapeutic advancements and aetiologic understandings are going to result only from a scientific methodology.Just caring is not enough, if you have not mastered the methods of care, which only science can supply.Psychotherapy: Psychiatrists continuing to do psychotherapy: Psychotherapy must be clearly defined, its parameters and methods firmly delineated, its proof of effectiveness convincingly demonstrated by evidence based and controlled trials;Psychotherapy researc...

Field of Psychiatry: Current Trends and Future Directions: An Indian Perspective

“…We lack knowledge of the aetiology and pathogenesis of most psychiatric disorders. We do not have a single biomarker in psychiatry yet (Singh, 2014[6]). We have no objective or prognostic investigations, and our drug and psychological treatments are often partially effective.…”

Task before Indian Psychiatry Today: Commentary

“…Proper usage of terms to denote or refer to these patients needs to be taught along with meanings of the common medical terminology used to diagnose and refer to them. This, along with the community initiatives suggested earlier, will be an important stride forward toward many of the long-term goals emanating from Singh's paper (Singh, 2014[20]).…”

“…The article written by Singh (2014)[20] on the task before psychiatry today speaks with great elaboration on the goals this field needs to set and achieve in the next two decades. It is rather broad in its outlook, and achieving the goals set in the paper will need one to surmount huge barriers and cross mighty chasms.…”

“…In this commentary on the article, “The Task Before Psychiatry Today Redux: STSPIR,” (Singh, 2014)[20], the author, while agreeing with most of the paper's findings, proposes a rather parallel judgment that intersects at the same paths ahead. There is a need for widespread and easily available essential mental health services in India.…”

Speaking to a wider audience about the positive contributions of Psychiatry

“…The positive contributions need to be conveyed to masses at large and their fears and misconceptions allayed (Singh, 2007[16], Singh, 2014[18]).…”