Meet 97-year-old Dr Sarada Menon who says women are more vulnerable to mental illness
Padma Bhushan Dr M. Sarada Menon is the first female psychiatrist in India and the founder of the Schizophrenia Research Foundation (SCARF), a WHO recognized Organization for the rehabilitation of people afflicted with Schizophrenia and other mental disorders. She is a former Madras Medical Service officer and the recipient of the third highest civilian honor in India, the Padma Bhushan, in 1992, for her contributions to society.
Even at 97, Dr. Menon, in a heart-to-heart chat speaks on the scenario of mental health in India.
What made you specialize in psychiatry?
I have not done any research in psychiatry nor have I published any articles on psychiatry except in the earlier days of my medical practice. I dealt with a lot of patients, interacted with them and it helped me clearly understand the patient and his / her environment. Observation, interpretation, trial and error methods of very simple interventions, expressing empathy to the patient and sympathy for the patient’s family, and practicing kindness in all dealings with the patient are the ways I opted in knowing the patient.
I am in the field of Psychiatry since 1959. I had been trained in Psychiatry at The All India Institute of Mental Health, Bengaluru. When I chose Psychiatry, my family, friends, and teachers were very much against it, but I had made up my mind, and have no regrets about my decision to become a psychiatrist.
My first exposure to people with mental illness was when I attended a class in Mental Diseases at the Government Mental Hospital, Chennai during my final year of M.B.B.S. There, I saw about 10 – 15 patients who were ill-clad, filthy in appearance, gesturing, posturing, talking to themselves, inclined to be aggressive and totally out of touch with reality. The professionals were not able to explain the cause of their poor mental health, nor what remedies could help in resolving the same; this set me thinking that how I could help those patients. I felt very sad, helpless, sympathetic and felt guilty thinking that doctors could not do anything, and there arose a deep desire in my mind to contribute something to the welfare of the mentally ill patients. This interest and desire to go further in the matter was strengthened when I saw a girl of 16 in a general hospital – very restless in bed with rails all around. She was shouting and crying; sedated with a painful injection, the effect of which lasted for about only 3 hours. We could not help her and she had to be discharged. I thought it was worth the while to work on this road less well taken and try to understand, treat, and plan rehabilitation, recovery, and restoration of these unfortunate persons.
I needed the training to start and there were no training centres in India then. A couple of years later, in 1957, I found the first training centre in Bengaluru and was deputed from Chennai to Bengaluru for attending the training. After the training, I was posted to the Government Mental Hospital, Chennai. Let me take a quote from William Shakespeare’s Play “Things base and vile, holding no quantity love can transpose to form and dignity’’ I had at least that to give the people with poor mental health.
Do you think that stigma in mental illness still persists in India?
Stigma related to mental illness still persists in India but it has reduced considerably. The higher strata of society, the over religious, educationally backward are more affected by these beliefs than the middle and poor classes. Families are more willing nowadays to meet a psychiatrist, attend mental health centres, and even take a mentally ill person to a function or an outing nowadays. With better awareness, I am sure it will disappear.
Are there any gender differences prevailing in the occurrence of psychiatric disorders? If so, Why?
India with its numerous states, languages cultural issues, socio-demographic differences will definitely show different figures related to mental health and illness of the population. Whatever the figures say, I feel women suffer more mental health problems. Social factors and gender-specific factors determine the prevalence and course of mental disorders in female sufferers. Gender differences prevailing in the occurrence of psychiatric disorders are due to genetics, physiological characteristics, psychological characteristics, environmental factors, and cultural issues.
Women are very vulnerable and therefore affected by mental disorders more than men. Limited access to resources, economic conditions, cultural issues, lack of education and financial dependence, domestic violence, less attention to any kind of illness makes women more vulnerable. All social tragedies affect women resulting in high-stress levels.
Men are, maybe, less vulnerable. They are better educated, have the opportunity to help themselves to further their developmental goals, more financially independent, more employed, and are physically able. They are less worried but can stave off the domestic problem through their work and networking practice. They have however their workplace problems competition, social aspects (culture educational socio-economic factors).
Behavior that would be a forerunner of mental illness should be detected early enough so that early treatment could prevent chronicity and disability. The public should be aware because often the patient may not have a complaint but others who feel the change may predict serious problems. Naturally, this will be a major problem for those less educated and more primitive.
You are the founder of the Schizophrenia Research Foundation (SCARF). Tell us more about it?
Schizophrenia Research Foundation, India was founded in 1984. After having worked in the Mental Hospital for over 19 years and subsequently working (to date) in a voluntary capacity for the progress of mentally ill people. Through my experience, I came to the conclusion that the mentally ill can be treated and restored to normal, or near-normal with proper and regular interventions such as rehabilitating the mentally ill people to reach the stage of recovery, reintegration, and restoration. Rehabilitation through care and Research was therefore planned. We run clinical services, case management and follow up with vocational training, job fair leading to open employment / family education programs, public education, training of personnel and everything needed to complete the effort. Donations from well-wishers, Government funding and assistance from abroad, all contributed to our financial requirement. Networking with other Non-Governmental Organizations helped to organize our programs. We started with a passion for work to improve the future of the mentally ill people, we used whatever we were able to get, did what we could, and will continue the struggle.
What is the scenario of mental health in India?
With the progress made in the understanding of mental illness and health, improvements obtained from the treatment given (new medication and other method), important inputs from Research being done in India and abroad, India has advanced in the management of mental health. Psychiatry offers many opportunities for innovative thinking and planning to treat mental illness and promote mental health. There are many mental health professionals who have proposed and tried out various remedies and have been successful. But there is a need for a better organization to establish reliability and validity for the various treatment options available for mental illness. The interventions vary from the religious method, superstitious suggestions to advanced medical and enumerable modern techniques.
The younger generation prefers modern technology while the older persons are more comfortable with previous time tested efforts. Besides all these, there are problems in the form of stigma, objections, and preferences of family members, cost of treatment non-availability, and inaccessibility of services that hinder the attempts to heal.
Are mental health treatment facilities in India adequate?
As mentioned earlier and also a well-known fact, India being a country of several states with different cultures, social beliefs and practices, socioeconomic conditions, educational status languages, health facilities, and such, provisions for a mental health organization will also be different. Every state will be having a center of excellence for mental health with good infrastructure and services to cope with the advances made the world over. The peripheral services which are available for treating mental health disorders are only of skeleton type and therefore it cannot fulfill the requirement for good service.
I would say that the reason for the inadequacy of service (except for centers of excellence) would be a shortage of staff at all levels, inadequate infrastructures, poor funding for mental health, administrative insufficiency and poor public awareness.
A healthy body is necessary for a healthy mind. The origins of many mental health problems lie in childhood. Good parenting, value-based education, encouragement of good practices like yoga and recreational activities as well as practicing healthy eating and talking to the child about the dangers of tobacco, alcohol, and drugs will enable children, the Nation’s future, to lead a good and healthy life. Keep in mind that time tested good practices should not be shelved to make room for the ultramodern, though fascinating, lifestyle of today.