Indian - Scientist | May 5, 1964 -
There is no health without mental health; mental health is too important to be left to the professionals alone, and mental health is everyone's business.
Vikram Patel
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There is no evidence to show that prohibition has ever had its intended impact. Of course, just as banning beef has reduced beef consumption, banning alcohol will lead to reduced alcohol consumption. But, there appears to be little or no correlation between, say, domestic violence or household impoverishment and prohibition.
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In the end, I do not think we will find the neat boundary between 'normal sadness' and 'clinical depression,' if only because mood is an innate human characteristic, like weight or the length of our hair. However, to reject the very notion of depression as an illness on account of these difficulties is throwing the baby out with the bath water.
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Most of the people who make decisions about global health are in the U.S. and Western Europe. There, the mental health care system is dominated by highly trained, expensive professionals in big hospitals, who often see patients over long periods of time. This simply can't be done in rural Africa or India. Who the hell can afford that kind of care?
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The difference in the quality of medical care received by people with mental illness is one of the reasons why they live shorter lives than people without mental illness. Even in the best-resourced countries in the world, this life expectancy gap is as much as 20 years. In the developing countries of the world, this gap is even larger.
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No matter where you are, depression responds to the same treatment.
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Mental health can improve overall well-being and prevent other illnesses. And since mental health problems have a serious economic impact on vulnerable communities, making them a priority can save lives and markedly improve people's quality of life.
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If our children are becoming teenagers who are abusive, have mental health issues, and are committing heinous crime, it only means that we have failed them as a society. We have failed to give them a safe, nurturing environment to ensure that they are well-balanced, useful persons in the society.
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The current approach that psychiatry takes almost ignores social worlds in which mental health problems arise and tries to become highly biomedical like other branches of medicine such as cardiology or oncology. But psychiatry has to be far more embedded in people's personal and social worlds.
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It is easy to lay the blame on successive governments for failing to address health as a fundamental right for the Indian people. But the real tragedy is that we, the people of India, have not taken our government to task for this catastrophic failure.
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Prohibition, like so many other policies imposed from the moral high ground, typically by those who do not drink, disproportionately affects the poor who resort to illegally brewed alcohol when they want a drink, not infrequently leading to their death, and are more likely to be harassed by the police.
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In many parts of the world, chaining of people with mental illnesses is not uncommon, nor is seeing people walking around in clearly an unwell state, half naked, and no one takes any notice of them. It is tragic. There is a basic human right, which is not about just healthcare, but it is about the right to life with dignity, a right to citizenship.
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