‘A LOT HAS CHANGED, A LOT HAS TO BE CHANGED’

Dr Shamsah B. Sonawalla (M.D.) is an Associate Director, Psychiatry Research and Consultant Psychiatrist at the Jaslok Hospital and Research Centre, Mumbai. A practicing psychiatrist for over 15 years, she has worked extensively in this field across India and the United States. She is also the founder of the TransMag Well-Being Clinic in Mumbai. Dr Sonawalla obtained her M.D. degree in Psychiatry from Bombay University (T.N. Medical College & B.Y.L. Nair Hospital). She then pursued her postdoctoral training in Psychiatry at Harvard Medical School. She returned to India in August 2002, and joined Jaslok Hospital as an Honorary Consultant Psychiatrist. Dr Sonawallah in conversation with Santia Dudi from the ADC on medical health, trends, notions and challenges in medical health in India and Mumbai.

The well established notion is that ‘Only mad people seek psychiatric help’. How strong is this perception in our society in today’s time?
As far as this stigma is concerned, a lot has changed and a lot has to be changed. There is a huge shift in this perception. Change is palpable. The stigma regarding mental illness has decreased. There was a time when people didn’t speak about mental illness outside the clinic. But nowadays it feels great to witness how people are speaking about mental health and mental illness in the open. Also the ways of treatment are also changing. Earlier  patients used to be treated cruelly and fortunately this is changing. Though the stigma and pressure also depends on the factor as to which section of society the patient belongs to. People from some segments don’t want to be seen in clinics seeking psychiatric help. A lot of families can’t handle mental ailments and a lot of people are not willing to speak about mental health but overall the stigma has decreased.

In what ways Mumbai is different when it comes to awareness about mental health?
Mumbai is ahead of the rest of the country and shockingly backward also. Actually it depends on various factors like where is person is coming from, his/her age and he/she is at which stage of life. But certainly people of Mumbai are much more aware.

How is India different from the West on mental fitness?
The trend is changing in India and we can say that we are more similar than different from west. The positive part in India is that the patients have family support. In India patients visit clinic with their family members which is rare in the West. But unfortunately we are different from the West on the concepts of awareness and acceptance.

What is the condition of mental health of children?
It’s a sad thing to admit but children are under more pressure today than ever. And depression in children has drastically shot up. Also it’s hard to diagnose the reasons for depression in children. At times it’s genetic and at times it happens due to the result of their surroundings. School phobia, behaviour problems or suicidal thoughts, are the kind of tendencies found in children.

And depression in women?
See today’s women want to become superwomen. The traditional roles of women haven’t changed a lot, but on the contrary they have been burdened with new responsibilities. Also the depression in women can easily be missed especially in the lower sections of the society. So a lot has to be done in this direction. Also women are driven by guilt, so taking time for their health and that too their mental health is not easy. But fortunately this is changing. The women are now taking their mental health seriously and coming out in huge numbers to seek psychiatric help. This is a positive change. Though a lot has to be done but it’s great to witness this change.

Talking about the awareness, do you believe that adding a topic/module on mental health in the syllabus in our schools and colleges can help?
Yes, absolutely yes. See the awareness has to be spread on individual level and the society level. And there can’t be a better platform than schools and colleges. It has already started. For example nowadays there is a counselor in many schools. Mental health can be taught in different and friendly ways. It’s a very important and effective platform. Also along with the awareness we have to come up with solutions. We just can’t keep spreading awareness and not offering a solution.

What are the challenges of being a psychiatrist?
Like all the other fields and professions there are many challenges in our profession as well. The major challenges are lack of good admission facilities. Lot of our patients need to be admitted and the lack of admission facility becomes a barrier. Though there are few admission centers but they are certainly not enough, not at all enough. The lack of awareness among people is another challenge. Educating patients and their families is also a challenging aspect of our job. And the lack of trained supporting staff adds to everything.
But I would like to mention and emphasize on the fact that how rewarding, gratifying and satisfying this profession is. Watching your patient getting well pays off for all the efforts one puts in as a psychiatrist.

How popular is the concept of regular mental check up?
Unfortunately it’s not popular. I strongly feel that mental check up should be a part of every medical check up. Also various camps can be organised for the same, the way it’s done for eye check up and other diseases. It’s high time that we should walk the talk.

What made you select psychology as your profession?
From my childhood days while growing up in school, I used to find the human mind and human behaviour very fascinating. I always used to love interacting with people and watching others interacting with each other. During my years as a medical student I was more inclined towards human behaviour and mind studies and all these factors played an important role in my career choice.

Some tips for the readers for their mental fitness.
Prevention is better than cure. Focusing on prevention will lead to your positive mental health. I always say one thing to my patients ‘back to basics’. Sleep enough, take a healthy diet and exercise. These basic things are extremely crucial and important. Also I would like to say one thing to  family members and friends, if you can’t help someone at least don’t harm them. Don’t discourage anyone for seeking psychiatric help. And try and make a positive difference in the patient’s life.