Paper short abstract:

An understanding of contemporary social factors, the history of development of health services, and the engagement with the people it serves, is necessary to inform the discourse on mental health policy planning. Adequate attention does not seem to have been paid to these factors in the discussions and plans regarding mental health care in India

Paper long abstract:

The development of mental health services India, shows a marked focus on biomedical model, and relatively less attention to social determinants of mental health. Social factors have not been adequately incorporated into ideas about mental health. Adapting bio-medical models to diverse social settings, may be one reason for the disparate, and often, chaotic service delivery.

We try to incorporate a historical perspective on the trajectories that mental health care and service delivery have undergone, in India, starting from the mental hospital system created during the colonial period, to the WHO influenced positions in the post-Independence period, and the paradigm shifts that have accompanied this. The emphasis on mental hospitals in 19th century, and on de-centralized community care in the 20th century, in India, both mirrored developments in Europe and North America. Their utility in the south Asian context was often questioned, but the tension between developing care systems that were compatible with global standards, as well as locally relevant, persists. Psychiatric services in societies undergoing rapid social and economic transition often have to make uneasy compromises between the need and provisioning for care, human rights issues, as well as ensuring that health care remains inclusive and accessible to all segments.

The on-going debates about the nature of the models, whether they should be specialist driven, public or private, whether they should be based in the primary health system, how ‘local’ and how ‘global’ they should be, are some of the ideas that we would like to explore in this presentation.