A Humanistic Approach Towards Mental Illness

Masterly perspective on the issue Dr. Sohail!

Re: # 5
dear abskii....transcultural mental health is the field of the future. if you pursue that, it

would benefit a lot of people and hopefully you will also learn a lot. these days i am working

with such a group in toronto. i and my friend rafiq sultan just finished translating a 100

pages mental health guide in urdu for urdu speaking immigrants from india and pakistan

such education is vital to raise social consciousness and reduce human suffering. thanks for

your keen interest in my article....sincerely sohail

Re: # 5
Abskii, what do you do??

Re: # 3

Another great article, with valid points. As somone who works with several types of mental illness, I also think that `respect` and `humane treatment` overlap, to the extent that they are much the same thing. To treat somone humanely you need to respect their basic human rights.
There are so many misconceptions about those with mental health issues, and I have not seen the attitudes change much. Only recently did somone gasp on hearing that I work with a schizophrenic who is breaking down and ask, wide-eyed: ``But isn`t it dangerous?``

More education work is needed, and more outreach work to educate those from a different background (ie. those from a different culture to the host counrty) about these disorders.

(A field of work that I want to break into).

Re: # 2
dear urstruly...thanks for your ideas about `respect` and `humane`. keeping semantics aside

in my opinion both attitudes overlap. i agree with you that when someone is sick they

need to be treated humanely and not expect a reciprocity but when their symptoms are in

control and they are functioning well then mutual respect will be a realistic expectation.

I have a few schizophrenic patients who are doing so well that their colleagues do not know

they see me and take regular medications. Sometimes such patients suffer because of

the prejudiced policies of the organizations. Humane treatment of psychiatric patients would

be a great social achievement and can be achieved with education.

...sincerely sohail

I don`t thhink that the people with schizophrenia, for example, are capable of grasping the concepts such as, ``respect``. I think their mental faculties cannot even conrol their biological selves very well. My contention is purely academic and should not be construed as that the mental patients are fair game for anyone. My contention is that common people should be educated to treat them differently from ordinary human beings. For example, the concept ``respect`` has reciprocatory connotations; and if we educate a common citizen to give ``respect`` to a schizopherenic, then practically it would amount to nothing, except frustration. On the other hand if an ordinary citizen is educated to be humane to menatl patients then its would be more productive since being humane has no reciprocatory connotations.

As far as ``respect` to schizophrenics is concerned our culture do promote the concept of ``Allah lok, or SaiN Lok``, which at least helps them survive. But I think it must change.

Re: # 4 bjkumar, you have raised a valid point - there is a stronger sense of community and family in certain cultures, which is very healthy. But alas a lack of knowledge and recognition of symptoms means that, according to one study (forgive me- I can`t remember the details), it found via annonymous questionairres that the rate of depression in Asian middle aged women* was three times that of a comparable group of western women. Possibly because of a lack of understanding, less willingness to seek help, and less resources for them.
This made me sad (ironic really).


*living in the UK.

Re: # 4
dear bjkumar...it is interesting that you raised a significant isuue of the differences between

urban and rural areas and between different classes. Urban middle class is more educated

and have more services available to them. In those countries where majority of the

population in villages with minimum education there is more tendency to go to holy shrines

for physical and mental problems rather than seeing nurses and doctors who are

unfortunately scarce. even in the West rural areas are less serviced. progressive

governments provide...unattractive area allowances.... to attract doctors and nurses. in

canada they used to ask foreign doctors to work in rural areas for three years to qualify for

immigration. i do not know whether that rule still exists or not. sincerely sohail

Dr. Sohail,

I think what Mr. Urstruly means in #2 is that perhaps “dignity” would have been a better term than “respect” in the sense that you have used in this article.

The article itself is generally good, in spite of its coursework like layout. I think it would have been a little more interesting and useful had you focused on more of real life cases (of the type you started the article with).

In the sub continent, the statement regard the very much lacking state of mental care is applicable to the field of medicine in general including such areas as eye care, dental care, general cholesterol levels, etc.

The societal class consciousness also affects the medical community – often the poorer patients get scant attention. There is also a tendency to take the “Doctor knows best” line – both among the doctors and the patients – and medical questioning is discouraged. This reduces the benefit of feedback and also can make the doctor overly sure of himself and less willing to keep up with the latest research.

Needless to say, in the sub continent many times depression is not recognized for the serious physical disorder that it is. Perhaps there are countless numbers of suicide cases that could have been prevented had medical intervention taken place in a timely manner.

However, in general desis tend to talk more openly among themselves (with family members and friends) which perhaps provides some of the benefits of psychotherapy automatically – something that the Westerners have to pay for.

The attitudes are changing now. People are less reluctant to get psychological evaluation for their family members. In general, awareness of healthy practices has increased. I think that at least in the urban middle class, the younger generation gets better care and nutrition and is showing its effect, in spite of some of the new unhealthy habits (like junk food).

Re: # 9
dear tolkinin....i agree with you that many patients who go to family doctors with physical

symptoms have psychosomatic problems and their emotional problems and stress of life

are contributing to their high blood pressure....peptic ulcer....migraines...and many other

physical symptoms....the more family doctors are becoming aware they are offering

emotional support and consulting mental health professionals. such problems are also seen

in immigrant families who are trying to cope with the stress of cultural

integration...sincerely sohail

Not only non recognition of mental illness but many patients seen by general practioneers are Psychsomatic.
The cultural problems in Indian SUB continent for people living there not with holding when elderly or less sophiscitated population like in Brad ford, Birmingham England Imigrants encounter FOREIGN set of rules there is bound to be Psychosocial upheavel in the form of crime Depression violence and may be some of the problems in U.K.

Re: # 10 by ranjit on December 8, 2006 6:53pm PT

{Hey doc, you dont need to go to Pakistan to treat mentally ill people. You have the perfect patient waiting for your help right here in the US - Mr. Behram Atashband, aka Retardo aka Austin waley Bawaji. He badly needs your expert attention as soon as possible. I have never met a bigger cuckoo than him. }

Actually, you yourself are the biggest fucked up Hindoo bharwa on this chowk.

{Of course, there is also the possibility that after trying to treat him you may go insane yourself. }

Just worry about your bipolar and autist hindoos who have infested this chowk.

You are just a myopic, delusional hindoo bharwa, that all

[....When I lived in Pakistan I used to see half naked mentally ill people walking around aimlessly on the streets...]

Hey doc, you dont need to go to Pakistan to treat mentally ill people. You have the perfect patient waiting for your help right here in the US - Mr. Behram Atashband, aka Retardo aka Austin waley Bawaji. He badly needs your expert attention as soon as possible. I have never met a bigger cuckoo than him.

Of course, there is also the possibility that after trying to treat him you may go insane yourself.

#10 Ranjit

Yaar, but I think you guys need to stop provoking him, too!

Re: # 13
dear HD....your letter is anspiring me to write another column about schizophrenia

and depression in the future....thanks for the inspiration....sincerely sohail

Do mad people evoke `pity` or do they evoke `empathy` in us?

Pity is condescending, an ugly thing in disguise.
Empathy has been defined as `appreciation of the other`s inner feelings`.

We hope DrSohail`s humane-treatment motivation is empathetic in origin :)

Yet, how can we be empathetic when we don`t know (or are scared to know) the madman`s inner feelings???

Perhaps in this forum DrSohail can draw on his experience and tell us about the `inner
feelings` of his patients.

What is it that classifies a person as insane? His thoughts?