Volume-1 Issue-1 July, 2011
These are exciting and challenging times for an effective integration between psychiatry and medicine. For a long while, psychiatry was perceived to linger in the fringes of medicine. This was unfortunately a consequence of inadequate inputs in the field of mental health in the undergraduate curriculum. However over the past decade, the landscape has changed dramatically. The discipline has witnessed a burgeoning growth in recent years thanks to the Medical Council of India, recognizing the importance of its presence in medical schools. Now without exception most of the medical colleges in the country have full fledged psychiatric units, often staffed by young dynamic professionals. This is a welcome augury for an effective integration between medicine and psychiatry. As Benjamin Rush wrote with remarkable insight in 1811:
“Man is said to be a compound of soul and body. However proper this language may be in religion, it is not so in medicine. [Man] is, in the eye of a physician, a single and indivisible being”
Impact of this indivisibility can be found in each and every person who is afflicted with a medical problem. Persons afflicted with various illnesses, respond and react to their problems in individually distinctive ways. Unless efforts are made to take cognizance of the emotional reaction of patients with medical problems, the response to treatments instituted, however effective they may be will have little impact in changing the course and outcome of the condition. For, it is well known that the perceptions and emotional reactions of patients play a significant role in altering the course of diseases.
In spite of considerable occurrence of emotional problems among medically ill patients, the referral rates for psychiatric consultations are alarmingly low. Patients admitted to a general hospital with emotional disorders are said to account for 25% of all admissions, yet referrals to consultation-liaison services rarely exceed 5%! There could be many reasons for this phenomenon. Prominent among them are: the sensitivity of medical professionals to mental health issues, their skills in detecting emotional distress, their attitude to psychiatry and the perceived stigma in referring to a mental health professional. Many of these factors can be effectively redressed by sensitization through training programs and an effective personal rapport between the physician and the psychiatrist. Initiating consultation-liaison bedside rounds will go a long way in consolidating this alliance. It is equally important to inculcate this orientation among medical students through structured lecture sessions and individual case discussions.
Most importantly, the publication of this newsletter is a step in the right direction to forge a mutually enriching professional linkage between psychiatry and rest of the medical Sciences.
Professor & HOD of Psychiatry, Kempegowda Institute of Medical Sciences (KIMS), Bengaluru
