The leafy, green campus of NIMHANS, spread across multiple acres, is always teeming with patients and doctors. However, one can notice a certain sense of comfort and contentment immediately upon entering the institute’s premises.
The apex centre for mental health and neuroscience education in India and a medical institution, NIMHANS is a bastion of peace and calm.
The institute’s history is storied and dates back to more than century. In 1847, the Bangalore Lunatic Asylum was founded, and rechristened in 1925 as the Mental Hospital by the Government of Mysore. The hospital became the first psychiatric postgraduate training institute in India. The man behind the asylum, Dr Irving Smith, was an 1809-born Englishman, a surgeon of the Mysore Commission under Mark Cubbon.
Dr Smith was inspired by the public mental health asylums created by the British and the French in the early 1800s and wanted to a similar facility in Bengaluru.
There was something special about this asylum. It had provisions for specialised care for mental disorders. By 1871, the asylum was established and could accommodate 260 patients. The simple, airy buildings were well-sanitised and had an adequate water supply. Doctors would travel by horseback to the asylum, which was located in the building that now houses the headquarters of the erstwhile State Bank of Mysore in Bengaluru.
By 1870, the asylum’s popularity had increased, with patients being brought in for ‘humane’ reasons. Cholera and plague epidemics broke out, forcing the asylum to move to Basavanagudi. A famine struck in 1878, which only the mentally ill patients survived. By the 19th century, the asylum’s patients included foreign nationals, with records showing that Dr Smith had over 35000 patients visiting, at a time when the city’s population was just 1.5 lakh.
Rechristened the Mental Hospital in 1925, the old asylum on Avenue Road closed in 1936-37, and the land was sold. A new site, some 100 acres donated by the Maharaja of Mysore, was chosen and staff and patients moved into new premises.
Dr Frank Xavier Noronha became the first superintendent of the new Mental Hospital. It was his, and Diwan Sir Mirza Ismail’s passion, for well-designed public spaces, that gave birth to the new structure, replete with vibrant gardens and lush landscapes.
In 1954, the All India Institute of Mental Health commenced operations in the same premises, and in 1974, AIIMH and the Mental Hospital merged as NIMHANS.
Today, walk into the sprawling grounds and you are greeted by various departments, from child and adolescent psychiatry, to psychopharmacology. From neurosurgery to neuropathology and psychiatric rehabilitation, amongst others. The institute has multiple centres for various purposes, like addiction medicine, yoga centre, well-being centre, neurobiology research centre, etc., and specific facilities, for biophysics, biomedical engineering and engineering.
Patients visiting NIMHANS fall under two broad categories. Those requiring detailed evaluation are admitted as inpatients and managed according to the protocols of each department of Neurology, Neurosurgery and Psychiatry. The non-emergency cases for out-patients are run on all days except Sunday and general holidays, from 9.00 am.
On an average, around 150 new and old patients are seen per day. Being a government hospital, one would expect NIMHANS to be reasonably priced. But the bill still comes as a pleasant surprise, since, for example, OPD patients pay just Rs 20 for their first consultation and Rs 10 for subsequent ones.
NIMHANS has been streamlining and digitalising procedures recently, to make OPD consultations smoother and less time-consuming. In 2017, a major digitalisation drive has dramatically shortened the waiting time, almost by half.
NIMHANS follows a holistic method of treatment, which includes medication and therapy. Psychiatric illnesses sometimes cannot be determined by a single diagnosis. Unlike common colds or even cancer, there are no physical symptoms.
Which is why treating a psychiatric illness requires multiple attempts and different combinations of medicines. Sometimes patients get annoyed/disheartened and stop their medicines mid-treatment. But at NIMHANS, patients are asked to follow up regularly, to discourage dropping off.
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Medication alone isn’t helpful either. As Dr Vivek Benegal of NIMHANS said, “Medicines can only take you from a disadvantaged state to a stable level. The rest is up to you. Medicines will not enhance you. They merely put you on a level playing field”.
At NIMHANS, the Department of Psychology and Human Relations, established in 1954, provides Cognitive Behavioural Therapy, Child and Adolescent and Family Therapy and Trauma Recovery amongst others.
Cognitive Behavioural Therapy, extensively used throughout addiction recovery, bipolar disorder treatment, and schizophrenia management, involves emphasising on what people think, rather than what they do. Psychologists aim to tackle the patient’s dysfunctional thinking that leads to dysfunctional emotions or behaviour because they believe people can change how they feel and what they do if they change their thoughts.
Over the recent past, major leaps and bounds in the realm of mental health, has made it possible to diagnose and clamp down on major mental illnesses. For example, a restless child isn’t necessarily naughty, but might be suffering from ADHD or ADD.
NIMHANS has pioneered the treatment for many disorders. Incidentally, the institute was the first to offer a support group for patients addicted to technology.
NIMHANS provides comprehensive support for various issues, from depression to anxiety, anger outbursts, insomnia, alcohol/drug abuse, and personal exploration and growth, etc. via individual counselling, family counselling and support groups.
The support groups are great because people suffering from ailments can come and, without inhibition, or judgement, discuss their issues. From Monday to Saturday, various support initiatives, like Asare—a parent support group, Flourish—a positive mental health clinic, a stress and lifestyle clinic and a right choice clinic, amongst others, are operational.
Apart from mental health services, NIMHANS offers a slew of services, like a blood bank, a legal aid clinic, multiple pharmacies, and even counters for food, with a full-fledged canteen service, providing hot, delicious and healthy meals.
The casualty and emergency services are run 24 hours a day, 365 days a year, by residents and a member of the faculty. In fact, patients who need short-term emergency services can use any of the ten beds available in the patient care section.
From a small mental asylum to the largest training centre for mental health and neuroscience professionals, and a haven for those with mental illnesses, NIMHANS has come a long way.
The philosophy that NIMHANS follows is clear in its glowing swan logo, which is analogous to the psyche.
The webbed feet of the swam immersed underwater, in a frenzied turmoil, just like several factors in the psyche.
The character of this noble institute can be summed up in its anthem—
“In the depths of the heavens, the moon sails shedding splendour that is a benediction.
Below, on the troubled waters of life moves the mind of man, swan-like.
Near-by is the lotus-heart, passion-laden and just blossoming. Hidden in the womb of waters lies peace, born of harmony, to be realised by one who has subdued passion.”