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Mental Health Month: The Crisis Continues in 2014

May is Mental Health Month: The Crisis Continues

The world and US keeps on inching towards progress in provision of mental health services to 450 million (World Health Report Geneva October 4 Report) estimated to be afflicted with a disability which makes others run away from it. In this month we need to remind ourselves of the barriers and problems to the treatment and justice  for those who are afflicted with highly debilitating and the most misunderstood disease in the world. We need to do that to offer hope to mentally ill and assuage people like me who are always angry with the injustice done to this population which generally lives in shadows. Some highlights are:

·         Stigma, misinformation, discrimination and neglect continue to prevent treatment of mentally ill.

·         Tradition ridden and ignorant segments of society continue to equate mental health problems to personal failure. This dogmatic belief is the most important impediment to treat mentally ill.

·         The policy makers all over the world are scared of cost of treatment of mentally ill, while ignoring the cost of this disability to the society which is much greater. It is one of the top disabilities over the world.

·         This continues to be a belief in society that mentally sick persons cannot lead productive lives. This is a myth propagated by ignorant or those interested in perpetuating the currently broken system. It is well known in medical community that with proper medical and psycho therapeutic care , 80% of schizophrenics and 60 % of those afflicted with depression  can lead productive lives. (WHO Report).  

·         As a result of this callousness to 450 million persons in the world, 40% of countries of the world have no mental health treatment. 25% do not have the basic drugs to treat mental health. On average there is 1 Psychiatrist per 100,000 people all over the world.

·         The prevalence of mental health over such a large scale perpetuates the cycle of poverty. Some mental ailments may emanate from the stresses and strains of being poor and homeless.

Nearer home in USA one does not find the situation any better. Our hospitals overmedicate routinely after a brief examination. The hospitals have no beds and no safety net for mentally ill once diagnosed and sometimes misdiagnosed. The deinstitutionalization with all the good intentions to award rights of mentally ill the right to live in a free society was botched in a big way. E Fuller Torrey a known mental health advocate has stated that the number of beds per 100000 persons in US is too low. Currently it is 14. He estimates that that it would suffice to make it 50. Joe Nocera, a NY Times columnist has summed it up well “What happened to the patients who left the hospitals after deinstitutionalization was horrendous. State mental hospitals would release patients with little idea where were they going. They often ended up on the streets, or in prison, which have become today's de facto mental hospitals".

In last 6 months we witnessed a rerun of this terrible movie in my hometown of Las Vegas in Nevada. They were dumping patients to California with 3 days of medications.

I have been associated with mental health for last 25 years and had hard time in containing my anger over this dismal state of mental health in our country. I am also the last person to lose hope over this. Here are some of the steps those members of society who can devote time to goodwill of disabled and those associated with mental health can take:

·         Make advocacy a part of your daily regimen. Take it up with legislatures, legislators, state and federal governments and utilize all legitimate forums for this purpose.

·         Assist your neighbors and communities by educating them about treatments, stigma and help wherever needed.  

·         Speak out when you notice homeless and use all available forums to highlight the callousness of the society.

·         Educate your friends and family members on mental health.

·         Emergency rooms at the hospitals make mentally sick persons wait for very long times. If you come across such a situation, advocate for them and get them help.

·         Never forget the election time. Force our representatives to spend more time and energy on mental health issues.

·         And last but not the least display your outrage on your sleeve and yell if you need to seek justice for the mentally ill.

My friend BS Bedi wrote a beautiful piece on Khushwant Singh who died today at 99. Here it is:

Bishan Singh Bedi on Khushwant Singh--

I'm not sure if I'm equipped to do an obit of the mighty S Khushwant Singh 'cos he was senior by more than three decades. Nor was he a 'friend' in the real sense. But I had loads of reverence for the 99 year old institution called Sardar Khushwant Singh, which fell today in normal course!

I'd like to think we had a lot in common--national pride was certainly one. Also,our love for scotch & humour, vulgarity was no taboo at all! I'd often get a post card from him, "Pl come and have a drink only if your dirty jokes are aplenty and fresh!".

Aparently,he was doing crossword today just before leaving his abode in Sujaan Singh Park. What a lovely way to go just one short of a ton! Once I told him a story of a rich man expressing a weird last wish of serving two large of deluxe scotch to all before and after the funeral, the wish was granted but not before he hit the bucket, the dying man asked for his four!! 

S Khushwant Singh was in peels. I was very tempted to ask his son Rahul if his Sire had any such wish! Only to be told that doctors were removing his eyes to be donated as per the will of the master writer/author/historian!!

On another occasion in Bombay in mid seventies, I was going into the steam/sauna of good old Taj and S Khuswant S was coming out. "What is the latest Bedi saab?". Luckily, I had a good one up my sleeve and let him have it! He just couldn't stop laughing!After about an hour, S Khushwant S walked into the sauna, all dressed up for a formal moment, "please tell me the gist of the story again Bedi saab!"!! I repeated the joke saying he can carry it in his editorial of the Illustrated Weekly if he so desired! And lo behold, he accepted the challenge and carried the joke with relevant alteration! "The original is unprintable and was told to me by none other than the captain of Indian cricket!" he wrote. I was very impressed with his bravado and became an unadultrated fan of S Khushwant Singh.

He was an authority on Maharaja Ranjit Singh.There was a do at Vigyan Bhavan in honour of the great Punjab ruler. Atul Behari Vajpayee, the then PM too was there whence prominent leaders from Lahore were also present. Maharaja Ranjit Singh was an  illiterate ruler from all accounts. But he was blessed with meaningful intuition to handle the French and British staff in his Darbar. And once the Punjab ruler was convinced of all deliberations he would then go ahead and scribble 'sahi' in urdu, which meant the treaty was as good as signed.

Now, while explaining all this to a very interested audience (house full!) at Vigyan Bhavan, S Khushwant turned towards Atal Behari Vajpayee and asked "Mr Prime Minister, when are you going to learn to write the word 'sahi'?!". The whole house came down I vividly remember. 

My early introduction to the great literary Sardar was through his widely appreciated book on partition "A Train to Pakistan". As a young impressionable Punjabi, I quite enjoyed the interpretation of some the choicest Punjabi swearing by S Khushwant Singh, not as in the Parliament these days, but very authentic all the same, to convey to the Lahoris in right earnest!!!

Once I got the feel of the Khushwant factor, it was easy to read/listen to him in all forums and enjoy his subtle and at times, not so subtle obsevations on matters of sex, booze and anything closely nearby! 

I reckon S Khushwant Singh derived huge vicarious pleasure from snubbing the clergy of all faiths and beliefs. He would claim to be an agnostic and yet did a great job of 'History of the Sikhs'! He would detest all sorts of religious movements on roads. Alas, not many in the Parliament would agree with him publically! That's when he would tear into his opponents ruthlessly!!

S Khushwant Singh was the only sikh writer to puncture the collective anti national designs in the Punjab in 70's and 80's, only to earn the sobrequet 'controversial' by the petty minded.

I was there at the release of his last book when he was 92 and in a wheel chair. The hall at the Le Meridien was bursting at the seams, with more than 70 percent of the audience from the feminine gender! It was an awesome sight when a youngish lass kissed him on his lips, only to confirm my belief that S Khushwant Singh was loveable/hateable, but never ignoreable!!

We'll not see the like of S Khushwant Singh in a jiffy simple because honesty is at such a premium these days. Also, the personal discipline of the Sardar in a glorified bulb was absolutely stunning--sleeping early and getting up very early for almost 80 of 99 years was not at all mythical, it was real!

Well, he may have left the world, but I doubt if he'll ever leave our thoughts and book shelves. We, as a nation need to celebrate the life of a man who was a constant reminder of Indianism at its best. RIP. 

The beauty of Flagstaff AZ

 

Reflections on Government

Keeping the Herd Together:

Man is gregarious and seems to thrive in company. Biology has played a major role in the evolution of man’s behavior and interaction with other humans. It was very clear from early pre- historic times that some of us were endowed with more physical power while the others had more mental prowess. Originally the numbers were the determining factor on which the humans controlled other humans. Soon the humans with mental prowess cooked up schemes which started to trump physical numbers only. A pointed stone could do more damage than a fist. Soon there were leaders and followers.  Thunders were installed as Gods and Mountain caves were the new temples. The smarter bunch conjured up Religion and the Priests became the heads of first governments. The Priests continue to determine a lot of government though we now have parallel civilian governments which call the shots also. The agrarian society kept humans in place for a very long time and most of their effort flowed into the growing food and feeding themselves. The conflict was small scale because the natural resources were plentiful. The idea of a government by some form of entity continued to thrive in form of churches and the need to defend the communities. The idea of keeping the herd together for myriad reasons was here to stay.

Abraham Lincoln’s quote “Government is coming together of people to do for one another collectively what they could not do as well as or at all privately” in Dall W. Forsythe’s Memos to the Governor may be cogent but tells us only half a story as to why people come together. The idea that people get together to do things collectively what they cannot do privately does not really explain the purposes of this collectivity. The history of mankind lies in the motivations surrounding this collectivity. The real question is which way the collective herd is lead by those endowed with the mental prowess to destroy the other herds. And what a tremendous havoc this collectivity has caused in many cases.

Destructive Power of the Herd:

The collective herd led by the most destructive of leaders armed with lethal weapons like nuclear weapons have killed about 41 million people in wars waged in every corner of the world in 20^th century only .Sometimes it is based on national pride like when Great Britain chose to subdue Falkland Islands which killed 30000 people. Ethnic violence in India/ Pakistan partition had killed 800000 people in 3 months. Pol Pot killed 1,770,000 in Cambodia. Civil war in China killed 6,200,000 people. (Milton Leitenberg 2003 in Cornell University Peace Studies Program). American Civil war killed about 618, 000 Americans. The American atom bombs dropped on Nagasaki and Hiroshima set another record by killing about 75000 people within a week. The wages of collectivity have been swerve and swift. It   makes one think and question the uses of collectives which are now sometimes known as democratic governments. We also need to remember Hitler and holocaust as an example of the very destructive nature of the herd. It tried to decimate a whole community of people. It was later tried on a small scale by Serbs in Balkans.  Rallying and getting together is not all good

The arrival of industrial age and later technological breakthroughs have in last few decades handed more power to the leaders of  the herd and it is a concern to the survival of the world as we know it. 

All is not Lost:

Despite the destructive nature of collectives to do things together and establish institutions that promote good of people have thrived and have brought the kind of civility to our societies which clearly distinguish us from the animalistic nature of human instincts. In most modern societies the governments and people need each other. The principle of rule of law is perhaps the most important concept invented in the modern times. It is not perfect answer to all the human problems but it instills order and brings peace to communities and societies which improve the quality of lives of people.

The Role of Modern Government in Society:

Abraham Lincoln’s words “coming together” have taken a different meaning in our modern society. First a government is the only entity that could use force. All other institutions have no such force. So what does it do with this force other than waging wars? It incarcerates people (more than 2 million in US), it enforces the economic burden on some and relieves it on others and in reality can forbid you to do things like driving over 65 miles or eat foods that may make you obese. And ultimately the meaning of government since Lincoln uttered his words has been transformed and become highly complex with the modern technology. The government can watch anyone at home via satellites and other gadgets. The governments can put bracelets on people and watch them wherever they go. The video cameras watch you at road intersections. Above all when people get together to protest or oppose something which the government does, it can watch you with drones from above and make you a scapegoat.

Laissez Faire:

An extreme fringe of people argues that the government’s power to use power to control individual lives through coercive force and economic controls should end. They in fact would like the people to be nincompoops. They would like to school children at home, build our houses wherever we like and as we like. They detest government interventions in housing, jobs, taxes and other economic activities. These people also feel that government can do no good and there is no such thing as public good.

Democracy and Government: 

In reality the governments have done a lot of good to the people they serve although they tend to self destruct at times. Historically we have come a long way. Firstly, the people can now talk and discuss the failings of the governments. Facebook and Twitter has shown in the Middle East that social interaction on the world wide web can confront the government. Secondly the increasing availability of safety net for the poor, deprived and oppressed has shown the advantages of collective actions. Thirdly the proliferation of electoral systems through democracies has made collective actions more viable. The democracy in large nations however is still a messy business and the progress towards human good and justice has been terribly slow. Democracies as practiced in the city states have not translated into good democratic practices in large monoliths like USA, Russia, India and China. They remain very imperfect societies where all good had to be muddled through.

 Mario Cuomo was probably the most policy savvy Governor of New York ever. He served the state very well and saved a lot of money to the state. Yet in the end he lost the election to an unknown. The people got tired of his budget cutting and advocating good economic policies. 

In the end I must say that Lincoln’s statement regarding government as getting together of people to do what they cannot do alone is correct but in an entirely different context than he thought. We are still trying to find out as to why the elements of governments that do good for humans are also the instruments to inflict heavy damage to them.

Beach in Sydney Australia

 

We are more than 400 years

Sydney Australia Opera House

Walk on. I am drying myself.

A Beauty Spot

Lazing in the Park

Sydney Australia Harbor