‘Neurology’s rise spells danger for psychiatrists’

Karachi
While neurology and psychiatry have a lot to gain through a ‘holy’ alliance, the latter may continue to ‘shrink’ as a medical discipline, and its practitioners will truly become 'shrinks'.
These were the views expressed by Editor-in-Chief Mowadat H Rana and Guest Editor Uniza Niaz in a paper titled ‘From Psychiatry to Mental Health: Integration of Mind, Body & Soul’ published in Journal of Pakistan Psychiatric Society.
“Sadly, we are today seen as doctors who prescribe a few psychotropic drugs, advise EEGs and give ECTs. We have reduced or shrunk our discipline to a bio-medical pill-oriented discipline that uses physical therapies alone. Psychotherapies, counseling and all other forms of non-pharmacological interventions once introduced and practiced with pride by psychiatrists are becoming exclusive domain of clinical psychology. Consequently neurology will nibble psychiatry from one end and clinical psychology from the other. This will be in addition to the unfortunate losses incurred to charlatans, faith healers and Aamils,” they added.
“The only saving grace for the psychiatrists of present and future generations is therefore to move on from the practice of psychiatry to a commitment to mental health,” the paper said. Mental health is already an integral part of the broader definition of health as defined by World Health Organisation. On its own, true mental health is a state in which an individual is not only free of mental illness but is able to realise his or her full potential; is resilient to the stresses of everyday life, and is a productive and responsible member of the society. In its scope as a health discipline the psychiatry deals as much with treatment, rehabilitation and prevention of psychiatric disorders, as with the promotion and protection of mental health of individuals, families, homes, societies and nations.
It may be noted that there are only 75 qualified psychiatrists in Pakistan while tens

of millions suffer from depression, anxiety, bi-polar and uni-polar disorder and other mental illnesses. This has paved the way for quacks that thrive across the country due to illiteracy.
“As an exponent of mental health, a psychiatrist is therefore a crucial member of a team of professionals trained in mental health advocacy, policy and service development, legislation and regulatory reforms, human and patient rights,” the paper pointed out.
The mental health research does not stop at finding the neuro-genetic basis of diseases of the mind or nanotechnology based personalised medicines and interventions to treat them. It goes on to study the challenges to mental health posed by environmental, socio-economic, cultural, religious, and spiritual dimensions of individuals and societies.
It offers to design interventions for healthier housing designs, progressive and humanistic educational systems and syllabi, and prevention and reversal of childhood adversity, conflict resolution, negotiation skills to prevent war and promote peace and offers to enhance efforts to bring the human fraternity closer to each other, as well as, in harmony with nature and the environment.
Senior consultant psychiatrist at Dr Ziauddin University Hospital, Dr Syed Ali Wasif, concurred. “My argument is that making a client a slave is inappropriate since a psychiatrist has a holistic and humane approach towards his client and it is his social and medical responsibility to educate her/him and impart her/him knowledge according to client’s mental state rather than taxing the client with his consultation fee in thousands of rupees. Painting, art and performing art are very important tools in mental health. So are art therapy, music therapy and psycho drama. These are well recognized forms of psycho therapy. However, it’s true that psychiatry is getting jolts with the development of neurology.”