| Abstract|| |
Organized delivery of mental health services in Goa had its origin during the Portuguese regime. From the inception of a mental asylum in the 1500s, mental health services have come a long way. In post liberation period, after 1961, under the guidance of a WHO Consultant, Dr. Govindaswamy, a new mental hospital was built at Panaji, Goa and it was named as the Abbe de Faria Institute. The Department of Psychiatry in Goa Medical College was established in 1968, and unlike in most parts of the country, where Psychiatry was a part of Medicine; here in Goa, it enjoyed an independent departmental status. With the merger of Department of Psychiatry with the mental hospital, an independent Institute of Psychiatry and Human Behavior emerged in 1980, a status it continues to retain till date. In 2016, the Institute of Psychiatry and Human Behavior has been identified to become a “Centre of Excellence” by the Ministry of Health and Family Welfare, Government of India.
Keywords: Center of excellence, department of psychiatry, goa, Abbe de Faria, institute of psychiatry and human behavior
|How to cite this article:|
Srivastava A, Cuncoliencar B, Pereira YD. Historical aspects of the Institute of Psychiatry and Human Behavior, Goa. Indian J Psychiatry 2018;60, Suppl S1:236-8
| Introduction|| |
Psychiatric services were present in the state of Goa during the erstwhile Portuguese regimen. During the Portuguese rule in Goa, a mental asylum was started at Chimbel, Goa, for accommodation of “lunatics.” Even before liberation of Goa in 1961, the Portuguese Government had enlisted the help of a World Health Organization (WHO) consultant, Dr. M. V. Govindaswamy (1950), to advise on organization of mental health services and set up a new mental hospital. This was the first chapter in the history of this institute.
In his letter to the Provedor da Assistancia Piblica, Dr. Govindaswamy recommended some alterations as well as additions to the existing structure. Some of the pertinent suggestions were made (Dr. Govindaswamy's original words from the letter are in italics).
- Structure: Lowering of compound wall (“No modern hospital is enclosed by a high compound wall”), integration between the two male and female ward blocks, rooms for private patient, verandas to double as day rooms and dining rooms, separate treatment rooms for specialized forms of treatments, and conversion of one out of two blocks for acute and disturbed patients for criminals and lunatic alcoholics (“but all bars and cages should be removed as well as vestiges reminding one of jails and prisons”)
- Education: Training and recruitment of more personnel and deputation of nurses for training to Bengaluru, Delhi, and Europe
- Legal aspects: Legislation was suggested for admission of involuntary patients, and a call was made for efforts to encourage voluntary admissions.
Based on these suggestions, a new mental hospital was built at Altinho, Panjim, Goa, in 1957 under the Provedoria da Assistancia Publica. It was aptly named “ABBE DE FARIA “ Institute after the renowned Goan Monk credited with inventing the technique of hypnosis. The mental hospital was also used to keep political prisoners in custody before liberation of Goa on December 19, 1961. In 1958, the hospital was brought under the control of Directorate of Health Services, Goa, and Dr. Adelia Costa (qualified in Psychiatry and Neurology at Lisbon, Portugal) took over as the first medical superintendent. As soon as she took charge of the hospital, she was moved by the pitiable conditions of lunatics languishing in the mental asylum. Care was mainly custodial. Dr. Adelia Costa submitted a detailed report to the Portuguese Government relating the pitiable conditions in which mental patients were being looked after in the mental hospital. The Portuguese Government immediately accepted her report and deputed Dr. Adelia Costa to France to select equipments such as ECT machines, ECT, electrocardiograph and EEG machines, and oxygen cylinders. Soon after modernized treatment was started, complete transformation was brought in the attitude of staff toward mental patients. The patients used to be dressed and groomed appropriately, medications were given, and patients were brought out from custody to a more open friendly environment. Electroconvulsive therapy was started. EEG and other biochemical investigations such as blood sugar estimations were also done. Meanwhile, two medical officers, namely, Dr. Lui Estibeiro Ataide and Dr. Rock Godinho were appointed to assist the medical superintendent. Under the able guidance of Dr. Adelia, they continued the human service. Dr. Adelia left the mental hospital in March 1962 and established herself in private practice which she continued until a few years back. Dr. Rock Godinho organized the Annual Conference of Indian Psychiatry Society for the first time at Panaji, Goa, in 1967 under the Chairmanship of Dr. J. C. Marfatia from Bombay. More medical officers were posted in the mental hospital, namely, Dr. Guiri Kamat, Dr. Ramkrishna Kudchadker, Dr. Krishna Pai Budbude, and Dr. Anand Acharya. Some of these medical officers, namely, Dr. Budbude and Dr. Acharya were also sent for training in psychiatry to the Central Institute of Psychiatry in Ranchi and National Institute of Mental Health, Bengaluru.
Meanwhile, legislative changes were afoot. The Indian Lunacy Rules were framed for the Union territory of Goa, Daman, and Diu in 1974 based on Indian Lunacy Act, 1912. This act though extended to the Union territory of Goa, Daman, and Diu in 1963 needed framing of specific rules and statutes for the union territory. In keeping with the legislations, a Board of Visitors was appointed. All admissions and discharges of lunatic patients were regulated by the Indian Lunacy Act, 1912, and supervised by the Board of Visitors. The total bed strength of the hospital at this time was around 300.
There was a conscious bid to improve the professional profile of the mental hospital. On the medical side, Dr. Cezar Braganza became the first candidate from Goa to qualify for MD of Bombay University from Department of Psychiatry of Goa Medical College. Three posts of psychiatric social workers and one post of psychologist were created and filled. Rehabilitation being prominent aspect of treatment, the posts of occupational therapy technicians and handicraft instructors were filled. These personnel were sent to NIMHANS, Bengaluru, for further training. They were instrumental in starting activities such as cane chairing, handicraft work, making paper bags, coconut shell work, gardening work, embroidery crochet making, and drawing for patients. Incentive patients were rewarded for their work. Later on, a full-fledged candle making unit was added.
| Formation of the Academic Department|| |
The Department of Psychiatry at Goa Medical College, Panaji, was established on April 19, 1968, with the appointment of Dr. S. D. Sharma as Professor of Psychiatry. Unlike other departments of psychiatry in various medical colleges in India, the department of psychiatry was not a part of medicine department. A regular outpatient department was started on May 01, 1968, within 10 days of his joining as professor. In this period of 10 days, it was a possible to appoint two house physicians, a typist, a psychiatric social worker, and a nurse and procure enough drugs to start the department. A comprehensive history record sheet was also developed.
Adding a research facet, an ICMR project on a study of Therapeutic Potentials of Brain Polarization in certain psychiatric disorders, which was earlier sanctioned under Prof. S. D. Sharma at Medical College, Baroda was transferred to Goa. This project resulted in the setting up of a small research cell in the department of psychiatry and the appointment of research staff. Within 1 year, the department was able to set up three research laboratories – psychology laboratory, biochemistry laboratory, and electronic laboratory with a qualified clinical psychologist, electronic engineer, and a biochemist. Dr. D'sa from the National Institute of Oceanography, Goa, guided the electronic engineer in the laboratory.
Inpatient facilities with a 20-bedded psychiatric ward were started in December 1969. Home visits to the patients were also started with the help of psychiatric social worker. The Medical Council Inspection team led by Col. Amirchand understandably adjudged the department as being “excellent.” After MCI Inspection and the visit of Bombay University team, both MD and DPM postgraduate courses of Bombay University were started in 1970. Dr. Wes Kiernan from the United Kingdom, a WHO visiting Professor was impressed by the activities and research work of the department when he visited the department in 1972. The West Zone Psychiatric Conference of Indian Psychiatric Society was held at Panaji, Goa, from October 31 to November 02, 1971, organized by the Department of Psychiatry, Goa Medical College. During the years 1974–1978, the Department of Psychiatry became the headquarters of the Indian Psychiatric Society as Prof. S. D. Sharma was elected as Hon. General Secretary of the Indian Psychiatric Society.
Right from the beginning, the department had established liaison services with the other clinical departments in medicine, surgery, obstetrics, and gynecology and pediatrics. This clearly helped in two ways. First, the postgraduate students in psychiatry were exposed to the psychiatric problems in physically ill patients and established healthy relationship with colleagues in other departments. Second, this helped in reducing the stigma attached to mental illness and more resident doctors got interested in psychiatry. Similarly, serious attempts were made to establish close link with the general practitioners in the community. In addition, special efforts were made to visit various schools and address emotional problems among schoolchildren. All India radio and print media were utilized in reducing stigma attached to mental illnesses. Later, it was realized that there was a need to bring some semantic changes in the name of the department. After long and sustained efforts with the Ministry of Health, Government of India, and Medical Council of India, the name of the Department of Psychiatry was changed to “Department of Psychiatry and Human Behavior.”
| Finally We Had the Institute|| |
While these changes were taking place in the medical college, the condition of patients in the mental hospital at Altinho, Goa, was receiving negative media coverage. In one of the reports, it was mentioned that the conditions of the patients in the mental hospital were nothing but deplorable. Due to these reasons, there was pressure from both public and the government to improve the condition of patients in the mental hospital. After lot of discussion and planning, it was decided by the Government of Goa to set up an independent institute named as “Institute of Psychiatry and Human Behavior” on December 08, 1980, by amalgamation of the Department of Psychiatry and Human Behavior under Goa Medical College and the Mental Hospital (Abbe De Faria ) under the Directorate of Health Services, Government of Goa, Daman, and Diu with a separate director. The institute finally came to existence!!
Thirty-five years, hence, the institute has grown leaps and bounds. Its alumni have blazed new trails in academic research in India and abroad. The institute has grown in its regional importance and has been periodically organizing regional meets and conferences. Recently in 2016, it has been identified to become the “Centre of Excellence” by the Ministry of Health and Family Welfare, Government of India.
We acknowledge the support of Dr Pradeep G. Naik, Director, Institute of Psychiatry and Human Behaviour.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| Post script|| |
The article describes the growth of psychiatry in Goa. As the European settlement, this was where the first interaction between European medicine and the Indian counterpart occurred. The Jewish Physician, Garcia de Orta, wrote the famous colloquies (1563) here, and the book was a "best seller" for many years in Europe and translated into many languages. The herbarium and hospital he developed were an essential halt , both for medical help and for stocking up medicines,a s the Portuguese ships used Goa while on their way further east all the way up to Japan. His book was translated into English by Clements Markham FRS, who is credited with growing cinchona in India. The book describes the effects of various substances on human body and merges the percepts from European and Indian medicine. Abbe De Faria, mentioned in the above article, was a contemporary of Anton Mesmer and has been a subject of many biographies. Over the next few centuries, Psychiatry as a discipline and as an Institute evolved and grew in the state of Goa. The name of Abbe De Faria continued to exert influence on the nomenclature of the institute and events related to Psychiatry in Goa. The history of Psychiatry in Goa offers a fertile ground for more research.
Dr. Ashish Srivastava
Institute of Psychiatry and Human Behavior, Bambolim, Goa
Source of Support: None, Conflict of Interest: None