History and Milestones
A Brief History
The history of the mental health care system in Karnataka dates back to the colonial times. In the18th century, the legendary warrior Tipu Sultan was killed by the British and power was handed back to the Wodeyar clan. A British army regiment was stationed in Bangalore, which was then part of the princely state of Mysore. During the period, especially from 1831-1881, under the administration of British Commissioner Sir Mark Cubbon, the region witnessed a lot of developments in the healthcare system. Western medicine was introduced and hospitals/dispensaries were opened for the care of British infantry, Indian soldiers and civilians.
The Bangalore Lunatic Asylum was founded in 1847. Dr. Charles Irwing Smith, a British medical practitioner in Bangalore, played a pivotal role in the establishment of the asylum. The simple yet airy structured asylum with 50 beds was located at Pete or Pettah , Dharmambudi tank area (the present State Bank of Mysore head office building at the intersection of Kempegowda Road and Avenue Road, Bangalore).
At the asylum, the mentally-ill were allowed to move freely on the premises and were provided with opportunities to take part in activities like rope-making, gardening, cleaning, and other domestic works. In the ensuing years, doctors from Indian Medical Service were appointed and the number of patients at the asylum began to rise. By 1914, about 100 patients were admitted and discharged, on an average, every year.
In 1925, the asylum was rechristened Mental Hospital signifying a paradigm shift in management of mental problems. The old asylum / mental hospital on Avenue Road was closed in 1936-37, and the staff and patients moved to the new site Lakkasandra, the second highest hillock in Bangalore.
More than 100 acres of land was donated by the Maharaja of Mysore to establish the Mental Hospital. Dr. Frank Xavier Noronha became the first superintendent of the Mental Hospital. At this time (in 1936), Sir Mirza Ismail held the coveted position of the Dewan of Mysore. This period was billed as the golden age of Mysore. Both Sir Ismail and Dr. Noronha were keen gardeners and avid horticulturists. Their common passion for well-designed public spaces led to the formation of a new structure for the Mental Hospital encompassing vibrant gardens replete with lush landscapes and open spaces. The duo personally planted many of the exotic tree species that can still be seen on the campus.
The new building itself was loosely based on the plans of the Institute of Psychiatry building, which was then housed at the Bethlem hospital site in Moorfields (United Kingdom). It was constructed by the civil engineering firm, the Mysore Engineering Company (MEC), which was staffed entirely by Indian engineers. It was considered essential that the spaces in an asylum provide an environment conducive for recovery, and this principle lay at the root of asylum design, where “where one could be both mad and safe”.
This careful consideration to a healing environment contrasted sharply with other asylums in India, which were often hand-me-downs from jails or barracks. This building, and the Hospital for Europeans and Indians in Ranchi, were the only two custom-built asylums in British India in the early 20th century, and were designed with the explicit purpose of providing a healing environment, and with all the necessary modern attributes.
Dr. Noronha, after his retirement, was succeeded by Dr. MV Govindaswamy who was a trained doctor in the Mysore Medical Service with BSc (Chemistry) and MA (Psychology) degrees. When Dr. Govindaswamy joined as the medical superintendent of the Mysore State Mental Hospital, he was faced with the challenge of developing the mental hospital into a ‘open’, model mental health care institution. Dr. Govindaswamy successfully transformed the hospital into a modern institute of mental health and neuro sciences, which further went on to become the leading and first-of-its-kind training and research centre in India.
In 1946, the Health Survey and Development Committee (also known as the Bhore Committee being under the Chairmanship of Sir JoesphBhore) reviewed the state of mental health in India and recognized the paramount need for the production of an adequate number of medical and auxillary personnel trained in various aspects of mental health. The Committee recommended that all the professionals employed in mental health work should possess a recognized Diploma in Psychological Medicine. The committee also opined that the expansion of mental health services could be carried out only if there were simultaneous intensive training programmes.
The State Government Mental Hospital, Bangalore, which had already built up certain traditions since 1938 in terms of under-graduate and graduate teaching in the field of Psychiatry was chosen as the centre of training by the Government of India. It became the first postgraduate training institute in psychiatry for the country.
Dr. MV Govindaswamy, played a vital role in the formation of the AIIMH and became its founder-director. Academic activities and courses in Psychiatry, Clinical Psychology and Psychiatry were introduced. He kept pace with all the developments in the global mental health scenario and ensured that all important forms of treatment introduced in major developed countries was brought to India. He was also successful in blending Indian psychology with philosophy to understand human behaviour better.
In 1974, AIIMH and Mental Hospital were amalgamated, giving birth to the National Institute of Mental Health and Neuro Sciences (NIMHANS). With this, the legacy of Dr. Govindaswamy to implement a multidisciplinary approach by integrating mental health and neurosciences turned into a reality.
|Bangalore Lunatic Asylum was founded. Dr. Charles Irwing Smith, a British medical practitioner in Bangalore, played a pivotal role in the establishment of the asylum.|
|The Bangalore asylum was renamed the Mysore Government Mental Hospital, an important step towards developing a medical approach to mental illness|
|Insulin Coma Therapy (ICT), developed by Austrian-American psychiatrist Manfred J Sakel, was introduced in the Mysore Government Mental Hospital by Dr. MV Govindaswamy, the then medical superintendent of the Mysore Government Mental Hospital, as in the UK (1935) and the US (1936).|
|The second highest hillock in Bangalore was allotted for the Hospital, which was earlier housed in a building on Avenue Road, where the State Bank of Mysore head office stands today. Maharaja of Mysore, KrishnarajaWodeyar laid the foundation stone for constructing the hospital in May, 1936.|
|A well-equipped laboratory and medical library were started. The Hospital was recognised as a teaching institution for MBBS, BA Hons. in Psychology, and LMP.|
|The first leucotomy operation in the country was performed on 21st September 1942 by Dr.MV Govindaswamy and Dr. BN Balakrishna Rao at the Hospital.|
|Following the recommendations of the Mental Health Advisory Committee of the Indian Council for Medical Hygiene under Sir AL Mudaliar in 1945 and Bhore Committee in 1946, the Government of India sanctioned the establishment of the All India institute of Mental Health on 1st April 1954. On 6th August 1954, RajkumariAmrit Kaur, the then Union Health Minister inaugurated the AIIMH and Dr. MV Govindaswamy was appointed as the Director on 15th September 1954.|
|The first postgraduate courses, Diploma in Psychological Medicine (DPM) and Diploma in Medical psychology (DMP) were started.|
|Children’s Pavilion comprising a child guidance clinic and a children’s ward was opened.|
|New post graduate courses in psychiatry (MD psychological Medicine), Neurology (DM Neurology), Neurosurgery (MCh Neurosurgery) and Post Graduate Diploma in psychiatric Social Work (DPSW) in affiliation with Bangalore University. Five special clinics: Anxiety Clinic, Behaviour Disorder Clinic, Headache Clinic, Hysteria Clinic and Mental Deficiency Clinic started functioning from the same year.|
|Occupational Therapy and Rehabilitation Centre with different sections was inaugurated.|
|The Neuro Centre, with a separate blood bank and a well-equipped neuroradiology section was inaugurated.|
|The Mental Hospital established by the Government of Mysore and the All India Institute of Mental Health established by the Government of India were amalgamated on 27th December 1974, resulting in the formation of the National Institute of Mental Health and Neuro Sciences (NIMHANS). Community Psychiatry Unit was also launched in the same year.|
|Neuropathology Museum storing human brain specimens for academic and research purposes was inaugurated. Community mental health services were launched at Sakalwara. A unique facility of family wards was also opened.|
|The Central Animal Research Facility (CARF) was started as an aid to research and teaching.|
|Electron Microscopy Lab in the Neuropathology Department was established.|
|Recognising its eminent academic position, NIMHANS was declared a Deemed University, with academic autonomy.|
|The Human Brain Bank was established with financial aid from the Department of Science and Technology (DST), Department of Biotechnology (DBT), and Indian Council for Medical Research (ICMR).|
|Advanced Centre for Ayurveda to augment clinical service and research activity was started.|
|The Neurobiology Research Centre (NRC), a sophisticated common research facility, was opened.|
|Inventa, a critical care ventilator, was developed by NIMHANS|
|The NIMHANS Centre for Well-Being at BTM Layout was started, with an aim to provide promotive and preventive services in the area of mental health.|
|NIMHANS was declared an Institute of National Importance, vide the Gazette of India Notification dated 14th September 2012 by the Government of India. Centre for Public Health (CPH) was established to provide inputs for strengthening public health components in formulating policies and programme development focusing on problems, priorities, challenges and solutions, in the same year.|
|ICMR Advanced Centre for Translational Research was started.|
Photograph Courtesy: State Bank of Mysore Centenary Souvenir
Text: Turning the Pages Project, NIMHANS, funded by the Wellcome Trust UK (Sanjeev Jain, Pratima Murthy, Alok Sarin)