Department of Geriatric Mental Health

Like most developed countries in the world, India with a proportion of nearly 8% senior citizens in the population has fallen in the category of greying country. This proportion is expected to escalate to 11.8% by 2015 and to 18.4% by the year 2025. In view of the alarming increase in the elderly population associated with high risk and higher prevalence of neuropsychiatric problems in them, the need for the establishment of speciality services, has become in preventive. The mental health problems of elderly should no more be considered as extension of neuropsychiatric problems as amongst adults since now it is proved in several researches that they are different. Thus there is a need to develop the facilities for clinical, academic and research activities exclusively dedicated to elderlies. There are departments of Geriatric Psychiatry in almost all the premier hospitals and teaching institutions of the world. The solo concerted effort of Dr. S. C. Tiwari has made this dream come true at this premier institute of the country.

After coming into existence, the newly created Department of Geriatric Mental Health will provide specialty clinical services to the elderly which will also include rehabilitative and tertiary services on “out” as well as “in” patient basis. Several community outreach programmes will be initiated which will reduce the burden of care providers caring the geriatric patients. O.P.D., in patient, emergency and intensive care services will be made available. The department will function as a platform for capacity building in the form of providing teaching and training to medical and paramedical personnel for the overall care of geriatric mental patients.

The following courses in Geriatric Mental Health will be started in phased manner.

The department will also get engaged in carrying out researches involving elderly population to provide data for evidence based practice in geriatric mental health and for framing policies for the care of the elderly. The Department of Geriatric Mental Health will collaborate with other such institutions/organizations in the country and abroad and will undertake all such functions/activities which will help in providing better understanding of the geriatric psychiatric patients to ameliorate their problems.

Inspite of the teething problems, the department has started functioning since 20 th August, 2005.The services available are-- specialty clinics (Memory & Dementia Clinic, Walk-in Clinic) and regular geriatric mental health clinic. Three Senior residents and one junior resident has been appointed. Response of the community towards utilization of services available in the department is very encouraging.

In attempt to organize the mental health services for the elderly in the State and in the country, Dr. S. C. Tiwari, Prof. & Head, Department of Geriatric Mental Health, King George's Medical University , Lucknow has taken initiatives in forming the Indian Association for Geriatric Mental Health in the year 2004. The First Annual National Conference of the Association was held from 20 th to 22 nd August, 2005 at Scientific Convention Centre, K‘s. Medical University, Lucknow. The Chief Minister of Uttar Pradesh, Hon'ble Sri Mulayam Singh Yadav inaugurated the historic event.

In the morning session on 20 th August, Dr. Vijay Chandra, Regional Advisor, Health & Behaviour,World Health Organization, South-East Asia Regional Office, New Delhi, Dr. Bela Shah, Sr. Deputy Director General, Indian Council of Medical Research, New Delhi, and Dr. N. G. Desai, Professor and Head, Department of Psychiatry, IHBAS, New Delhi delivered key note addresses on Present and Future of Geriatric Mental Health Services in India, In the afternoon session on Clinical Assessment of Mental Health Condition in Elderly with special reference to memory problems, Dr. Charles Pinto, Prof. & Head, Department of Psychiatry, B.Y.L. Nair Hospital, Mumbai Central, Mumbai spoke on “Psychiatric interview /examination technique” and Dr. P. S. Mathuranath, Assistant Professor, Department of Neurology, Division of Cognition & Behavioural Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum spoke on “Clinical Cognitive assessments and clinically useful Scales/Inventories”. In the post tea session on 20-08-2005 on the theme of Diagnostic dilemmas in Psychogeriatric, Dr. R. K. Mahendru, Consultant Psychiatrist, “Sumiran”, 3/91, Vishnupuri Kanpur presented his paper on “Depression” and Dr. Anukant Mittal, Professor in Neuropsychiatry, Government Medical College, Thane, Mumbai, on “Psychoses”. The opening session on 21 st August, 2005 was marked by the guest lecturer by Dr. Vijay Chandra, Regional Advisor, Health & Behaviour, World Health Organization, South-East Asia Regional Office, New Delhi an eminent neurologist who has done intensive research in the field of geriatric mental health, who spoke on “Dementia and Alzheimer's Disease : Indian Perspective”. This was followed by presentations on the theme of “Diagnostic Dilemmas in Psychogeriatric” in which Dr. B. Krishnaswamy, Professor and Head of Geriatric Medicine, Madras Medical College, Chennai, spoke on “Acute Confessional States” and Dr. K. S. Shaji, Regional Co-ordinator for India and South Asia, 10/66 Dementia Research Group, Department of Psychiatry, Medical College, Thrissur, Kerala, spoke on “Dementia”. Regarding psychopharmacological issues in psychogeriatrics, Dr. R. C. Saxena, Ex. Head, Department of Pharmacology, King George Medical University, Lucknow spoke on “Psycho pharmacokinetic and Psychopharmacodynamic issues”; Dr. E. Mohan Das, Consultant Psychiatrist, Elite Mission Hospital, Kooraanchery, Trichur, Kerala spoke on “Monitoring and Management of Adverse Drug Effects” and “Pharmacological Management of Dementia”, and Dr. J. K. Trivedi, Professor, Department of Psychiatry, King George Medical University, Lucknow spoke on “Pharmacological Management of Psychoses”. On the theme of Non-pharmacological Management in Psychogeriatrics, Dr. Sonam Yang Chen Rana, Regional Programme Co-ordinator, United Nation Development Programme, Asia Pacific Region, Regional Office, Colombo spoke on “Care giving in elderly : Experiences and Lessons from a Care Giver”, Dr. V. G. Jhanwar, Consultant Psychiatrist, Deva Mental Health Care, B-27/70, Badhal Kothi, Durgakund, Varanasi spoke on “Non-pharcmacological Management in Dementia” and Dr. S. C. Godiyal, Associate Professor, Lucknow's Era Medical College, Hardoi Road, Lucknow spoke on “Specific issues in Geriatric Mental Health Care”.

On the concluding day the 22 nd August, some important issues in Geriatric Mental Health were taken up. Dr. Devika Nag, Ex. Head, Department of Neurology, King George Medical University, Lucknow spoke on Prevention and Protection of falls”, Dr. A. K. Agarwal, Ex. Head, Deptt. of Psychiatry, King George Medical University, Lucknow spoke on “Suicide”, Dr. Ashok Chandra, Professor, Department of Medicine, King George Medical University, Lucknow spoke on “Multiple Diagnoses”, Dr. Thirunauvukrasu, Prof. & Head, Dept. of Psychiatry, Stanley Medical College, Chennai, spoke on “Early symptoms of Dementia in clinical practice” and Dr. T. S. S. Rao, Dept. Psychaitry, JSS Medical College, Mysore, spoke on “Geriatric sexuality”. A panel discussion on “Specific issues in Mentally Sick Elderly” constituted the last scientific session in which Dr. Surendra Singh, Vice Chancellor, Kashi Vidya Peeth, Varanasi, initiated & concluded the discussions on “Social Issues”, Dr. S. S. Nathawat, Prof. & Head, Department of Psychology, University of Rajasthan, Jaipur on “Psychological Issues”, Mrs. Bulbul Gudiyal, Advocate, High Court, Lucknow Bench, Lucknow on “Legal Issues” and Sri S. N. Singh, I.G. Human Rights, Govt. of U.P. on “Security issues”.

Over 100 participants from out side and a large number faculty members, special invitees and senior citizens attended the conference which was very well covered by the media. The cultural evenings performed by elderlies 65 years and above in Hotel Taj Residency hall and Amarpali resort was highly appreciated.