The Department of Psychiatry has been a pioneer in providing mental health services in a General Hospital Setting. The department runs regular out-patient walk-in and follow-up clinics in addition to weekly specialty clinics for child and adolescent psychiatric disorders, psychosomatic disorders, common mental disorders, severe mental disorders, dual diagnosis disorders and brain stimulationtherapies. Consultation liaison services are provided for the patients admitted in other wards of the hospital andemergency psychiatric services are provided on a round-the-clock. The department also provides community outreach services 6 days a week at the CRHSP, Ballabgarh, including one day each at the Primary Health Centre at Dayalpur and Chhainsa. Besides pharmacotherapeutic interventions, psychological treatments, modified electro convulsive therapy (MECT) and advanced treatments like rTMS, tDCS and biofeedback are routinely provided. During the year 2017-18, the department provided out-patient consultation services to a total of 17, 204 new cases and 66, 333 follow up cases and in-patient management to 282 patients.
The department is at the forefront of medical education with courses for MBBS, B.Sc/M.Sc nursing, MD (Psychiatry) and PhD (Clinical Psychology) scholars. The departmentalso conducts short term training courses of residents posted from other departments (Medicine, Geriatric Medicine, Emergency Medicine, Palliative Medicine, and DM Neurology). For MBBS students, teaching includes theory lectures of 20 hours (6th semester) and clinical training of 7 hours (3rd semester), 25 days (4th-5th semester) and 40 days (in 6th/8th semester).The department undertakes regular collaborative research with national and international agencies like World Health Organization (WHO), University of California, National Institute of Health Research (UK), ICMR, and is one of the leading partners for research regarding the development of psychiatric classificatory system (ICD-11) by WHO. The department organizes year round public educational events for public dissemination of research knowledge and to promote awareness of mental health issues.
Currently primary mandate of the department is to develop highly trained manpower, and formulate curriculum and techniques for undergraduate and postgraduate medical education. Exploration of general mental health morbidity, culturally appropriate treatment of mental disordersand epidemiology of substance abuse remains the main research focus of the department.
History of the Department:
The Department of Psychiatry had informal beginning in 1958, when DrLuvia Taylor Gregg, Honorary Consultant in Psychiatry, began formal teaching in psychiatry for the first batch of MBBS students. Dr Gregg planned to introduce 100 hours of teaching in psychiatry in MBBS curriculum. Prof KL Wig, the then Head, Department of Medicine (later Director, AIIMS) was instrumental in integrating teaching of psychiatry throughout the clinical posting in medicine, so that the exposure to psychiatry was spread to all the 3 years on weekly basis. Since there was no inpatient unit in psychiatry, MBBS students were sent to the Mental Hospital, Agra for exposure to inpatients in psychiatry. DrVimlaVirmani, who later headed the Department of Neurology, had worked as clinical tutor in the initial years of the Department history.Dr SC Malik, one of the earliest post graduate pass out from AIIMS, wrote in one of his memoirs, “we had about 80-100 hours' exposure in psychiatry at the under-graduate level. Psychiatry at that time was (mostly) ‘Dynamic Psychiatry’ with highly laden emphasis on psycho-analysis and analytically oriented psychotherapy. For the undergraduates it was a very thrilling experience and many of us approached Mrs. Gregg to know about ourselves - our hidden complexes etc. Our exposure to psychiatry was spread to all the 3 years on a weekly basis”
Dr AS Mahal joined as Assistant Professor in 1962 and Dr D Satyanand as Professor and Head in Aug 1963. DrSatyanand started regular MD Psychiatry programme in psychiatry, the first in the country. Post graduate psychiatry in general hospital setting provided the groundworks for de-stigmatizing psychiatry and in moving mental disorders outside the custodial boundaries of mental asylums, within the community. The MD course also fostered integration as medical residents could now opt for Psychiatry as their specialization in general hospital settings.
Anothermilestone contribution of the department was the development of rural mental health services, through the Indian council of Medical research funded mental health project at the Comprehensive Rural Health Services Project (CRHSP), Ballabhgarh during 1964, under the leadership of DrD Satyanand. The integration of Psychiatry training in rural undergraduate medical curriculum is a continuing legacy of this project. The department continues to provide regular care at its rural centres to fulfill its obligation towards development of rural and community psychiatry.
Another first achieved by the department of psychiatry, under leadership of DrSatyanand, was the beginning of Child Guidance Clinic in Delhi in 1964. From seeing only cases of mental retardation and hyperkinetic disorders initially, this clinic, now caters to a wide variety of psychiatric disorders and behavioral issues of children.
The first batch of successful psychiatrists completed their training at AIIMS in 1964 and DrSatyanand retired in late 1966. During 1967-1968, Dr Erna Hoch, a Swiss psychiatrist, who had migrated to India, headed the Department as Honorary Professor and Head for about one and half year.From 1969-1980, she was medical director and professor of psychiatry in the only psychiatric hospital in the province of Cashmere (Kashmir). In 1988, Erna Hoch returned to Switzerland to live in the Tessin. Her famous book “Sources and Resources” represents a collections of articles written while in India propounding on the cultural influence of mental ailments and their treatment.
Prof JS Neki, who joined the department in September 1968 as Professor and Head, introduced the concept of ‘Guru-Chela’ paradigm in the practice of psychotherapy with due consideration to Indian culture and context. He was also instrumental in opening doors for Psychiatry in other departments. Due to his efforts, posts for psychologists were created in the department of Pediatrics and Neurosciences.
Prof N N Wig (Picture courtesy: Shubh Singhvia Flikr) and Prof Rajat Ray
In 1980, Prof NN Wig joined the department. He was part of the expert group formed for preparing draft of National Mental Health Programme (NMHP), which was completed in 1982. Prof Wig also strengthened the relationship of psychiatry with neurosciences in 1984, by holding the first faculty position in Neuropsychiatry at AIIMS.
The de-addiction services started in AIIMS outpatient department in 1976.Prof D Mohan, then Head of the Department, and an AIIMS alumnus, persistently endeavored to minimize the gross imbalancebetween the resources required to meet the increasing needs for de-addiction services and those available. Thus was formed the De-Addiction Centre (DAC), initially functional from premises of DeenDayalUpadhyay Hospital. The DAC subsequently evolved to become National Drug Dependence Treatment Centre (NDDTC), a national centre and a WHO collaborating centreand became fully operational from its new premises in Ghaziabad from April 2003.
Prof R Ray, who became head of the department after the retirement of Prof D Mohan, was pioneer in carrying out the first national survey on substance use disorders under Ministry of Social Justice and Empowerment, Government of India, carried out from March 2000 to November 2001.
Prof SK Khandelwal, who became the head in 2013, developed the department further with multiple liaison services and creation of specialty clinics at AIIMS. His position as faculty of neuropsychiatryfurther strengthened the relation of psychiatry with neurosciences. DrKhandelwal is also credited with opening ofone of the first lithium clinic in India where free testing could be carried out for patient suffering from Bipolar Disorder. Under his leadership, various National CMEs and public lectures have been organized. In 2016 the department hosted the World Congress of Social Psychiatry under the leadership of Prof Khandelwal and Prof R K Chadda, who succeeded Prof Khandelwal as the Head of the Department and Chief of the National Drug Dependence Treatment Centre upon his retirement.