How Can We Define Mental Illness or Disorder?

Stethoscope: How can we define mental illness or disorder?

Professor Firoz: A mental disorder is an illness with psychological or behavioural sign associated with impaired functioning due to a biological, social, psychological, genetic physical or chemical disturbance. It is measured in terms of variation from some normative concept. Each illness has characteristic sign and symptoms.

Stethoscope: We understand that a large percentage of the population is suffering from mental health or psychiatric disorders. Would you please tell us the approximate number of people suffering from mental disorders?

Professor Firoz: We now know that about 15 per cent of Bangladeshi population is suffering from mental health disorders. This has been gathered from an extensive study and survey undertaken randomly in 120 villages all over Bangladesh.

Stethoscope: We understand that the Institute of Mental Health and Hospital is established recently and you are the first director. Actually when has it been established.

Professor Firoz : Well, the out patient department of the National Institute of Mental Health and Hospital (NIMH) started functioning from 2001. Dr. Professor Hedayetul Islam and Professor Anwara Begum acted as Project Director for quite sometime. The Indoor treatment and admission of patients for the indoor started in May 2002. I took over the responsibilities of Director in the month of May, 2002. The Institute is the only and the first of its kind in Bangladesh. However, there is a mental hospital in Pabna (Hemayetpur) which is purely a service hospital. Our institute has a service hospital along with academic and training functions. There are 150 beds at present. Establishment of a 50 bed addiction unit in this hospital.

Stethoscope : What sort of courses are run by the institute?

Professor Firoz : We are presently running MCPS, FCPS and Ph.D coursers. We are going to introduce MD course from January, next year. We also run a diploma course in psychiatric nursing.

Stethoscope : Is there any classification of mental or psychiatric disorders?

Professor Firoz : Yes, there is classification of mental disorders. They are broadly described as psychotic, Neurotic, Functional and Organic.

Stethoscope : Should substance abuse and substance induced disorders be called mental disorders?

Professor Firoz : Yes, they are very much psychiatric or mental disorders. You see nobody is immune from drug addiction. Substance abuse occurs in all segments of all societies. The proper evaluation of any patient requires an assessment of substance use. Substance abuse results in decreased work and school performance, accidents, intoxication while working, absenteeism, violence, crime, theft etc. We treat substance abuse patients here and a fifty bed drug addiction unit is going to function within coming few months in this institute's hospital. For the drug addicts patients we provide systematic treatment. First of all they are made to stop drug and they are given detoxification therapy. This may often result in withdrawal complication. If occurs, methadone is given to combat withdrawal. Then methadone withdrawal may require slower detoxification. Once detoxification is achieved, the patient is kept under surveillance for a few days or a couple of weeks to continue absence from drug taking. During this period the patients are given psycho-therapy, behaviour therapy and counselling etc. They are released with instruction to come back for follow p periodically. It may be pointed out that treatment of abuse on dependence involves self discipline and long-term treatment. Unfortunately there is hardly any long-term stay centre in the country for treatment and rehabilitation of the substance abusers or addicts. However, there are about 120 drug detoxification centres in Dhaka alone.

Stethoscope :
Thank you, Dr. Firoz. We understand that you have written a number of books on psychiatric diseases etc. for dissemination of information and for raising awareness against the social stigma in the general people. Would you please name a few of your publications?

Professor Firoz : Well, I can mention my regular magazine 'Monojagat' first followed by A Hand Book of psychiatry, All about Depression, Quick reference to clinical psychiatry, Sex Guide-1, 2, and 3, Purusher Ekanto Kotha, Mayaeder Ekanto Kotha etc.

Stethoscope :
Thank you Professor Firoz for the interesting interaction.

Professor Firoz :
Thank you also. It is my pleasure. I enjoy sharing ideas and views with the media. You are always welcome.

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