Hostname: page-component-8448b6f56d-tj2md Total loading time: 0 Render date: 2024-04-19T23:14:09.770Z Has data issue: false hasContentIssue false
  • English
  • Français

Behavioral Emergencies in India: Would Psychiatric Emergency Services Help?

Published online by Cambridge University Press:  25 March 2011

Sahoo Saddichha  and
Pandey Vibha
Sahoo Saddichha*
Affiliation:
Resident in Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore, India
Pandey Vibha
Affiliation:
Research Consultant, Division of Clinical Research, Emergency Management and Research Institute, Hyderabad, India
*
Correspondence: Sahoo Saddichha, BA, MBBS, DPM, MD Resident in PsychiatryNational Institute of Mental Health & NeurosciencesBangalore, India 560029. E-mail: saddichha@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction: Behavioral emergencies constitute an important component of emergencies worldwide. Yet, research on behavioral emergencies in India has been scarce. This article discusses the burden, types, and epidemiology of behavioral emergencies in India.

Methods: A computerized search of Medline, Psychinfo, and Cochrane from 1975 to 2009 was performed, and all articles were evaluated and collated. The results were summarized.

Results and Conclusions: There is an acute need for psychiatric emergency services in India. Suicides, acute psychoses, and substance-related problems form the major portion of behavioral emergencies, while current trends show a rise in disaster- and terrorism-related emergencies.

Keywords

behavioral emergencyemergency psychiatryemergency servicespsychosocial
Type
Comprehensive Review
Information
Prehospital and Disaster Medicine , Volume 26 , Issue 1 , February 2011 , pp. 65 - 70
Copyright
Copyright Saddichha © World Association for Disaster and Emergency Medicine 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

World Health Organization (WHO): India (2006) Available at http://www.who.int/countryfocus/cooperation strategy/ccsbrief india ind 06 en.pdf. Accessed 25 March 2009.Google Scholar
WHO: World Health Report 2003—Shaping the future. Available at http://www.who.int/entity/whr/2003/en/whr03_en.pdf. Accessed 01 April 2009.Google Scholar
WHO: Global Burden of Disease 2004 Update. Geneva: World Health Organization, 2004.Google Scholar
WHO: World Health Report 2001. Mental health: New understanding, new hope. Available at: http://www.who.int/whr/2001/en/whr01_en.pdf. Accessed 09 March 2009.Google Scholar
Math, SB, Chandrashekar, CR, Bhugra, D: Psychiatric epidemiology in India. Indian J Med Res 2006;126:183–192.Google Scholar
Faberga, H Jr: Psychiatric stigma in non-Western societies. Comprehensive Psychiatry 1991;32(6):534–551.CrossRefGoogle Scholar
Javed, Z, Naeem, F, Kingdon, D, Irfan, M, Izhar, N, Ayub, M: Attitude of the university students and teachers towards mentally ill, in Lahore, Pakistan. Journal of Ayub Medical College Abbottabad 2006;18(3):55–58.Google ScholarPubMed
Kumar, S: Indian mental-health care reviewed after death of asylum patients. Lancet 2001;358(9281):569.CrossRefGoogle ScholarPubMed
Sudarsanan, S, Chaudhury, S, Pawar, AA, Salujha, SK, Srivastava, K: Psychiatric emergencies. MJAFI 2004;60:59–62.Google ScholarPubMed
Stitt, R, Ditty, M: Behavioral emergencies. Available at http://www.ncemsf.org/about/conf2005/lectures/Stitt%20and%20Ditty%20-%20Behavioral%20Emergencies.pdf. Accessed 01 April 2009.Google Scholar
Isaac, M: Trends in the development of psychiatric services in India. Psych Bull 1996;20:43–45.CrossRefGoogle Scholar
Lamberg, L: Psychiatric emergencies call for comprehensive assessment and treatment. JAMA 2002;288:686–687.CrossRefGoogle ScholarPubMed
Reddy, MV, Chandrasekhar, CR: Prevalence of mental and behavioural disorders in India: a metaanalysis. Indian J Psychiatry 1998;40:149–157.Google ScholarPubMed
Chavan, BS, Singh, GP, Kaur, J, Kochar, R: Psychological autopsy of 101 suicide cases from northwest region of India. Indian Journal of Psychiatry 2008;50(1):34–38.Google ScholarPubMed
Ramachandran, V, Menon, MS. Study of psychiatric emergencies. J Assoc Physicians India 1973;21(3):313–316.Google ScholarPubMed
Kelkar, DK, Chaturvedi, SK, Malhotra, S: A study of emergency psychiatric referrals in a teaching general hospital. Indian J Psychiatry 1982;24:366–369.Google Scholar
Trivedi, JK, Gupta, AK: A study of patients attending emergency out-patient services of a large teaching institution. Indian J Psychiatry 1982;24(4):360–365.Google ScholarPubMed
Adityanjee, Mohan, D, Wig, NN: Determinants of emergency room visits for psychological problems in a general hospital. Int J Soc Psychiatry 1988;34(1): 25–23.Google Scholar
Saddichha, S, Vibha, P, Saxena, MK, Methuku, M: Behavioral emergencies in India: a population based epidemiological study. Soc Psychiat Epidemiol 2009; Jul 28. [Epub ahead of print]; PMID: 19636478.Google ScholarPubMed
Accidental Deaths and Suicides in India 2006 New Delhi: National Crime Records Bureau Ministry of Affairs, 2007Google Scholar
Vijaykumar, L: Suicide and its prevention: The urgent need in India. Indian J Psychiatry 2007;49:81–84.CrossRefGoogle ScholarPubMed
Roy, A: Suicide. In: Sadock, BJ, Sadock, VA, (eds.): Comprehensive Textbook of Psychiatry 7th ed.Lippincott Williams & Wilkins publishers. 2000;2031–2040.Google Scholar
Pillai, A, Andrews, T, Patel, V: Violence, psychological distress and the risk of suicidal behaviour in young people in India. Int J Epidemiology 2009; 38(2):459–469.CrossRefGoogle ScholarPubMed
Prasad, J, Abraham, VJ, Minz, S, et al: Rates and factors associated with suicide in Kaniyambadi Block, Tamil Nadu, South India, 2000–02. Int J Soc Psychiatry 2006;52:65–71.CrossRefGoogle Scholar
Sharma, M, Taneepanichskul, S: Characteristics of aggression and violent behaviour among psychiatric inpatients in psychiatric wards of a tertiary hospital in New Delhi. J Health Res 2008;22(S):29–32.Google Scholar
Kanchan, T, Menezes, RG: Suicidal hanging in Manipal, South India—Victim profile and gender differences. J Forensic Legal Med 2008;15:493–496.CrossRefGoogle ScholarPubMed
Jacob, KS: The prevention of suicide in India and the developing world. Crisis 2008;29(2):102–106.CrossRefGoogle ScholarPubMed
Joseph, A, Abraham, S, Muliyil, SK, George, Ket al: Evaluation of suicide rates in rural India using verbal autopsies, 1994–9. BMJ 2003;326;1121–1122CrossRefGoogle ScholarPubMed
Fleischmann, A, Bertolote, JM, Wasserman, D, et al: Effectiveness of brief intervention and contact for suicide attempters: a randomized controlled trial in five countries. Bull WHO 2008;86(9):703–709.Google ScholarPubMed
Parkar, SR, Dawani, V, Weiss, MG: Clinical diagnostic and sociocultural dimensions of deliberate self-harm in Mumbai, India. Suicide and Life-Threatening Behavior 2006;36(2):223–238.CrossRefGoogle ScholarPubMed
Nagendra Gouda, MR, Rao, SM: Factors related to attempted suicide in Davanagere. Indian J Community Med 2008;33:15–18.CrossRefGoogle ScholarPubMed
Arun, M, Yoganarasimha, K, Palimar, V, Kar, N, Mohanty, MK: Para suicide—An approach to the profile of victims. JIAFM 2004;26(2).Google Scholar
Nath, S, Patra, DK, Biswas, S, Mallick, AK, Bandyopadhyay, GK: Comparative study of personality disorder associated with deliberate self harm in two different age groups (15–24 years and 45–74 years) Indian J Psychiatry 2008;50(3):177–180.CrossRefGoogle ScholarPubMed
Saddichha, S, Prasad, MNV, Saxena, S: Attempted suicides In India: A comprehensive look. Archives of Suicide Research 2009 (in press).Google Scholar
Rehm, J, Room, R, Monteiro, M, et al: Alcohol. In: Ezzati, M, Lopez, A, Rodgers, A, Murray, CJL, (eds.): Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors. Geneva: WHO, 2003.Google Scholar
Adityanjee, , Mohan, D, Wig, NN: Alcohol-related problems in the emergency room of an Indian general hospital. Aust N Z J Psychiatry 1989; 23(2):274–278CrossRefGoogle ScholarPubMed
Bhalla, A, Dutta, S, Chakrabarti, A: A profile of substance abusers using the emergency services in a tertiary care hospital in Sikkim. Indian J Psychiatry 2006;48:243–247.Google Scholar
Chagas, SM, Gaunekar, G, Patel, V, et al: The prevalence and correlates of hazardous drinking in industrial workers: A study from Goa, India. Alcohol Alcoholism 2003; 38(1):79–83.Google Scholar
Bhalla, A, Dutta, S, Chakrabarti, A: A profile of substance abusers using the emergency services in a tertiary care hospital in Sikkim. Indian J Psychiatry 2006;48(4):243–247.Google Scholar
Gururaj, G: Epidemiology of traumatic brain injuries: Indian scenario. Neurol Res 2002;24(1):24–28.CrossRefGoogle ScholarPubMed
Vijayakumar, L, Rajkumar, S: Are risk factors for suicide universal? A case-control study in India. Acta Psychiatrica Scandinavica 1999;99(6):397–398.CrossRefGoogle ScholarPubMed
WHO: Global Status Report on Alcohol. Available at http://www.who.int/substance_abuse/publications/en/india.pdf. Accessed 09 March 2009.Google Scholar
Hillard, R, Zitek, B: Emergency Psychiatry. New York: McGraw-Hill, 2004.Google Scholar
McAllister-Williams, RH, Ferrier, IN: Rapid tranquillisation: Time for a reappraisal of options for parenteral therapy. Br J Psychiatry 2002;180:485–489.CrossRefGoogle ScholarPubMed
Raveendran, NS, Tharyan, P, Alexander, J, Adams, CE: Rapid tranquillization in psychiatric emergency settings in India: Pragmatic randomized controlled trial of intramuscular olanzapine versus intramuscular haloperidol plus promethazine. BMJ 2007;335;865.CrossRefGoogle ScholarPubMed
Hillard, JR: Emergency treatment of acute psychosis. J Clin Psychiatry 1998; 59(S1):57–61.Google ScholarPubMed
WHO: Mental health in emergencies. Available at http://www.who.int/mental_health/media/en/640.pdf. Accessed 05 February 2009.Google Scholar
Institute of Medicine: Neurological, Psychiatric, and Developmental Disorders: Meeting the Challenge in the Developing World. Washington, DC: National Academy Press, 2001.Google Scholar
Institute of Medicine of the National Academies: Preparing for the Psychological Consequences of Terrorism: A Public Health Strategy. Available at http://www.nap.edu/books/0309089530/html/. Accessed 23 Feburary 2009.Google Scholar
Bassuk, EL, Birk, AW: Emergency Psychiatry: Concepts, Methods, and Practices. New York: Plenum Press, 1984.CrossRefGoogle Scholar
Chadda, RK, Malhotra, A, Kaw, N, Singh, J, Sethi, H: Mental health problems following the 2005 earthquake in Kashmir: Findings of community-run clinics. Prehosp Disaster Med 2007;2(6):541–545.CrossRefGoogle Scholar
Kar, N, Mohapatra, PK, Nayak, KC, Pattanaik, P, Swain, SP, Kar, HC: Post-traumatic stress disorder in children and adolescents one year after a super-cyclone in Orissa, India: Exploring cross-cultural validity and vulnerability factors. BMC Psychiatry 2007;7:8.CrossRefGoogle ScholarPubMed
Khan, H, Kalia, S, Itrat, A, et al: Prevalence and demographics of anxiety disorders: a snapshot from a community health centre in Pakistan. Annals Gen Psychiatry 2007;6:30.CrossRefGoogle ScholarPubMed
Murray, C, Lopez, A: The global burden of diseases: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. In Cambridge, MA: Harvard School of Public Health, WHO and World Bank Boston; 1996.Google Scholar
Bourne, E: The Anxiety and Phobia Workbook, 4th ed.Oakland: New Harbinger Press, 2005.Google Scholar
Sit, D, Rothschild, AJ, Wisner, KL: A review of postpartum psychosis. Journal of Women's Health 2006;15(4):352–368.CrossRefGoogle ScholarPubMed
Agrawal, P, Bhatia, MS, Malik, SC: Post partum psychosis: A clinical study. Int J Soc Psychiatry 1997;43:217–222.CrossRefGoogle ScholarPubMed
Chandra, PS: Post-partum psychiatric care in India: The need for integration and innovation. World Psychiatry 2004;3(2):99–100.Google ScholarPubMed
Malhotra, S, Varma, VK, Misra, AK, Das, S, Wig, NN, Santosh, PJ: Onset of acute psychotic states in India: A study of sociodemographic, seasonal, and biological factors. Acta Psychiatrica Scandinavica 2007;97(2):125–131.CrossRefGoogle Scholar
Collins, PY, Varma, VK, Wig, NN, Mojtabai, R, Day, R, Susser, E: Fever and acute brief psychosis in urban and rural settings in north India. Br J Psychiatry 1999;174:520–524.CrossRefGoogle Scholar
Varma, VK, Malhotra, S, Yoo, ES, Jiloha, RC, Finnerty, MT, Susser, E: Course and outcome of acute non-organic psychotic states in India. Psychiatric Quartely 1996;67(3):195–207.CrossRefGoogle ScholarPubMed
Chandrashekar, H, Prashanth, NR, Naveenkumar, C, Kasthuri, P: Innovations in psychiatry: Ambulatory services for the mentally ill. Indian J Psychiatry 2009;51:169–170.CrossRefGoogle ScholarPubMed
‘Dial 100'—A model of public-private partnership. Report of the National Workshop. Chennai; 18–19 July 2008; Conference Hall, Institute of Mental Health, Chennai. Banyan, A Nongovernmental Organization, 2008.Google Scholar
Hillard, JR: Manual of Clinical Emergency Psychiatry. Washington, DC: American Psychiatric Press, 1990.Google Scholar
Math, SM, Nagaraja, D: Mental Health Care and Human Rights. In: Nagaraja, D, Murthy, P (eds.): Mental Health Legislation: An Indian Perspective. India: National Human Rights Commission, 2008, pp 54–55.Google Scholar
Mental Health Act, 1987. Available at http://nhrc.nic.in/Publications/Disability/annexure3.html.Google Scholar
Talbot, JA: Deinstitutionalization, Emergency Services and the Third Revolution in Mental Health Services in the United States. In: De Clercq, M (ed.): Emergency Psychiatry and Mental Health Policy: An International Point of View. Amsterdam: Elsevier Science BV, 1998, pp: 85–96.Google Scholar
Vibha, P, Saddichha, S: The burden of behavioral emergencies: Need for specialist emergency services. Intern Emerg Med 2010 May 8. [Epub ahead of print].CrossRefGoogle ScholarPubMed