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Saturday, August 23, 2008

four things!!

Life can be difficult. Relationships are often difficult. However, after 20 years’ experience with patients and families facing profound challenges, Dr. Ira Byock has seen that four simple phrases can help us through the unpredictability of daily life.
"Please forgive me" "I forgive you," "Thank you," and "I love you."

An excerpt from the book The Four Things That Matter Most A Book About Living by Ira Byock, M.D.

Restoring Closeness
The Four Things are powerful tools for reconciling the rifts that divide us and restoring the closeness we innately desire. When bad feelings occur in our close relationships, we tend to put off the work required to make things right. We always assume we’ll have another chance…later. That’s understandable, but it’s a mistake. Feeling resentful toward the people we love, or once loved, feeling distant from them, erodes our own happiness.
A brush with death often instills in us a newfound appreciation for the gift of life. Simple pleasures – a cup of tea, sunshine on one’s face, the voices of our children – feel like miracles. When we’ve had a close call that shakes us up, the anger we’ve felt toward people closest to us no longer seems significant. Ill will dissolves in love, appreciation, and affection, and we recognize the urgency of mending, tending, and celebrating our relationships.
Because accidents and sudden illness do happen, it is never too soon to express forgiveness, to say thank you and I love you to the people who have been an integral or intimate part of our lives, and say good-bye as a blessing. These simple words hold essential wisdom for transforming that which matters most in our lives – our relationships with the people we love.

Friday, August 15, 2008

Mental Health Issues discussed via email by Capt johann and Dr Achal Bhagat

From: captainjohann
Subject: Re: National trust/inclusion of mental illness and other issues

Dear Dr.Achal Bhagat,
Which of the following allegations according to you are defamatory Sir?
1.You have accepted you are a psychiatrist
2.You have not denied that you filed a case in supreme court for"modified ECT" or is it called impleading in the Erawady case in which 25 mentallyill were burnt alive on behalf of SAARTAk.
3.I do know you were working for Apollo at that time .
4.government psychiatrists supporting normal ECT and private psychiatrists supporting modified ECT is old hat.
I want to be told which is a lie?
Now that you have accepted the main issue of RIGHTS OF MENTALLYILL and also as you work for human rights issues i like to know the following
1.Blind or partially blind DISABLED are NOT represented by Ophthalmologists but by disabled or their carers.
2.Hearing disabled are represented by the persons who are disabled or their carers but NOT by ENT specialists
3.Physically disabled are represented by very articulate Physically disabled like Mr.mahesh or Dr.javed Abidi but NOT BY Orthopedists
4.disabled due to Mental retardation are represented by eminent and knowledgeable people like Mr.Kadkari,Mr. Mehta of PARIWAR or by Dr.HT Dholakia of AWMH again all carers.
5.I have no connection with Leprosy cured whether they are represented by themselves or by skin specialists.
My question to you as a Psychiatrist who fights for RIGHTS FOR MENTALLYILL why is it Mentallyill cured or their carers are NOT REPRESENTED in the august portals of government as you have been doing who is a Psychiatrist? Did not you find a single CURED MENTALLY ILL PERSON who is capable of representing the mentally ill disabled like Ms.Akila maheshwari( a recovered schizophrenic) ,ProfAnil vartak,Dr.lalitha Sehgal,Dr.Krishna Khurana ,Rukmini Pillai,Nirmala srinivasan,Rathna chibber all cares who could have represented our INTERESTS better especially on "narrow issues"

Dear sir you call the inclusion of mental illness in national trust act as "narrow issue".
For me as a carer it is a Major issue sir. the following are some of the other "narrow issues' in which we as carers are trying to bring implementation or awareness in government Bureaucracy.
1.Inclusion of mental illness in national trust act 1999
2.Inclusion of a recovered mentally ill person or a carer in the CCC ,CEC,SCC,SEC as established in PWDEA act 1995.)Politicians ,bureaucrats who never attend are normally the members. Out of 39 only 5 out of 7 disabilities are represented. .
3 All the other disabilities have special Institutions under the aegis of Rehabilitation council of India to cater to physically disabled and mentally retarded but not Psycho social disabled.Infact psychosocial disabled was not even included in the disablities list of Rehabilitation council act of 1992.With lot of emails,letters to editors, they included it only in 2005, i think and started visiting Richmond college of Psycho social rehabilitation, a private institution started by a psychiatric nurse from UK with her own savings.
4.UNCRPD is a red herring for me.The National trust act and DISABILITY COMMISSION with worthy ideas was started by the previous NDA regime due to some Minister's ward having mental retardation. In fact i was having a SADISTIC WISH THAT at least one amongst the worthy parliamentarians or Ministers have a ward with psychosocial disability( I admit i am guilty of inhuman thoughts as i am a human).Now the UPA regime within a month of coming to power disbanded the commission instead of putting its own nominees. They realy worked fast REAL FAST ON THAT.
5.What you have done for NSSO(national sample survey) seperate survey for all the seven Disabilities (at present we are clubbed with MR)because government works on Statistics.
I do not want to burden you with Health Ministry issues which we cares are considering as More Important but you may consider small.
6.Budget for mentally ill disabled is measly 75 lakhs out of 1087 crores for all disabilities. any effort to increase it sir?
7.What is your view on wandering mentallyill. Why not Banyan type organisation in every state of India

1.clinical Trial of Psychiatric medications and how the psychiatrists conducting must not be posted to WHO, geneva
2.A senior Drug company said it considers Psychiatrists as consumers and not the ill who pop the pills nor the carers who pay for them. What is your take on this?
3.Health Budget increased from 19 crores to 198 crores (now 450 crores)due to Erawady tragedy or whose effort?
4.counterfeit Psyhiatric medications being made in Bareilly,Noida, ambala, etc etc and being supplied through CGHS/ESIC. what is your role in preventing this?
5.CGHS puts a cap of 3 years for inpatient treatment or go to Ranchi for permanent care. Your view?
6.Involuntary and voluntary admission
7.No psychiatrist does house call. Your view?
8.Suicides and suicide attempts are hushed up in government hospitals due to present rules. Your view?
9.we have only 3000 psychiatrists for a nation of 1 billion. Your view
10.NIMHANS TYPE of organization for every state as ordained by supreme court Interim order on Erawady in 2002. Why still no action? who is sabotaging in the health Ministry inspite of increased budget which is being surrendered?
11.Black box warnings in drug inserts and how they donot match in Indian drugs. Indian health Ministry doesnot enforce it as in USA> Your view?
12.354 WHO essential drug list doesnot contain respirodone and clozapine. Your view?

1.Drug Pricing and control order is being sabotaged by Drug Multi nationals like JJ,Pfizer,etc etc Your view?
2.Ever greening and Generic drugs. Your view?
With kind regards.
Dear Bhargavi,
Please make me answerable to my mails only. I have not abused colGoel nor amitha dhanda. I am defenitely pained by the attitude of Poonam natarajan.
"Greatness lies not in never falling but in rising everytime we fall"
Captain Johann samuhanand, BANGALORE INDIA
91 80 42023252
www.captainjohann. blogspot. com

--- On Fri, 8/8/08, Achal Bhagat wrote:

From: Achal Bhagat
Subject: Re: National trust/inclusion of mental illness and other issues

Date: Friday, 8 August, 2008, 12:11 AM

Dear All
First just to put the record straight.
I am a psychiatrist who has not 'certified' anyone till now. Believe it or not, I also have the audacity of seeing myself as a human rights activist, inspite of being a mental health professional! Was it Amartya Sen who said people have multiple identities or was it said by Tweedledum (or Tweedledee)? I did not think I was worth a gossip but it seems I am. So having been put in the dock by Captain Johann I am amused at such attention. I plead not guilty sir, I have not administered ECT for past seventeen years.

Making allegations about people and their intentions without actually even having met them is not very helpful and in fact defamatory. But we (those fighting for the rights of people with mental illness) are too few and we cannot afford to lose energy through such debates about people's intentions. So I will let it pass, Captain Johann. I coninue to respect you for what you are doing for the cause of people with mental illness. Now to the issue on hand.
I haven't followed all the communication that has been floating on this e-mail list but I believe it is about inclusion of mental illness under the National Trust and proposed National Trust Act Ammendments

Ok. First, the narrow issue of whether mental illness should be included under the National Trust Act. I think there is no debate on that in my mind. If the disability laws are discriminatory towards one group of disabled how can we expect rights of all people with disability to be addressed. National trust Act as it stands today is discriminatory. So NTA needs to change in its entire objective not just add a disablity or two.

The issue at hand is bigger, it is how in the light of UNCRPD do we fight for a review of laws, programs and policies in our country so that rights of people with mental illness are not infringed any further? I believe we need to oppose ammendments which are being pushed through with little or no consultation. We need to oppose both the process and content of the ammendments in NTA and the PWD Act unless a wider debate is possible and the alignment of the laws to UNCRPD is in letter and spirit. The present ammendment process has not really been a review of all laws according to the principles of UNCRPD. By ratifying the UNCRPD we have as a country automatically committed ourselves to a much more significant change than is being proposed at the moment.

The more significant change may mean a single comprehensive disability law which encompasses the civil, political socio economic rights of all people with disability. It also implies a new National Policy on Disability. It also implies that every state in India should also have a policy on Disability. It also implies that mechanisms for inclusive planning and monitoring in health, labour, education, women and child and twenty one other ministries are defined so that people with mental illness are not made to run between various ministries. It also means questioing the need for institutions like RCI and National Trust as there is a cost attached to running such institutions. The cost is not just a financial cost but such institutions lead to invisibilisation of people with disability from other mainstream planning and delivery processes. It also implies debating the issue of gaurdianship and substituted decision making.

These are significant debates. These cannot brushed aside in a rush to propose just any ammendments. Any process of hurrying the ammendments through is a betrayal of the spirit of the UNCRPD. The next ammendment process is not likely to happen for a decade. Let us not kid ourselves into believing that we have got it right in such a short time.

I do not think calling a meeting of a few professionals (even if such a meeting includes me) or some caregivers or having four zonal meetings amounts to a consultative process as envisaged in the UNCRPD. We need to come together, get organised and challenge the process and the hurry. It is a difficult fight. We, in the mental health sector are not organized as a group. The government and its organizations still want to push through the ammendments which have not been thought through. My colleagues, who are mental health professionals want to protect the existing heirarchy and at present not really clued in on the impact of UNCRPD. I can only plead with people who represent the cause of disabilities other than mental illness that while trying to protect your own rights please also ensure that no one discriminates against people with mental illness.

I am suggesting that we do participate in great numbers in all consultations and raise questions about the process and content. It is not just about including mental illness as one of the criterion for availing the benefits under the Act, it is about recognizing people with mental illness as people with equal capacity and equal entitlements. If one focusses on rights, inclusive planning and a society for all then National Trust provisions are actually provisions which belong to a past era. Most provisions have the assumtion of incapacity. This assumption of incapacity is evident in the day to day functioning of the trust e.g. A marketing agency set up by National Trust after the convention was ratified still had 'unsound mind' as a clause for excluding people to be on its board. It is this assumption of incapacity that needs to be challenged in the law and in our everyday lives.

I read a story today as narrated by Fali Nariman. He wrote that bees have survived because each bee which is squashed by a human hand, stings the hand. It may still get squashed but the fact that it did sting made the other bees survive. Come let us do some Gandhigiri, let us ask some stinging questions not just distribute roses.

Starting next week we at Saarthak are starting a blog on implementation of UNCRPD for people with mental illness. We are also in the process of writing to all parliamentarians to ensure that they raise questions if some "reheated" ammendments do reach the parliament.

Dr. Achal Bhagat
Director, Saarthak

--- On Thu, 7/8/08, captainjohann wrote:

Date: Thursday, 7 August, 2008, 5:05 PM

Dear Bhargavi,
First of all i want to acknowledge and thank you for providing this info about NATIONAL TRUST ACT.
But I am definitely pained by the ATTITUDE OF MS.POONAM NATARAJAN. I have started this fight for inclusion of Mental illness (disabled ) long back and I am dissappointed to be ignored.
I am forwarding my letter to Ms.Poonam natarajan and others on this issue.Mr.kanjilal, another carer has been continuously writing to Mr.Ashish kumar and poonam natarajan by registed post many times. I am forwarding my earlier letters to poonam natarajan,others which includes your co/trustee Ms.Amitha dhanda on this issue.If you go through this carefully you will understand the concerns of the carers.
When Ms.Ruma Bhagat a lawyer(disabled herself) who is also member of the National trust visited bangalore, she emphatically told that it is impossible for other disabilities to be included in national trust. But when i pointed out the affidavit which the Under secreatry Mr.mahendra Sharma in the Ministry of Social justice has filed in supreme court of India in Writ petition(civil) no 301 of 2005, she kept her own council.This affidavit gets confirmed vide letter no F.NO.2/17/99- BOA-VOL-II of Deptt of economic affairs(banking division) issued by Ministry of finance to Indian banks association. Both these letters were given by me notonly to you BUT ALSO TO MS.POONAM NATARAJAN who came to know about the scheme of Integrated development of Persons with disabilities( IDPD) only then.
I am suprised to see a psychiatrist Mr. Achal Bhagat( who was filed case in supremecourt for sake of Modified ECT so that apollo hospital in Delhi will get business which had that equipment at that time) was conducting the NTA at Delhi but not representative of psychosocial disabled or carer's representative. A PSYCHIATRIST' S ROLE IS ONE OF CERTIFICATION AND HE HAS NO ROLE IN DISABLITY SECTOR as is the case with other SIX disabilities who are always represented by THEMSELVES OR by THEIR CARERS.
In my opinion this National level consultation is a ruse by the ministry to get over the presure for inclusion of disabled due to mental illness in national trust act by making all disabilities part of national trust act who DO NOT REQUIRE GUARDIANSHIP. How can a cerebral palsy,autistic child,Alzheimer, disabled due to paranoid schizophrenia live without guardians.I only hope i am wrong.We the carers or psycho social disabled (with rights given by UN convention) only want the "Niramaya" insurance scheme,"Udhayam Pracha,Gyan Prabha,Arunim schemes etc benefits in the existing scheme of things.

with kind regards

"Greatness lies not in never falling but in rising every time we fall"
Captain Johann samuhanand, BANGALORE INDIA

www.captainjohann. blogspot. com

--- On Mon, 4/8/08, V Bhargavi wrote:

Dear Capt. Johann

I was really saddened and disappointed to see your and Akila's emails
on the NTA. With all expectations of proactive and collective
response, I had personally forwarded news about the

absolutely everyone on the Bapu networks. I am sorry that this has
been used destructively only to do more mud slinging at each other,
and setting up destructive communications, when what is needed is
love, co-operation and alliance building.

A more mature response would have involved engaging with the NTA on
inclusion, and writing to Ms Poonam directly. The fact that we are not
able to take such constructive, positive steps is probably the reason
why we are all still stuck in the mental illness sytem, and not the
mental health system.

Let us create a mental

system by first looking at how we write
and communicate with each other, and creating ways of working
together. There are enough road blocks already.

The NTA has put up their entire program on the website. Everything,
including the telephone contacts of the senior most people, is also
loaded on the web.

consultations are
also planned. Let us
use this amply available information and create proactive strategies
instead of wasting our energies finding suitable abuses for each

Good wishes,

and may love and peace prevail in the mental health sector,

Hope to see some of you at the NTA meetings,

Bhargavi Davar
www.camhindia. org

Mental health is about Love. There is no room for Force in it.