“Mental health prevention needs a paradigm shift. The most important is increased awareness about the causes, consequences and management of mental illnesses”

Prof. dr. Roy Abraham Kallivayalil is the vice-principal, professor and the Head of the Psychiatry Department of the Pushpagiri Institute of Medical Sciences, Thiruvalla, Kerala, India. He is the general secretary of the World Psychiatric Association, Geneva (2014-2020). He is also the president of the World Association for Social Psychiatry, Paris (2016-2019), and president of the National Alliance for Mental Health, India.

He was chairman at the WPA Preventive Psychiatry Section (2011-2014), general secretary of the World Association for Social Psychiatry (2010-2013), president of the Indian Association for Social Psychiatry (2007-2008 and 2010-2011), general secretary (2002-2006) and president of Indian Psychiatric Society (2012-2013), founder general secretary of the SAARC Psychiatric Federation (2014-2016) and associate editor of the Indian Journal of Psychiatry (2007-2011) and national vice-president of the Indian Medical Association (2016-2017). He was principal of the Ernakulam Medical College, Kochi, India, and professor and the Head of Psychiatry Department of the Thrissur and Kottayam Government Medical Colleges. He was also chairman board of examiners, member, board of studies and member at the Faculty of Medicine of the Cochin University of Science and Technology, and member of the Senate of Mahatma Gandhi University. In 2007, the Goverment of Kerala honored him with the “Best Doctor Award”.

He is member of the editorial board of World Psychiatry (the journal with the highest impact factor) and of the International Journal of Person Centered Medicine, international advisor of the Japanese Society of Psychiatry and Neurology (2017-2019) and International Distinguished Fellow of American Psychiatric Association since 2013. He has more than 50 publications in peer reviewed scientific journals and he has edited the book “Suicide Prevention – A Handbook for Community Gatekeepers”. Also, he received from the President of India the World Federation of Mental Health (WFMH) Award for Meritorious Services to the cause of mental health in 2017.

Doina Cozman: What are the challenges of the concept of social psychiatry in the context of personalized medicine?

Roy Kallivayalil: The concept of social psychiatry has always faced innumerable challenges. So, this is nothing new. Personalized medicine follows the theory, everyone is unique, and believes that by analyzing information about genomes, certain patterns can be identified which will help to identify risks, detect illness earlier and determine the best possible interventions. They profess to target therapies towards the best outcome in disease management. We welcome advances in all branches of medicine, including personalized medicine, but strongly assert that it cannot provide all the answers in the care of persons with mental illness or in helping their families. We know, a man is also a product of his environment. This realization has made the ‘bio-psycho-social’ model advocated by social psychiatry, to make a triumphant comeback.

D.C.: Do you predict a major paradigm shift in mental health prevention in the coming years? If so, in what way?

R.K.: I agree that mental health prevention needs a paradigm shift. The most important is increased awareness about the causes, consequences and management of mental illnesses. The biggest barrier before us is stigma. We should overcome this through increased advocacy, health education and training programs. Psychiatry and mental health are totally neglected in medical curriculum, in most countries of the world except in the high‑income countries. Proper training of our young doctors in psychiatry during their medical studies is absolutely essential in the promotion of mental health and prevention of mental illness.

D.C.: Will globalization change – in all its aspects, including the migration phenomenon – the way we approach health?

R.K.: We have to accept globalization as a fact of life. Migration is taking place all across the world. Mental health problems are lesser and can be more easily mitigated if migration has been one’s choice. It is the opposite in the case of forced migration, when people have to leave their place of living, their families and their means of living. They face an uncertain future, and the mental health consequences can be catastrophic. We need to cultivate a humane attitude to migrants while simultaneously searching for political solutions.

D.C.: How can psychiatrists contribute to managing humanitarian crisis situations?

R.K.: Psychiatrists are duty bound to provide mental health relief in humanitarian crisis. It will help people to keep up their morale on the face the imminent grave challenges before them. Psychiatrists must be part of all medical relief teams for crisis management. Not only should they provide immediate emotional support, but they also need to do regular follow‑up to identify conditions like PTSD, depression, anxiety, substance use, adjustment disorders and others.

D.C.: What expectations do you have regarding the hosting of the World Congress of Social Psychiatry in Bucharest? 

R.K.: We have very high expectations! Romania is the birth country of WASP founder Joshua Bierer and this is one important reason why we have chosen Bucharest as the venue among the various applicants for the congress. We had a huge attendance of 1,100 delegates at the last World Congress at New Delhi in 2016 and our intention is even to surpass this. We are happy that the Romanian Association of Psychiatry led by prof. Doina Cozman and the Romanian Social Psychiatry Association led by prof. Alexandru Paziuc are working hand in hand. They are helped by the WASP EC and our past president, prof. Eliot Sorel, who was born in Romania. We are happy about this coordinated work by all those interested in social psychiatry, ably supported by the PCO Paloma led by Alina and Theo. Our member societies all over the world have also evinced keen interest. All these, abode very well for the congress! Let me wish grand success for the WASP Bucharest 2019 Congress and extend my congratulations to all, especially in Romania, for their hard and committed work!

Interview by prof. univ. dr. Doina Cozman,
editor-in-chief Psihiatru.ro