Setting up a private practice in mumbai is an onerous task. The present paper looks at the difficulties face by young psychiatrists when starting a private practice in psychiatry. It suggests certain guidelines to be followed to ensure the development of a successful practice. It also suggests methods to gain popularity among patients and society along with the ethics to be followed, knowledge base to be garnered, and the role of using multiple therapies and versatility in private practice.

Indian womanhood today is at crossroads. The present paper discusses the status of Indian womanhood and its psychological underpinnings. It discusses how Indian women have suffered at the hands of their families and society leaving no path but to succumb to psychiatric illness. The role of mental health professionals and family members in supporting and promoting growth and development of the Indian woman is outlined.

This is a psychiatrist's journey through teaching, research and making friends of professional colleagues. It also chronicles the research done in the Department of Psychiatry at KEM Hospital, Mumbai, India and the important influences over the author's life.

Forty-five years of work with children has enriched my knowledge. Child development and psychology has made basic concepts of general psychology and abnormal psychology clearer. 'Meanings' have become more meaningful. It has made me a better professional; large number of communication and teaching skill has been the end result of such a long association with diverse groups of children who needed special care. Apart from professional skills as a clinician and as a teacher, it has made me a better person and a better parent. I have been fortunate to work with a large number and different groups of children who were in some way very special. Some were classified under various disabilities or diagnosed under different categories. I also had the privilege of working with different institutions, e.g., child guidance clinics run by a paediatrics department and a psychiatry department of a general hospital and a teaching hospital. Years of association with College of Special Work and Institute of Social Science have made me understand the very important facet of sociocultural influence on the development of human behaviour. I was further fortunate to work with children in closed and open institutions, residential care units and day care units, institutions where court committed children were observed, treated, trained and cared for, destitute children and delinquent children in remand homes, rescue homes and custodial care homes. I was fortunate to be part of the group which dealt with children who were in conflict with the law, belonging to diverse categories like street children, working children, child sex workers and sexually abused children. This paper is a reflection on experience gained over the decades.

Mumbai and its suburbs constitute a huge population. There are limited services here in the field of psychiatry, mainly located in major hospitals and teaching centres. There is a need to decentralize services. Psychiatrists themselves have limited resources to plan out community-based services, or set up centres, which would cater to all the requirements of the local population. Hence, it is necessary that a group like the Bombay Psychiatric Society make collective efforts to urge government and municipal authorities to create such facilities at different centres in the city and suburbs.

The present article traces the formation of the Indian Psychiatric Society and the progress of post-graduate training in psychiatry in India in general and Mumbai in particular. It covers the standard of psychiatric education, the goals and recommendations for improvisation of residency programmes, and the future of post-graduate psychiatric training.

A review of the literature regarding psychiatric thoughts in ancient India is attempted. Besides interesting reading, many of the concepts are still relevant and can be used in day-to-day practice especially towards healthy and happy living. Certain concepts are surprisingly contemporary and valid today. They can be used in psychotherapy and counselling and for promoting mental health. However, the description and classification of mental illness is not in tune with modern psychiatry.

Jaina religion has existed for thousands of years. Lord Mahavir was the last of the 24 Tirthankaras, 23 having preceded him. The principals of Jaina religion teach us: (1) Self-control, which includes: (a) Control over physiological instinct of hunger and sex; (b) control over desires; (c) control over emotions; (2) meditation; (3) introspection; (4) concentration; and (5) healthy interpersonal relationship. The principles of Jaina Religion can contribute to Positive Mental Health.

The paper discusses the issue of doctor-patient relationship in view of a changing world with special emphasis on mental health professionals. It takes into account transference and counter-transference issues in doctor-patient relationships. It deals with issues pertaining to consent and liabilities, confidentiality and patient protection. Role of a psychiatrist as a leader in the art of communication is touched upon. In the end issues about professional fees and ethics too is dealt with.

This paper highlights the mental health needs of the elderly. It tackles the issues of their institutionalisation and community care. Rapid urbanisation in Indian society throws up special problems in elderly care. There is great evidence of a raise in morbidity, mortality, hospitalisation and loss of functional status related to common mental disorders in the elderly patients. Overlap of depression and anxiety is very common with up to almost half of the elderly patients reporting significant depressive and anxiety symptoms. Also, depression is the most common psychiatric disorder in late life. Growth in the elderly population means a direct increase in age related diseases such as dementia and poor mental health outcomes such as depression, anxiety, suicide and serious constraints on the quality of life among elderly individuals. The need to identify new and unmet problem areas and develop efficient therapeutic outcomes for this special population is stressed.

This Presidential Address of the Bombay Psychiatry Society covers the state of psychiatry in India in 1997. It posits that with the advent of newer brain imaging technologies in India such as computerised tomography, magnetic resonance imaging, single photon emission computerised tomography and brain electrical activity mapping, an era of evidence-based psychiatry in India has arrived. The Address cautions against the dehumanising potential of excessive reliance on technology. The need for a greater emphasis on psychiatry during undergraduate medical education is discussed along with the need to destigmatise psychiatric disorders. Finally, the need to encourage quality research in psychiatric disorders is stressed.

It is important that every citizen knows the law of the state. Psychiatry and law both deal with human behaviour. This paper attempts to highlight the interplay between these two by discussing about various legislations like The Family Courts Act 1984, Narcotic Drugs and Psychotropic Substances Act 1985, Juvenile Justice Act 1986, Consumer Protection Act 1986, Persons with Disability Act 1995, The Maintenance and Welfare of Senior Citizens Act 2007.

This paper talks of support systems for mental health professionals wherein the Bombay Psychiatric Society (BPS) should devote some meetings exclusively to problems pertaining to the profession, e.g., long and odd working hours leading to potentially hazardous practice schedules, unhealthy competitive attitudes and culture. A crash course in self-defence against potentially psychotic patients and drug addicts is advocated as also awareness of the potential hazards in dealing with the litigious paranoid patients, erotomaniacs and some of the difficult hysterical patients. Potential medicolegal problems arise in treating an uncooperative patient without his knowledge and consent on an outpatient department basis, admitting such an uncooperative patient to a nursing home or a hospital, administering electroconvulsive therapies, maintaining detailed clinical records of patients, and legal issues involving smaller psychiatric private nursing homes. This paper stresses on the use of Yoga as a recognised psycho-physiological therapy. Furthermore, it suggests on the need for BPS, as a professional body, to have a cell to guide and help aspiring young professionals in setting up private practice. It points out the need to evolve some concrete programmes that in the long run should help alleviate stresses and strains and promote positive comprehensive health amongst mental health professionals.

Child Psychiatry has always described disorders of childhood. Parents form an important dimension of Child Psychiatry since they present the child's behaviour before the therapist. Modern life is full of increasing competition among children, thereby increasing stress among children as well as parents. Modern parents are overly aware, concerned and anxious about their children's future. As a result children get under the pressure of comparison, competition, ambition and goal-setting. All this typically results in the vicious cycle of parental pressures, miscommunication, generation gap etc. No textbook gives clear-cut guidelines about practical aspects of parenting, which is more an art than a science. Dealing with parents in therapy has to take into consideration their psychological make-up and the way it relates with the child. For professionals it is important to empathise with the parents in therapy and at times to share their own experiences of parenting.

The family is an integral part of one's life. It is very essential that every individual employed or unemployed invests time therein. The family is a source of support and growth for an individual, and the lack of family support or loneliness may be a causative factor in the genesis of psychiatric disorders, especially depression. In India, family plays a paramount role when it comes to mental health of the individual. Tips on how one should invest time in one's family along with the role of a family in one's personal and social structure are discussed.

Psychiatry and crime are linked in certain ways. On one hand, we have criminal offenders with serious psychopathology; and on the other hand, we have psychiatric patients who may commit criminal offences during the influence of a psychiatric disorder. The psychiatrist in practice has to come in contact with the criminal justice system at some point of time in his career. Forensic psychiatry under whose realm these issues reside is a branch yet underdeveloped in India. The present paper reviews the inter-relationship between crime and psychiatry and the factors involved therein.

When caught in the dilemma of career choice, a critical conversation helped the writer crystallize the decision to plunge into the field of mental health. The decision just not only kindled interest in psychiatry but passion to study the science of the mind despite the fact that in earlier times psychiatry mainly catered to patients with chronic schizophrenia and uncontrolled bipolar disorder. Weathering the curious glances of colleagues the writer pursued to explore the field of the science of the mind. Not restricting himself to classical trends in private practice, he explored every opportunity to reach out to the common man through writing articles in popular newspapers and also ran a TV Show to respond to people's queries on mental health. He further ventured into training and development of young MBA aspirants and trained himself into an international coach and facilitator. The science of Behavioural Economics beckons him now.

Psychiatric Societies and Associations have variegated roles and functions. They provide their members an academic resource and a place for social networking. They also have responsibilities to the profession and to the community they serve. The nature of work they conduct should be aligned to the needs of all stakeholders. Only when there is such harmonious working will the community respect the fraternity and the Association. We, therefore, need to respond to the need of the hour, which in the current time is prevention of suicide in children and adolescents and facilitation of continuing professional development for our members.

Sports helps an individual much more than in the physical aspects alone. It builds character, teaches and develops strategic thinking, analytical thinking, leadership skills, goal setting and risk taking, just to name a few.

Mumbai, like any other Metro city, has its own share of contentious issues influencing psychiatric management. These could be old ongoing issues like myths about medications, electroconvulsive therapy and counselling, or newer ones like our stand on homosexuality and crime related to psychosocial factors. A range of these issues is considered in this paper along with some possible solutions. Getting due credit and status for psychiatry as a medical branch is also a challenge we need to address.

The significance of mental health in the entire health scenario has increased. However, the representation of psychiatry in the current MBBS curriculum for undergraduate students in India still remains much less than desirable. Further, stigmatising attitudes lessen these future doctors' ability to detect and manage patients with psychological problems despite adequate knowledge about psychiatry. Students believe that psychiatrically ill patients are unpredictable and can be dangerous to others. Some feel that psychiatry is unscientific, imprecise and treatment is not effective. Traditional teaching methods are directed more towards imparting knowledge than changing the attitudes of students. Newer teaching and assessment techniques should be used to bring about attitudinal changes and develop interest among medical students. Case based and problem based learning, small group teaching, simulated patients, using movies, multidisciplinary seminars, integrated teaching, attitude questionnaires, objective structured clinical examinations etc., could be introduced in the curriculum to achieve this objective.

There are a number of spoofs and light-hearted writings in blogs, journalistic pieces and book form (even from former Nobel Laureates), which attempt at 'understanding' the secret of getting a Nobel. This is not one of them. It is more pedantic without necessarily being dry. It first analyses the meaning of the concept, 'the greatest benefit of mankind', which is the crux of the Nobel Will and the overarching requirement for a Nobel in Medicine.Further discussion in the paper is divided into 5 parts:

1. General qualities for a Nobel: The need to be really bright is a given; what is necessary is to be sufficiently crazy about a research topic to make it an obsession; be ready to forgo many creature comforts for long stretches of time; and after all this, be ready to accept that the Nobel may never happen, yet continue to do a type of research solely because it is intrinsically worth doing.
2. Nobel in Physiology or Medicine: Here, the key is to do fundamental/basic research to answer persistent, nagging, unanswered questions of medicine which others neglect because they are discomforting. Or, find treatments that change the whole manner a disease has been hitherto treated.
3. Nobel in Psychiatry: There are many Nobels waiting to be won, provided: (a) The branch becomes more precise; (b) Science, quantitative study and biology remain its bedrock; and (c) There is an almost obsessive preoccupation with unravelling the mysteries of the brain. One has to choose wisely where to put in efforts, e.g., fields like fundamental research into the causes of psychiatric disorders, especially schizophrenia, depression, bipolar disorders. Or their definitive treatments. Or, work at the cellular or molecular level of the neuron and brain; or, the glandular or genetic level of the systems connected with psychiatric disorders; or, in brain radio imaging. If other, or allied, fields are chosen, to work with finding quantitative data and attempt to pinpoint their precise biological correlates.
4. Indian Nobel in Medicine: There is first the need to give up the colonial mindset that everything trend-setting in science comes only from the West. As also, for Departmental Heads, to protect and nurture those with research excellence rather than the mediocre and the sycophants. For governments, to set up an autonomous Research Excellence Council to expressly and exclusively cater to promoting research excellence, with a sizeable fund to put this into practice.
5. All these four points are summarised as four rules.
6. Indian Nobel in psychiatry: Practical suggestions are presented in the form of an 11 Point Action Plan based on 1-4 above.