# 11 National Institute of Mental Health and Neurosciences

Interview with Director NIMHANS Dr B N Gangadhar and Clinical Neuropsychologist Dr Shantala Hegde

The National Institute of Mental Health and Neurosciences traces its origins right back to the early 19th century when the first rudimentary attempts at addressing mental health issues were made in India. Today NIMHANS undertakes a wide range of activities in creating awareness and also on destigmatising mental health both within and outside NIMHANS.

As CSP’s Bangalore Global Icons No 11, we have picked Dr G N Gangadhar, Director of NIMHANS and eminent music cognition neuropsychologist at the same institute – Associate Professor Dr Shantala Hegde.

Professor Gangadhar says that NIMHANS was the first Institute created as an exclusive Department of Mental Health Education way back in 1980’s, “to give thrust and to ensure that the awareness activities are conducted continuously. Before NIMHANS, the All India Institute of Mental Health (AIIMH) was recognised as a multi-disciplinary service, as a research and academic facility with the distinction of even establishing ancillary departments such as biochemistry, biostatistics, social work etc. It took a holistic stand on problems related to the mind and brain and the nervous system. In this, NIMHANS mirrored global thinking in its initial years and now continues to be a multidisciplinary organisation which makes it unique. The central government is now modelling other mental health institutions on the lines of NIMHANS as ‘NIMHANS-like’ institutions’.”

Director NIMHANS Dr B N Gangadhar

Spread around 135 acres at the heart of the city, NIMHANS has long been a pioneer in addressing mental health issues. “Public health is one important area where, work at NIMHANS lead to a national program, District Mental Health Programme.  The other areas are Addiction Medicine, Psychiatric Rehabilitation (for which NIMHANS received a national award), Geriatric Psychiatry (Award winning) Women and Perinatal Psychiatry (other countries have emulated this), non-invasive brain stimulation, biological psychiatry including molecular genetics (led to international grants), Child and Adolescent Psychiatry (we serve on national committees), Suicide Prevention, Yoga and meditation in mental health (we recently set up a department of Integrative Health) and also stem cell research,” says Professor Gangadhar.

Asked about the vision of NIMHANS in the coming years, he foresees technology playing an important role in capacity strengthening, providing Mental Health services and Human Resource Development. “This is expected to play an important role in reaching mental health for all.  For this reason NIMHANS has strengthened telemedicine through VKN (Virtual Knowledge Network) and formally created a NIMHANS Digital Academy.  Several hundreds have been trained and accredited by this.  Accordingly the number will cross 1000 in this one year itself.  NIMHANS also foresees a role in a national effort to convert Mental hospitals to Academic institutes to augment trained human resource in the country.”

NIMHANS has been a collaborating centre for the World Health Organisation for a long time.  NIMHANS has regularly participated in international activities through WHO in terms of bringing out health related manuals, training visitors from neighbouring countries who have been deputed by WHO (the latest one will be a team from Maldives in November 2019). Faculty of NIMHANS have been independently invited by WHO from time to time for several academic and clinical agenda, from formulating ICD 11 criteria to inspecting WHO projects in other countries to writing reports/manuals/guidelines et, says Professor Gangadhar.

A large scale nationwide National Mental Health Survey (NMHS) was conducted by NIMHANS which helped in understanding the burden of Mental illness in India. It emphasised the importance of Mental health and also the scope for research in the field of Mental health. NIMHANS has established collaboration and is researching on several specific disorders at international level including in Obsessive Compulsive Disorder, Dementia etc.

NIMHANS Integrated Centre for yoga (NICY), which has been established in the Institute of National Importance i.e. NIMHANS, has been striving to do research on the scientific underpinnings of yoga in both healthy people as well people with various psychiatric and neurological disorders. NIMHANS is conducting an international conference on 26th and 27th of June 2020 titled “Yoga And Neuro-sciences Traditions And Research Approaches” or YANTRA 2020.

At NIMHANS there are both basic science researchers and clinician researchers. Faculty members from both Basic Sciences and Clinical Sciences are carrying out research work in different areas related to Neuroscience and Mental Health on par with what is happening in the global scenario.

Dr Shantala Hegde is a clinical neuropsychologist carrying out clinical and research in two streams – one in the area of Clinical Neuropsychology and Neurorehabilitation and the other in area of Neuromusicology. She is the first Clinical Psychologist in the country to receive the Intermediate Fellowship by the India Alliance DBT Wellcome Trust.

“The CPHI Intermediate Fellowship has given me the opportunity to hone my skills as a clinician, and as a researcher under the mentorship of Professor Dr Gottfried Schlaug (Director, Music and Neuroimaging Laboratory, Stroke Recovery Laboratory, and Division Chief, Cerebrovascular Diseases Associate Professor of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School), a leading researcher in the field of Neurology and Neuromusicology.  I am thankful for this opportunity to pursue my interest to bring the two areas of my interest together, towards helping patients with neurological conditions, in particular, Parkinson’s disease. It is surely the beginning, but worth a journey to look forward to.”

Dr Hegde is faculty in charge of the Music Cognition Laboratory inaugurated in June 2011. This is the first laboratory in India which aims at neuroscientific investigations of music perception and cognition and to study its neural correlates.

The research focus of this laboratory is music cognition and neuromusicology from basic science to clinical application. The aim is to carry out basic science research (on musically trained, untrained healthy participants and various clinical conditions) as well as clinical research examining the effects of music based intervention to other domains of functioning like cognition, language, emotion and overall functionality in various neurological and psychiatric conditions using neurocognitive evaluation, EEG/ERP, fMRI methods.

The laboratory is equipped with sound proof rooms, 64-channel EEG/ERP system, a recording studio with infrastructure and audio system to carry out audio recording and audio-data processing.

“Research work so far has examined musical emotion, music and language, rhythm perception, effect of music on other cognitive processes in musically trained and untrained individuals. The variations in musical rhythm perception in clinical conditions such as Parkinson’s disease, Schizophrenia and effect of music intervention during spinal surgery on levels of anxiety and pain as well as its effect of anaesthetic drug dosage, level of cortisol has been carried out,” says Dr Hegde.

Dr Shantala Hegde (extreme left) with mentor Professor Dr Gottfried Schlaug and team at Harvard

In her study investigating the variations in emotional experience during the different phases of raga elaboration, Dr Hegde found that emotional variations within certain ragas were often larger than between ragas. Indian classical musicians have the ability to strongly vary the expressivity associated with a specific raga in their performances, but within the constraints of the raga framework (Hegde et al, 2012).

In an electroencephalography (EEG) study, 20 musically untrained individuals listened to NICM ragas; they showed increased overall alpha, delta and theta power in comparison with an eyes-closed rest condition. The observed changes during music listening had previously been linked with highly relaxed states, such as meditative states (Hegde et al, 2012).

The world of mental health sciences in India has grown due to the efforts of NIMHANS. From the ‘lunatic asylum’ in the 19th century to the Mysore Government Mental Hospital in 1934, the All India Institute of Mental Health in 1954 and NIMHANS in 1974 to acquiring the status of a Deemed University in 1994 and being bestowed the status of Institute of National Importance through a separate act of Parliament in 2013, NIMHANS has grown in stature and made tremendous strides over the decades.

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