Time's 100 most influential people: India must celebrate doctors like Vikram Patel

Among the 100 most influential people in the world listed by Time magazine on Thursday is an Indian psychiatrist Vikram Patel. He is neither a household name like Narendra Modi nor a favourite of business press like Chanda Kochar - two other Indians who are on the list - but is someone whose work touches millions of lives in India and elsewhere silently. 

Patel divides his time between London, where he is a professor of international mental health at the London School of Hygiene and Tropical Medicine, the Public Health Foundation of India (PHFI) in New Delhi and in Goa, where he runs a community mental health programme through a voluntary group called Sangath.

"We want to put the affected person and his or her family at the heart of science, practice and policy," Patel told me last week in New Delhi, while talking about his work in mental health and his efforts to integrate mental health care along with other chronic conditions. Mental and neurological disorders, he says, are not usually on health system agenda to address non-communicable diseases. "Mental illness often co-occurs with diabetes and hypertension and cancer, and often times they affect each other. For example, depression affects outcome of diabetes. So when you are looking at health system solutions, we need to look at all these conditions together especially in a country like India when you are not going to have a separate health worker for each condition."

Patel has already started putting his unique approach in action through his work with PHFI and the newly established Centre for the Control of Chronic Conditions in partnership with the London School and other national and international centres. 

The epidemiological research conducted by Patel has revealed a high burden of mental disorders in low- and middle-income nations and showed a strong link between mental disorders and poverty. In most poor countries, 90 per cent of people affected by mental illness go untreated because psychiatrists are in such short supply. That's why Patel's emphasis is on training community workers and general practitioners so that they can provide care. "We are developing a mobile app for community health workers to integrate management of diabetes, hypertension, alcohol use and depression," he informed.

Research groups led by Patel in India are engaged in a project on developing a common approach to mental and neurological disorders, and cardiovascular diseases. "We are trying to find out why mental illness and cardiovascular diseases occur together and if there is a common mechanism. For instance, if someone in the family has had a stroke, it is likely that care givers may develop depression. So we need to develop interventions for people to deal with multiple conditions. Though we are working in India, this work will have global significance," according to Patel.

As one of the key architects of the National Mental Health Policy of India released in October last year, Patel has sought to remedy the poor state of mental health care on the country by focusing on universal access to mental healthcare and protection of all rights of the mentally ill.