Unit 1

Clinical Psychology and its Scope

The field of Clinical Psychology integrates science, theory, and practice to
understand, predict, and alleviate maladjustment, disability, and discomfort as well as
promote human adaptation, adjustment, and personal development. Clinical Psychology
focuses on the intellectual, emotional, biological, psychological, social, and behavioural
aspects of human functioning across the life span, in varying cultures, and at all
socioeconomic levels.

Clinical psychology is the psychological specialty that provides continuing and

comprehensive mental and behavioural health care for individuals, couples, families, and
groups; consultation to agencies and communities; training, education and supervision; and
research-based practice. It is a specialty in breadth — one that addresses a wide range of
mental and behavioural health problems— and marked by comprehensiveness and integration
of knowledge and skill from a broad array of disciplines within and outside of psychology
proper. The scope of clinical psychology encompasses all ages, multiple diversities, and
varied systems.

"The field of clinical psychology integrates science, theory and practice to understand,
predict, and alleviate maladjustment, disability and discomfort as well as to promote human
adaptation, adjustment, and personal development. Clinical psychology focuses on the
intellectual, emotional, biological, psychological, social, and behavioural aspects of human
functioning across the life span, in varying cultures and at all socioeconomic levels"( society
of clinical psychology, 2002).

Specialised knowledge

● Understanding of psychopathology and mental health across the lifespan

● Ability to assess cognitive, behavioural, emotional, and interpersonal functioning, and
to integrate and synthesise test data with observations, interviews, and other data
sources
● Ability to conduct psychological and behavioural intervention to improve health and
functioning using a wide range of evidence-based interventions
● Ability to conduct, disseminate, and implement research on a range of clinical
psychological processes
● Establishment and maintenance of therapeutic relationships and communication with
a broad diversity of populations
● Ability to recognize and respond to ethical, legal, regulatory issues as they pertain to
the practice of clinical psychology
● Understanding of professional expectations that guide behaviour, promote self-
reflection, integrity, and accountability
 ● Awareness and understanding of how developmental stages and life transitions
intersect with the larger bio sociocultural context, how identity evolves as a function
of such intersections, and how these different socialisation and maturation
experiences influence worldview and identity

Problems addressed
The specialty of clinical psychology addresses behavioural and mental health issues faced by
individuals across the lifespan including:

● Adjustment issues and traumatic stress reactions

● Emotional and psychological problems, including serious mental illness and crisis
intervention
● Interpersonal or social problems and dysfunction
● Behavioural problems including substance abuse and dependence
● Intellectual, cognitive, and neurological conditions

Populations served
Clinical psychologists provide services to individuals, couples, and families across the
lifespan, and populations from all ethnic, cultural, and socioeconomic backgrounds. The
problems or needs addressed range from minor adjustment issues to serious mental health
problems. Clinical psychologists work with groups and communities to address or prevent
problems and intervene in organisations, institutions, and communities to enhance people’s
effectiveness and well-being.
Skills and procedures utilised

● Assessment using interviewing, behavioural assessment, administration and

interpretation of psychological test measures
● Intervention using a range of evidence-based approaches for individuals, families, and
groups
● Supervision and training of students and other trainees as guided by theory and
research
● Consultation with a range of health and behavioural health professionals and
organisations

Overview of the profession and practice

Characteristics of Clinical Psychology

1. Emphasis on Science: Psychology is the branch of science that is devoted to studying
and understanding behaviour. As a subdiscipline of psychology, clinical psychology is
imbued with the values and assumptions of science. In addition to the scientific
assumptions that pervade clinical psychology, clinical psychology is a discipline that
 employs and values scientific methods. As such, there is a strong emphasis upon
research in clinical psychology. Many but not all clinical psychologists do research.
However, even those who do not are taught to value research and to apply knowledge
gained through research to address practical problems.
2. Emphasis on Maladjustment: Clinical psychology is a specialty within psychology
that concerns itself with abnormal behaviour and emotional suffering. For the most
part, clinical psychology concerns itself with problems with which human beings
struggle. As researchers, clinical psychologists apply scientific methods to understand
how problems such as phobias, self-induced vomiting, compulsive gambling, and
many others develop and are maintained. As clinicians, psychologists seek to
understand the problems their clients experience and apply that understanding to help
them gain relief. The focus upon “maladjustment, disability, and discomfort” is one of
the characteristics that sets clinical psychology apart from other subdisciplines of
psychology.
3. Emphasis on the Individual: Psychology, as a science, seeks to understand the general
relationships among variables that govern behaviour. That is, psychology is interested
in understanding behaviour at a nomothetic level. Clinical psychology is interested in
this level of understanding. However, the emphasis in clinical psychology is upon
how general principles can be applied to understand the individual. This idiographic
level of understanding is central to the practice of clinical psychology. Clinical
researchers have also found that the degree of social support and the range of coping
strategies that a new mother has influence whether she becomes depressed and the
severity of depression. This nomothetic information is used by the clinical
psychologist to develop an idiographic understanding of the client referred for
postpartum depression. What are the significant stressors faced by this woman? How
does she cope? Who supports her? With the answers to these and other questions, the
clinician develops an understanding of this particular woman’s experience of
postpartum depression. Treatment is based upon this idiographic understanding.
4. Emphasis on Helping: Many disciplines within psychology apply a scientific
approach to understand human behaviour (e.g., personality, social, cognitive
psychology). Other disciplines, most notably psychiatry, are concerned with human
maladjustment. And there are, of course, many other helping professions (e.g.,
medicine, nursing, social work). It is the integration of these characteristics within a
single discipline that distinguishes clinical psychology. Clinical psychology applies
the assumptions and methods of psychological science to problems of human
behavioural, emotional, and mental functioning to better understand and treat these
problems.

History and Growth

Ancient Roots
- First, as clinical psychology is a discipline involved in studying and treating mental
disorder, it is worth noting that awareness of mental illness, as distinct from physical
illness, can be dated as far back as 2100 B.C. to the ancient Babylonians
- In fact, most ancient cultures, including those in South and Central America as well as
the ancient Hebrews, recognized and attempted to treat mental disorders. Typically,
mental illness was viewed from a religious perspective, and treatments such as prayer,
wearing of amulets, or religious rituals were used. It is interesting to note, however,
that despite the religious lens through which psychological disorders were viewed,
some ancient writings suggest recognition of psychological factors and treatment. For
example, foreshadowing Freud, ancient Hebrew scholars viewed dreams as
expressions of unacceptable wishes and recommended unrestrained communication
about one’s worries and troubles
- Western cultures traditionally trace the roots of medicine and philosophy to the
ancient Greeks. A predecessor of contemporary thought about the biological bases of
mental illness (see Chapter 4) can be found in the writings of Hippocrates (c. 446–377
B.C.), who hypothesized that psychopathology resulted from imbalances in one or
more of the four bodily humors: blood, black bile, yellow bile, and phlegm. An excess
of black bile, for example, was considered to be the source of melancholy
(depression). The term melancholy means “black bile” in Greek (Routh, 1998).
Hippocrates also organized mental conditions into types, some of which are still in
use today. Phrenitis was use to describe the condition in which a person had a high
fever and talked nonsense. The condition cleared when the fever subsided. Mania
described the person who was acutely agitated in the absence of fever. Hysteria was
used to describe women who presented with vague or difficult-to-understand bodily
complaints. Paranoia described the person whose thinking was bizarre in the absence
of fever.
- The writings of the Greek philosophers also foreshadowed ideas that would reappear
centuries later in psychiatry and clinical psychology. Socrates (c. 470–399 B.C.)
believed that the answers to all questions lay inside the individual and wrote about the
healing powers of speaking and self-expression (Brems et al., 1991). Plato’s (c. 428–
347 B.C.) writings about the soul are strikingly similar to Freud’s ideas about
personality. Plato believed the soul had three levels, the logistikon (residing in the
head and responsible for logic and reason), the thumos (residing in the chest and
responsible for courage and aspirations), and the alogistikon (residing in the stomach
and responsible for instincts and appetites) (Brems et al., 1991). Finally, Aristotle (c.
384–323 B.C.) believed in the healing power of words spoken by patients with mental
disorders. All three of these well-known Greek philosophers advocated for humane
treatment of the mentally ill.
- The Greek philosophers were, of course, not the only ancient scholars to study and
theorise about mental illness. Mental disorders, like all forms of illness, result from an
imbalance of the powers of “yin” and “yang,” according to the Yellow Emperor’s
Book of Internal Medicine, which was published in China in the second century B.C.
(Routh, 1998). This book includes descriptions of traditional Chinese medical
treatments including some, such as acupuncture, that are still in use today.
- In Europe, the link was clearly broken during the Dark Ages. Medieval Europe saw a
deterioration of science and philosophy and the ascendance of religion. Mental illness,
like most everything, was viewed through a religious lens. Psychopathology was
 understood as the product of demonic possession or other supernatural forces.
Following from this point of view, religious rituals were the treatment of choice.
- Although religious thinking about the causes and treatment of abnormal behaviour
did not recede quickly, the Renaissance saw the reemergence of a scientific and more
humanistic approach to people with mental disorders. Important figures during this
period of time included Paracelsus (1493–1541) and Johann Weyer (1515–1588).
Both men were physicians who rejected spiritual causes of psychological and
emotional difficulties. Paracelsus introduced a completely biological approach to
mental illness. He argued that human behaviour could be understood as a function of
biological processes. He practised a form of medicine that was similar to what we
might call homoeopathy today (Brems et al., 1991). Weyer made a careful study of
individuals identified as sorcerers and witches and was successful at discerning
physical causes for their unusual behaviours. Through his observations, Weyer
developed a sophisticated descriptive classification system that included toxic
psychoses, senile psychosis, hysteria, delusions, paranoia, depression, and epilepsy
- Lightner Witmer founded the first psychological clinic at the University of
Pennsylvania in 1896, and that is the year most scholars recognize as the birth of
clinical psychology

Eighteenth and Nineteenth Centuries: Laying the Groundwork for Clinical Psychology

In the eighteenth and particularly the nineteenth centuries important social and scientific
developments set the stage for the birth of clinical psychology. Four areas that laid the
foundation for clinical psychology were improved understanding of mental disorders,
scientific approaches to the measurement of individual differences, the emergence of
scientific psychiatry, and the concept of hysteria and the ascendance of psychological
determinism.

Understanding Mental Disorders

- By the eighteenth century, mental illness, or “madness,” was generally accepted as
falling under the purview of the medical profession. With the acceptance of the
medical model came the development of psychiatry as a speciality branch of
medicine. The early pioneers of psychiatry included Benjamin Rush (1745–1813) in
the United States, Philipe Pinel (1745–1826) in France, Vincenzo Chiarugi (1759–
1820) in Italy, and Francis Willis (1718–1807) in England. The mentally ill were
housed in asylums, where they were often chained or otherwise restrained. In most
asylums beatings were common, and patients were ridiculed and mistreated by their
guardians. They were fed the coarsest of slops. Visits by physicians were infrequent
and “treatment” usually consisted of some method of adjusting bodily fluids including
purges, bloodletting by leeches or other means, and vomits.
- In the late eighteenth century, significant efforts were made to reform the way in
which the mentally ill were treated. This shift in treatment philosophy has come to be
known as the moral treatment movement. This movement was initiated, nearly
 simultaneously, by Phillipe Pinel in France and William Tuke (1732–1822) in
England.
- By the mid nineteenth century, numerous institutions in the United States were
employing moral treatment. However, within twenty years, most institutions had
abandoned the tenets of moral treatment and had evolved into custodial institutions
for housing the chronically mentally ill.
- Although it predated clinical psychology, the moral treatment movement is significant
for the field because it anticipated a shift from a purely medical to psychological
treatment. In addition, it facilitated the development of institutions devoted to the
treatment of the mentally ill. Finally, the moral treatment movement was instrumental
in shifting societal views of the mentally ill from useless individuals who needed to be
ostracised from society to a more humanistic view of the mentally ill as human beings
deserving of compassion despite their irrationality

Measurement of Individual Differences

- One of the important figures in the early history of psychological testing was Sir
Francis Galton (1822–1911).Galton was one of the first to advocate for, and practice,
a scientific approach to the measurement of individual differences (i.e., the dispersion
of characteristics in the population).
- With respect to the history of clinical psychology, one of the most important people
inspired by Galton was James McKeen Cattell (1860–1944). Cattell, an American,
had received his doctorate in 1886 in the laboratory of Wilhelm Wundt in Germany,
where his dissertation focused upon individual differences in reaction times.

Emergence of Scientific Psychiatry

- During the nineteenth century there was a growing faith in science and the scientific
method. It was in this context that scientific psychiatry emerged as a legitimate
discipline.
- The nineteenth century saw the initial identification, naming, and detailed description
of several major psychiatric conditions. For example, J. Langdon Down described a
syndrome involving mental retardation that continues to bear his name. General
paresis was identified as a syndrome caused by syphilis. Ewald Hecker published a
monograph on hebephrenia, describing its symptoms and deteriorating course.
- Probably the most significant nineteenth-century contributor to the development of
modern psychiatry was Emil Kraepelin (1855–1926), who published the first edition
of his textbook on psychiatry in 1883. In the textbook, which would eventually go
through eight editions, Kraepelin provided a rich and detailed description of dementia
praecox, a syndrome marked by hallucinations, delusions, progressive deterioration in
intellectual functioning, and incongruent emotional expression.
- Kraepelin differentiated dementia praecox from manic-depressive illness. The former
condition was believed to have endogenous causes (i.e., due to inherent, constitutional
factors), while the latter was an example of a condition he thought was due to
exogenous factors (i.e., caused by external conditions).
 - The emergence of scientific psychiatry helped set the stage of clinical psychology in a
variety of ways. First, improved classification created a need for improved methods of
making differential diagnoses. Assessment, as we will see, is one of the cornerstone
activities of clinical psychology. Diagnostic assessment was one of the first practical
problems psychological tests were developed to address. Second, the differentiation of
mental retardation from other psychiatric conditions created a need for valid
instruments for assessing intellectual functioning. Third, psychiatric classification
systems, most notably Kraepelin’s, identified some psychiatric conditions that may
have non-biological causes. The most important psychiatric syndrome for which non-
biological causes were considered was hysteria.

The Birth of a discipline: 1890-1910

- In the 1890s psychology was a young but rapidly growing science. The first
psychology laboratories had been established in 1879 by Wilhelm Wundt (1832–
1920) at the University of Leipzig in Germany and William James (1842–1910) at
Harvard University in the United States.
- In 1896, Witmer established the world’s first psychological clinic. The clinic worked
primarily with children who were having difficulties in school.
- Witmer was the first to formally propose a new helping profession, distinct from
medicine and education, to be called clinical psychology. He established the field’s
first journal, the Psychological Clinic, and was its first editor.
- Alfred Binet was another important figure in the birth of clinical psychology. In
1889 he co-founded the first psychological laboratory in France as well as the first
French journal of psychology. Binet received a doctorate of sci ences degree in 1894
and in 1895 became director of the psychology laboratory he had co-founded.
- In 1904, the Minister of Public Instruction in Paris appointed a commission to study
how to best serve the needs of impaired children in the educational system. The plan
was to develop special classes to assist these children. The problem faced by the
commission was how to identify the children who could not benefit from instruction
in the regular classroom. Binet, along with Theodore Simon (1873–1961), the chief
medical doctor of an asylum in Paris, offered to assist with the problem. The product
of their collaboration was the 1905 Binet-Simon scale
- Another important development in this time period was the creation of the first pro
fessional organization for psychologists in the United States. The American
Psychological Association was founded in 1892 by G. Stanley Hall and six other
“rugged pioneers.”

World War I through World War II

- When the United States entered WWI, APA president Robert Yerkes (1876–1956)
formed a committee to work with the Army to develop methods of classifying recruits
according to their abilities. Among the more important products of the group’s work
was the development of two group administered tests of intelligence called the Army
Alpha and the Army Beta. The Alpha test was a verbal scale for use with English-
 speaking recruits. The Beta was a nonverbal test of intelligence that was developed to
assess men whose primary language was not English.
- Individually administered tests of mental abilities were also developed. Lewis
Terman revised the Binet scale, collected normative data from a sample of children
and adults in the United States, and published the Stanford-Binet Scale in 1916.
- In 1921 Herman Rorschach (1884–1922) published Psychodiagnostik, in which he
described a method of diagnosing patients, and characterising features of their
personalities, based upon their responses to a set of ten ink blots.
- World War II triggered another growth spurt in psychological testing. Once again,
psychologists were asked to develop and improve upon tests that could be used for the
evaluation and classification of military personnel.
- The dominant theory in psychiatry and clinical psychology at this point in history was
clearly psychoanalysis.
- Outside of psychoanalysis, other important theory development was occurring around
this time. In Russia, Ivan Pavlov (1849–1936), a physiologist, was doing his landmark
work on classical conditioning.
- Although not initially aware of Pavlov’s work, John B. Watson (1878–1958) initiated
a new branch of psychology, behaviourism, with an article entitled “Psychology as a
Behaviorist Views It”. Watson is considered the founder of U.S. behaviourism.

Post WWII
- By the end of WWII the APA’s interest in clinical training had changed
dramatically. The organisation responded to the demand for clinicians that followed
the war.
- Beginning in 1948, the APA started to accredit doctoral training programs in clinical
psychology. Shakow’s committee had specified that accredited programs were to be
site-vis ited every five years by two or more psychologists who would evaluate the
training program.
- Taking the year 1950 as a rough jumping-off point, we trace developments up to the
present in the following areas: training, psychother apy, psychological testing,
professional practice, specialization, and growth.

Professional Role and Functions

Clinical psychologists are involved in research, writing, teaching, assessment, consultation,
administration, and other professional activities
1. Research: Most clinical psychologists are products of graduate programs that include
extensive training in research design, methods, and statistics. Clinical psychologists
who train in traditional scientist-practitioner programs (see section on training) must
conduct at least one piece of original research in order to obtain their degree. In fact,
training in research is one of the characteristics that distinguishes clinical psychology
from most other helping professions.
2. Teaching: Clinical psychologists are engaged in a variety of forms of teaching. About
50 percent of clinical psychologists report that they spend some portion of their
 professional time teaching (Norcross et al., 1997b). Between 15 and 20 percent are
employed as professors at colleges, universities, and other academic institutions
(American Psychological Association, 1999; Norcross, Karg, & Prochaska, 1997a).
Clinical psychology professors typically teach courses that are within the domain of
clinical psychology. Clinical psychologists work with graduate students to help them
develop clinical skills in assessment, psychotherapy, or other applied activities (e.g.,
consultation). Clinical supervision includes didactic instruction in the theoretical and
empirical basis for clinical activities but also draws from the clinical supervisor’s own
experience. Clinical supervision might take the form of modeling interviewing, testing
or therapy skills, observing the trainee, listening to audiotape recordings of therapy
sessions, or critiquing videotaped sessions along with the supervisee. Clinical
supervisors often need to help supervisees manage their own anxiety about clinical
work or to work through feelings aroused by the client. Clinical psychologists who do
not hold academic positions are also frequently involved in teaching. Psychologists
are often called upon to do in-service training for other helping professionals or
paraprofessionals. For example, a clinical psychologist might provide tele phone
hotline volunteers training in crisis intervention. Psychologists may train medical
students in basic interviewing skills or teach a group of lawyers about the limitations
of psychological tests. Clinical psychologists also often share their knowledge with
psychol ogists and other professionals through continuing education workshops or
grand rounds presentations.
3. Psychotherapy: Psychotherapy involves helping people to understand and resolve
problems. The term psychotherapy encompasses a broad array of psychological
interventions including behaviour modification, individual counselling, family
therapy, parent training, and others. The proto type for psychotherapy is a one-on-one
meeting between the therapist and client to discuss the client’s problems. This form of
therapy, referred to as individual psychotherapy, is the most common form of therapy
engaged in by clinical psychologists (Norcross et al., 1997b), but it is not the only
form of psychotherapy. Therapy can include meetings in groups, with couples, or with
extended families.
4. Assessment: After psychotherapy, psychological assessment is the most frequently
engaged in activity by clinical psychologists (Norcross et al., 1997b). Psychological
assessment involves collecting information about people’s behavior, interests,
emotions, thoughts, intelligence, interpersonal styles, and so on and integrating this
information to develop a greater understanding of the person. Clinical psychologists
use interviews, psychological tests, and observations to collect the data upon which
they base their assessments.
5. Consultation: When functioning in the role of consultant, a clinical psychologists
may utilize skills in teach ing, research, assessment, or even psychotherapy. Clinical
psychologists are often hired by organizations to provide advice and share their
expertise. A school might hire a clinical psy chologist to evaluate students who
present significant behavior problems. The psychologist evaluates students and then
works with the staff to design learning environments that best suit to the students’
needs. A clinical psychologist might consult with a pediatric oncology center to
 develop strategies to help patients comply with unpleasant medical procedures. In a
business setting, a clinical psychologist might be hired to help employees learn to man
age stress.
6. Administration: Although not the most glamorous of professional activities, many
clinical psychologists find themselves holding administrative responsibilities as their
careers develop. At univer sities, clinical psychologists are department chairs, deans,
vice presidents, and presidents. Psychologists also frequently occupy administrative
positions in hospitals, clinics, and men tal health agencies. On average, clinical
psychologists report spending about 10 percent of their time with administrative
duties

Unit 2
• According to the Centers for Disease Control (CDC), mental illness refers to “conditions
that affect a person’s thinking, feeling, mood, or behavior.” These can include but aren’t
limited to depression, anxiety, bipolar disorder, or schizophrenia.

• Mental health reflects “our emotional, psychological, and social well-being.” Affecting
“how we think, feel, and act,” mental health has a strong impact on the way we interact
with others, handle problems, and make decisions.

• Mental health is the ability to “cope with and adjust to the recurrent stresses of living in
an acceptable way” (Anderson K N, Anderson LE & Glanze, 2002).

• The World Health Organization (WHO 2005) has recently defined mental health as “a
state of well-being in which the individual realizes his or her own abilities, can cope with
the normal stresses of life, can work productively and fruitfully, and is able to make a
contribution to his or her community”.
• Mental health is all about mental well-being.

• According to the World Health Organization (WHO), someone who is mentally well can
realize their potential, cope with normal stressors and contribute to their community in a
productive way.

• Mental health is about physical, mental and social well-being.

• Good mental health allows someone to live a fulfilling, satisfying life while dealing with
everyday challenges.
Historic views on Mental Health
• Early societies believed that everything is nature was alive with spirits.
• Illness was thought to be caused by the worth of evil sprits. People with mental
illness were possessed by the demons or forces of evil.
• Treatments focused on removing evil sprits, magical therapies includes
frightening masks and noises, incantations, vile odors, spells etc used.
• Physical therapies includes trephining-cutting holes in the skull to encourage the
evil sprits to leave- massage, bleeding, induced vomiting etc
• Hippocrates was the first to base treatment on the belief that nature has a strong healing
force.
• He proposed the humoral theory of disease.
• According to this theory mental illness as a result of an imbalance of humors- the
air, the fire, the water and the earth
• Each basic element had a related humor or part in the body.
• An imbalance in the humors resulted to illness.

• Plato- life is a dynamic balance maintained by the soul- “irrational soul” in the heart and
“rational soul” in the head.
• If the rational soul was unable to control the undirected parts of the irrational
soul, mental illness resulted.

• As like Greece, Romans also believed that demons caused illness.

• But the Romans showed little interest in learning about the body or mind.
• They treat the patients with pleasant physical therapies such as warm baths,
manage, music and peaceful surroundings.

• In China- the mental illness was rarely diagnosed because they believed that it lost their
status in the society.
• The illiterate interpret the mental illness as the entering of supernatural power and
exorcism was the common treatment.

• In India , according to Sigerist’s (1945) account many persons receive medical care for
physical and mental illness from indigenous practioners; mainly followed by the principle
of Ayurveda.

• Ayurveda has duly recognized the individuality of manas (psyche) and sarera (body) and
their inseparable and interdependent relationship in a living body. Emotional
disturbances, volitional transgression, unwholesome food are said to be the causes of
mental disorders, in general
• From 500CE-1100 CE, church developed into a powerful institution.
• Early Christians believed that the mental illness was either the punishment for
sins, possession or the result of witch craft.
• To cure the mental illness the priest performs demonic exorcisms- religious
ceremonies in which patients were physically punished to drive away the evil
possessing sprits.

• The first English institution for mentally ill people was initially founded in 1247:
Bethlem Founded by Alderman Simon FitzMary.
• By 1330, Bethlehem Royal hospital had developed into a lunatic asylum that
eventually became infamous for it’s brutal treatments.
 • Philippe Penal liberated patients from their 24 chains and accepted them as
human beings in need of medical assistants, nursing care and social services.

Mental Health and India

• INDIA- The earliest mental hospital in India was established at Bombay in 1745,
• which was made to accommodate around 30 mentally ill patients. Surgeon
Kenderline started one of the first asylums in India in Calcutta in 1787.

• Later, a private lunatic asylum was constructed, recognized by the Medical Board under
the charge of Surgeon William Dick and rented out to the East India Company.[12]
• The first government run lunatic asylum was opened on 17 April 1795 at
Monghyr in Bihar, especially for insane soldiers.[14] The first mental hospital in
South India started at Kilpauk, Madras in 1794 by Surgeon Vallentine Conolly.
• During this period, excited patients were treated with opium, given hot baths and
sometimes, leeches were applied to suck their blood. Music was also used a mode
of therapy to calm down patients in some hospitals.[19] The mentally ill from the
general population were taken care of by the local communities and by traditional
Indian medicine doctors, qualified in Ayurveda and Unani medicine.

• Mental Asylum at Ranchi first opened in 1918 as a hospital for European patients.

• Berkeley-Hill not only helped to raise the standard of treatment and care, but also
persuaded the government to change the term ‘asylum’ to ‘hospital’ in 1920.

• the origins of psychiatric rehabilitation in India can be traced to innovative service

programs, which were initiated at the Central Institute of Psychiatry (CIP) in 1922.
• A library on mental health started in 1918 at CIP with 300 books and journals
which dated back to 1910.

• The first psychiatric outpatient service, precursor to the present-day general hospital
psychiatric units (GHPU), was set up at the R.G. Kar Medical College, Calcutta in 1933
by Ghirinder Shekhar Bose.
• Dr. Benjamin Rush was the important figure in 19th century-
• he advocated clean conditions, good air, lighting, food and kindness.
• As a result of his efforts mentally troubled patients were no longer caged in
basements of general hospitals.

• Dorothea Dix was another prominent figure of moral treatment.

• Dix fought for the rights of mentally ill people.
• Dix’s efforts helped for the construction of 30 mental hospitals throughout U. S
and the care of mentally ill were greatly improved.
• Emil Kraeplin
• developed the taxonomy of mental disorders in 1896.
• He proposed the disease model of abnormality, was subjected to analysis and
considered normality to be relative to physical, geographical and cultural aspect of
define group.
• Later the classification system of mental health disorders was developed on the basis of
WHO’s ICD (ICD: WHO 1992), this is in it’s eleventh version (ICD-11).
• The first international classification edition, known as the International List of
Causes of Death, was adopted by the International Statistical Institute in 1893.
• ICD helps for the identification of health trends and statistics globally, and the
international standard for reporting diseases and health conditions.
• It is the diagnostic classification standard for all clinical and research purposes.
• The chapter ‘F’ classifies psychiatric disorders as metal behavioural disorders,
code them on as alphanumeric system from F00 to F99.