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Psychiatry

The department was started in 1999 and has expanded into a 30 bedded inpatient unit with community, outpatient, emergency & liaison services. The department has been running a population based community outreach program since 2005.

The multi-disciplinary team also involves the clinical psychologist, social workers, psychiatric nurses, research assistant, EEG technician, ward nurses, community project coordinators and workers.

GOALS & OBJECTIVES

  • To provide accessible and comprehensive clinical services at a tertiary level with links to community and primary care settings.
  • To provide training for Medical Undergraduates and Post graduates ensuring the attainment of necessary competencies.
  • To conduct relevant research that translates into meaningful outcomes.
  • To incorporate practices that ensures the rights of individuals with mental illness.

CLINICAL SERVICES

The department treats individuals with mental health problems such as,

  • Depressive and anxiety disorders
  • Schizophrenia
  • Bipolar disorders
  • Addiction disorders
  • Obsessive compulsive disorders
  • Learning & behavioural disorders
  • Developmental disorders (Mental retardation, Autism) etc.,

Outpatient Service

      Timings (for registration): 8 am to 11.30 am

    • The patient/relative should have a valid contact number.
    • Consultations can be done on all days except Sundays and OPD Closed days.
    Initial consultation
    • People coming for a first time consultation are to bring along a close relative.
    • During assessment, the history will be collected by a junior resident and subsequently you will be seen by a consultant. Psychiatry evaluations usually involve time and can take 1-3 hours approximately.
    • After the consultation, you will be advised to follow up with the same treating team.
      • Prior to and during treatment there may be a need to do some investigations such as blood tests, psychological assessments, assessments for intelligence and learning disorders, etc., as necessary
      • Your treatment may involve therapy with medicines and psychological therapies such as cognitive therapy, behavioural therapy , parent management training, etc
      • A hospital file in your name will be made to record illness and treatment details. You will be provided with a hospital card that bears your name with your hospital id number.
    • People seen in casualty after OPD hours or those reporting late to OPD with non emergency problems, requiring a detailed assessment are called again on the next working day.
    Follow up Consultation
    • Most psychiatry consultations require regular follow up with your treating team/ doctor. Ask your doctor about the regularity of these visits and follow their advice.
    • Patients who may require emergency care and inpatient treatment will be immediately sent to the Psychiatry ward. Emergency care and services will be provided by a psychiatrist and nursing team.
    • Elderly (> 65 years of age), pregnant woman, mothers with very young children and non-ambulatory patients can approach the outpatient nurse so that they can be seen on a priority basis.
Speciality Clinics
    • Child and Adolescent clinic: Timings- Saturday 10.30 am to 1 00 pm Emotional, behavioural, stress related disorders as well as problems related to learning and development in children and the youth are addressed.
    • Deaddiction clinic: Timings - Friday 10.30 am to 1 00 pm Problems related to tobacco use,smoking,pan chewing,cannabis use ,alcohol use, misuse of prescription drugs, opiods etc are dealt with .
    • Geriatric clinics The memory clinic and nueropsychiaty clinic are run as part of an effort to identify and manage cognitive disorders,dementia,depression and anxiety in the elderly.
    • Memory clinic: Timings - Tuesday 10.00 am to 1 00 pm
    • Nueropsychiatry clinic: Timings - Wednesday 10.00 am to 1.00 pm
In-Patient services
  • The duration of inpatient stay can vary depending on an individual patient’s need. Please clarify from your treating doctor the approximate length of your stay
  • In-patient admissions to psychiatry wards are done only when another relative/ family member is available to stay around the clock.
  • Once you/ your relative’s treating doctor decides to admit you, you will be sent to the admission counter to provide details.After this, you will be accompanied to the ward / room.
  • You will be received by the nursing staff who will also explain to you the rules and regulations of the hospital.An intern will be in the ward also
  • You and your relative will have therapy sessions with the Junior residents regularly and will be seen by consultants during rounds and when necessary in the consultant rooms
  • The Residents will discuss any emergencies emerging after regular working hours with your consulting doctor .
  • You may be involved in recreational activities/group discussions/therapy room activities/outdoor assignments as indicated during your stay with us
  • You may also be referred to various other departments depending on your health needs.
  • The discharge date will be discussed with you by the treating doctor in advance. Be sure to make your clarifications with the resident.You/ your relative will be given a discharge summary,indicating your follow up date , with all your treatment details ,as well as a prescription .
Community Outreach services

    Since 2005, a comprehensive population based outreach programme is in place targeting a population of approximately 1,00,000. This is currently embedded in a comprehensive rehabilitation programme for multiple disabilities.It has the following components

  • Door to door screening for individuals with mental health morbidity
  • Monthly outreach mental health clinics by residents/consultants, social workers, coordinators
  • Home based follow-up by community workers for individuals in the programme
  • Outcome monitoring on multiple parameters for individuals in the programme
  • Referral system for Accessible and affordable Emergency and inpatient facilities
  • Activities involving clients and caregivers to improve mental health literacy and advocacy for the mentally ill
  • Self-help groups involving lay people, relatives and individuals with mental illness
  • Facilitating the access of client rights and benefits
  • Promotive and preventive activities including substance use prevention and Life skill training programmes.
Academic Activities & Training
    Postgraduate training:

    The Department takes in 2 post-graduates(MD Psychiatry) for training yearly since 2012.

    Post-graduate academic activities / training include the following:

  • Seminars (weekly), Journal club (fortnightly), case conferences (weekly), case discussions(weekly), short topic discussions(weekly) at the department level
  • Faculty lectures (monthly).
  • Basic research training (centralized) and lectures/seminars in psychology and basic neurosciences.
  • Thesis protocol and update presentation
  • Clinical communication skills training by faculty.
  • External postings for neurology(1 month), medicine(1 month), legal psychiatry(2 weeks) and child psychiatry (2weeks).
  • Training in optimal delivery of emergency/ liaison services.
  • Grand rounds- held on Tuesdays and Thursdays mornings with focus on elicitation of clinical signs & symptoms, communication with patients & relatives and other management skills.
  • Training & supervision in psychotherapy,ECT and psychometry.
  • Internal assessments

  • Assessments involve 6 monthly formative and summative assessments on theory, clinical and academic work by department faculty.Summative assessment also includes a practical examination.
  • Undergraduate training:

    Objectives

    To be able to

  • Conduct a clinical interview and mental status examination towards diagnosing common mental disorders.
  • Provide first level management of psychiatric emergencies and decide timing & level of referral
  • Diagnose and treat common mental disorders such as depression, anxiety, substance abuse and stress related disorders.
  • Recognise and initiate treatment (prior to referral) for severe mental disorders such as bipolar disorder, schizophrenia, dementia and substance dependence.
  • Develop a working knowledge of basic principles of liaison psychiatry in areas such as suicide prevention, grief, pain disorders and delirium.
  • Clinical posting timing
  • Semester IV-2 weeks clinical postings.
  • Semester V-20 lectures.
  • Internship -2 weeks
  • Teaching/ learning methods

    Lectures/ seminars/case presentations and discussions/ self-learning material/formative & summative assessments.

    Clinical posting schedule
  • 8:30 to 9:30 AM- Small group discussion/ seminar
  • 10:00 to 11:00 AM- Psychiatry case taking in ward/OP/ medical & surgical wards for liaison cases.
  • 11:00 AM to 12:00 PM- case presentation and discussion.
CME

A CME was organized on26th March /03/2009, in conjunction with Venad Guild of Psychiatrists, on Borderline Personality disorder.The sessions were well attended by both faculty and students from various private and government institutions. The CME was Inaugurated by Dr.Glorine Gnanathankam, Principal Dr. SMCSI Medical College and Dr.Jayaram,President Venad Guild of Psychiatrists.Faculty included Prof.Mathew Varghese -NIMHANS , Prof. Deepa Braganza-CMC Vellore, Prof.Anil Prabhakaran & Dr. Vidhu Kumar TVM MCH who handled the sessions in an expert fashion Two credit hours were awarded by the Travancore Cochin Medical council.

Workshop

A 3 Day Workshop on “Building Competencies in Mental health care” was conducted on 18-20th August 2011. This workshop was designed in view of the changing role of psychiatrists, with an emerging need to develop broader competencies to meet the challenges of providing mental health care. Psychiatrists may be called upon to inform policy or develop mental health systems, with the aim of providing comprehensive mental health care besides clinical or academic work.

Seminars focused on global mental health (with an emphasis on India), concept of comprehensive mental health care, services design and evaluation, and research in complex interventions. Techniques such as Pre-workshop material for self-directed learning, presentations, group work, panel discussions and practical exercises were employed.

Reknown faculty such as Dr.Mohan IsaacProfessor Population Mental Health,Perth, Dr. R. Thara(Director, SCARF), and Dr.Anna Tharyan Dr.JagathishaThirthalli, Dr.KrishnaKumar, Dr.Manojkumar Dr.VarghesePunnoose, Mr.Milesh, Dr.Christina George, Dr.Harish and Dr.Jayaram served as faculty during the 3 days.

Participants from Kerala,Tamil Nadu and Karnataka attended the woerkshop ,which was appreciated for its scope and depth.

Researches

RESEARCHES
Sl. No Topic Author Guide
1 Effectiveness and acceptability of a community worker delivered life skill education programme in a mental health programme Dr. Barjis Sulthana P
2 Determinants of delirium in elderly inpatients in a general ward setting in a teaching hospital- A case control study Dr. Jitha G Dr. Christina George
3 Pathways to In patients care, insight and psychopathology in individuals with Schizophrenia spectrum disorders in a tertiary care hospital Dr. Barjis Sulthana P Dr. Christina George
4 Factors associated with Alcohol Dependence Syndrome in inpatients treated in a tertiary hospital. Dr. Arun Ayyappan Dr. Christina George
5 Prevalence , pattern and correlates of agitation in psychiatric inpatients in a tertiary hospital Dr. Tisha Rachel Jacob Dr. Christina George
6 Prevalence and correlates of suicidal ideation and suicidal attempts among inpatients with alcohol dependence syndrome in a general hospital setting Dr. Arun Ayyappan Dr. Christina George
7 Cross sectional study on prevalence and correlates of caregiver burden in individuals with Schizophrenia Dr. Tisha Rachel Jacob Dr. Christina George
8 Pattern of Depression, Empathy and Burnout in Medical students : An 18 month follow up study Dr. Shabna Mohammed Dr. Christina George & Dr. Anoop R.L
9 Incidence and risk factors for delirium in patients in a resource poor medical intensive care setting in South India Dr. Vini Vivek Dr. Christina George & Dr. Anoop R.L
10 Patient Care Empathy, Burn out, Work factors and personal characteristics among clinicians in a South Indian state Dr. Christina George and Dr. Anoop R.L

Paper Presentation

PAPER PRESENTATION
Sl. No Topic Author Remarks
1 Impact of a community worker led Life skills education -a one year follow up Dr. Barjis Dr.SMC Research Paper Celebration Day-2015Dec-1
2 Effectiveness of a community worker led Life skills education -a one year follow up Barjis Sulthana, Arun Kumar, Christina George South Zone conference – Oct 2015
3 Olanzapine Induced Restless leg Syndrome Jitha G,Sri Sai Priya ,Christina George WPA Kochi –Sept 2015
4 Lithium toxicity induced Nueroleptic malignant syndrome –A case report Barjis Sulthana ,Arun Kumar ,Christina George WPA –Kochi-Sept 2015
5 Prevalence, patterns and correlates of Antipsychotic polypharmacy in inpatients with schizophrenia in a tertiary care centre Jitha G, Sai Priya,Christina George Kerala State Conference-Aug 2015
6 Psychotherapy for the Psychiatrist Christina George Midterm CME-Kerala –IPS-2015
7 Quetiapine in Bipolar disorder Christina George Venad Guild of Psychiatrists -2015
8 Socio-demographic profile and drug seeking situation alcohol dependent patients: Cross sectional study–Hyderabad Arun Kumar ANCIPS – Jan 2015
9 Caregiver Burden in a Community Mental Health Program — a Cross Sectional Study Shabna Mohammed, Arun Ayyappan, Christina George ANCIPS-Hyderabad -Jan 2015
10 Self Immolation in a case of Borderline Personality Disorder Vini Vivek, Tisha Rachel,Christina George ANCIPS –Hyderabad -Jan 2015

Publications

PUBLICATIONS
Sl. No Topic Author Journal Remarks
1 Pattern and correlates of agitation in an acute psychiatry in-patient setting in a teaching hospital Christina George, Tisha Rachel Jacob, Arun V. Kumar Asian journal of psychiatry Volume 19, Pages 68-72 2016 Feb
2 Antenatal depression in coastal South India: Prevalence and risk factors in the community Christina George, Anoop RN Lalitha, Abish Antony, Arun V Kumar, KS Jacob International Journal of Social Psychiatry (2015)
3 Sex therapy in a case of unconsummated marriage Neena Sawant, Arun Kumar, Chetali Dhuri Clinical Medicine Journal Vol. 1, No. 3, 2015, pp. 98-100.
4 Caregiver Burden in a Community Mental Health Program — a Cross Sectional Study Shabna Mohammed, Sri Sai Priya, Christina George Kerala Journal of Psychiatry (2015) 28 ( 1)26-33

Teaching Staff of Department of Psychiatry
SL NO: NAME OF FACULTY DESIGNATION
1 Dr. Akhila. C. Jyothi Junior Resident
2 Dr. Jose Mathew Junior Resident
3 Dr. Arya Jith Senior Resident
4 Dr. Christina George Professor and HOD
5 Dr. Sri Sai Priya Assistant Professor
6 Dr. Shabna Mohammed Assistant Professor
7 Dr. Arun Kumar V Assistant Professor
8 Dr. Priya Kumar Senior Resident
9 Dr. Jitha.G Junior Resident
10 Dr. Barjis Sulthana. P Junior Resident
11 Dr. Boby Cherian Skaria Junior Resident
12 Dr. Elizabeth John Junior Resident
13 Dr. Suja Thomas Junior Resident
14 Dr. Sreejith .M.Cheruvilakam Junior Resident

Dr. Christina George

Professor and HOD (MD)

(Promoted as Professor on 11.3.2011)

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