# 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.