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24 Urban-Legends about Mind, Behavior and Drugs.

24 urban legends/myths collated from the twitter handle @ULTweets (thanks to @btaylorblake) which are connected to the theme of mind, behavior and drugs.  (See another 24 medical legends in another post linked here)

1. Mysterious girl crying in the cemetery

2. 10% of brain myth

3. Characters in Winnie the Pooh and mental disorders

4. Blue Whale And Momo

5. Parenting

6. School Stress

7. Mass hysteria about child lifting

8. Braid chopping phenomenon

9. Depression therapy and satanic panic of the 80s

10. Force of imagination (delusion of blood letting)

11. Suicide Suite

12. Gloomy Sunday

13. Random urine drug test

14. Opioid hysteria

15. Opioid crisis

16. “The Mad Gasser of Mattoon”: Collective anxiety attack / Transient delusion

17. Havana Syndrome

18. Mandela Effect (false memory)

19. Marijuana laced with Fentanyl

20. LSD

21. Halloween candy laced with [meth]

22. Contaminated food, candy and gum

23. Urban legends as expressions of social tension

24. Collective environmental guilt

24 Medical Urban-Legends.

24 medical urban legends/myths collated from the twitter handle @ULTweets (thanks to @btaylorblake).  (See another 24 legends/myths connected with mind, behavior, and drugs in another post linked here)

1. Surgeon and the boy

2. Welcome to the HIV club

3. AIDS Mary

4. Organ donor

5. Surgeon and 300% mortality 

6. Cardiologist’s tweet

7. HIV needle

8. ISIS and HIV

9. Abortion

10. IUD (Intra Uterine Device)

11. Sperm bank

12. IVF (Invitro fertilization)

13. Breast implant

14. Legend from Cancer

15. Radio-waves from cell phone

16. Necrophilia

17. Menstrual cycle 

18. Unusual Injury

19. Optogram

20. Tape worm and bosom serpent

21. X celebrity and semen

22. Obamacare

23. Rib removal for auto-fellatio

24. Doctor


From Bluewhale to Momo and PUBG: viral media scares continue

This post summarizes and archives three viral media scares that happened in the last few months: the first is a global one, the second is India specific and the third Kerala specific.

Momo Scare 

The scare about the Momo Challenge was busted much easier than the Bluewhale Challenge (see my article on the blue whale). It peaked at about 8 months back and was positively identified as an urban-myth at that time (The Washington Post, Sept 5, 2018), however, reappeared again in the last few months requiring a further round of busting! (Wired, Feb 28, 2019) This time around many news agencies came clear that it is a hoax ( TheGuardian,  Times of India, March 2019) and a moral-panic. ( NYTimes ). More links at the end of the post. The scare effect was a near replay of the responses (of media, police, experts and other authority figures) during the Bluewhale ‘threat’ nearly two years back. See tweet by police on momo. This article talks about similarities between Momo and Bluewhale and why children are at the center of conspiracy theories. This article on the details of the timeline of emergence of Momo Challenge. An alert letter from a school

PUBG Scare

Scare related to the online game PUBG was mostly an Indian media phenomenon. Its highpoint was an overzealous intent by some state actors to ban it. It started with the National and a State Commission for protection for child rights giving an adverse recommendation against it which was then taken up by the state education department. State police issued a circular to ban it which culminated in arrests too for playing the game! The media lapped up the sequence and added more sensational coverage on how adversely it was affecting kids. The ‘dangers’ for children ranged from distraction from studies to exposure to a ‘highly addictive’ thing to inducing violent tendencies. The latter claims were challenged by me through tweet feedback to the paper.

Suffice to say that PUBG scare is yet another moral panic of the contemporary time. But why PUBG and why now?

The specific timing is provided by the setting — online gamers have suddenly increased by over 50% from last year to 278 million in 2018. This is made possible by the free fall in the prices of internet data packages and smartphones and also online games becoming available on all platforms (both desktop and mobile — without the need for gaming consoles). The dizzying increase in digital consumption at the societal level created a rapid flux which challenged the society’s adaptive capabilities thus feeding moral panic as a response.  And PUBG, something that children and youth engage in and not easily understood by adults becomes an easy target. But why PUBG specifically:  because it is simply the most popular smartphone game in India. It allows team-based play allowing voice interaction over the internet which makes it very engaging. Besides, it is free to download and can be played on a smartphone.

Facing backlash in social media, police soon backstepped on its ban move, nevertheless media continues with its sensational headlines like the one today. See my tweet response to the paper below. See another piece of disinformation.


The viral scare about an Instagram hashtag by the same name triggered rumors that it was a sinister mechanism to instigate youth to self-harm. Newsmedia connected it to a triple suicide of teens in the Wayanad district of Kerala. However, on closer look, #psychochekkan has more to do with the youth’s online expressions at creating memes using picture illustration and messages— many of them deal with ideas of despair though. My friend and psychiatrist has put together some of them in a tweet for illustration purpose.

A possibility of a suicide pact ( സൈബർ സൂയിസൈഡ് ഉടമ്പടി) through social media facilitation was widely speculated in media in this connection. However, there was no proof forthcoming making Psychochekkan another media scare, this time confined to Kerala.


more links for archiving purpose:


my articles in popular media on the same: part 3

Two months into the reportage on the mythical online game, and no sign of any evidence to support its existence, two of my articles get published in popular media.

  1. The first was in health section of  azhimukam, a malayalam online news and views media PDF
  2. The Hindu open page article: Illusion as news      PDF1   PDF2

And today, Oct 8 is incidentally 5 years since this blog was started 🙂

adding more artifacts

  1. Supreme court calls it a “national problem”! this again is presented as breaking news!.
  2. According to Additional Solicitor General P.S. Narasimha, a committee constituted by the Ministry of Information Technology found that around 28 cases have been traced to have links with Blue Whale game. A probe was on and a complete picture of the extent and means of the game would be ascertained in the next three weeks. 

  3. thehindu-oct-28

    source :Thehindu-oct28

    Another article that calls it a myth

  4.  Central gov tells supreme court that blue-whale influence not established in any of the reported cases. PIL seeking ban on the game was disposed of by the court as it cannot be banned as it is not an app, no link identified, it is one to one. But till yet no transcript of a conversation between the mythical curator and a teen not got!Blue Whale role in deaths not established, Centre tells SC - The Indian Express

Local-spread of Blue-whale legend in Kerala: part 2

My initial blog on the blue-whale pandemic which captured the trail upto 1 week after the local media-outbreak in Kerala, was posted a week back. I had observed at that time that the media-interest in it had waned, however that was not to be! As the real oceanic cousins of the digital-whale are wont to surprise, it was but a dive, disappear and resurface!

What followed was another bout of hysterical paroxysm for the media – this time rendered more jarring by the breaking-news visual media and its expert-ized prime-time discussions. So much happened over the few days that I thought it did be better to have a part2 to document the artifacts. These artifacts span the visual/ print/virtual/ digital/ social media expressions like trolls, messages, poems, narrative anecdotes, …..

This time again it was the malayalamanorama group (manoaramanews channel) which ignited the proceedings like its print-arm had done it earlier. It was breaking news : ” killer games gets its first prey in Kerala” , “16 year old die after playing blue whale, says mother”, “proof that the boy had completed the blue whale tasks”

IMG-20170815-WA0003     IMG-20170815-WA0004  IMG-20170815-WA0005     IMG-20170818-WA0002

This sets off the cascade, artifacts from which are collated below:

police chief


media discussions in which psychiatrists, cyber experts etc participated

IMG-20170816-WA0004   IMG-20170816-WA0003     abn

trolls and images in social media

IMG-20170820-WA0005                  trolll

IMG-20170820-WA0007           IMG-20170818-WA0001

Testimonial with poem

another poem 

facebook-page post by a collective of doctors who are “myth busters”

twitter (There is a more dangerous game than in India. It is called  farming. Participants commit suicide in the end. Families too.)

blog post

whatsapp handout  

Youtube search history with “kerala blue whale” threw up ~800 videos uploaded in last one month.

newspaper follow through:

IMG-20170817-WA0001    IMG-20170817-WA0002

Gov of India request to google and Facebook


Kerala child rights commission initiates a case

Intex Aqua Wing_20170817_110434_300

news reports on updates by police

police1   police2

full text of above report as it came in bignewslive -refutation by police

A report that asks to focus on depression


Thus the Blue whale true to its folkloric nature stimulates a lot of cultural expressions too, over and above the hysteria in the news media and the media-men.

August 20: news reports

1. IG incharge of cyber investigation in Kerala categorically says no game exist.


2. An admin of a meme generatiing website  comments on how they felt spreading “awareness” in early stages can be counterproductive and hence kept away from it as part of being socially responsible.

“We try to create socially responsible memes as part of our collaboration with the Cyberdome.For instance, even before the news of the Bluewhale game spread, the officers were interested in spreading awareness. However, we advised them against it as people have a tendency to experiment with things which we urge them not to try out,” said Hrishikesh Bhaskaran, an ICU admin, adding that they made sure that no such memes were posted.

3. Meanwhile reports of the hysteria-cycle starting at neighbouring state of Karnataka!
Added later:
nice analytical article which came in facebook and reprinted in mathrubhoomionline.
ബ്ലൂ വെയ്_ലിന് നിരോധനം _ Blue Whale game (1)




The local-spread of the blue-whale pandemic in Kerala: fanning of an urban-legend by media and experts.

If you were in Kerala during last week, the chances are that you could not have escaped knowing about the Blue Whale Game! Ever buoyed by a sensation-seeking online media, the game’s cross-border global spread finally touched the shores of Kerala exactly one week back. Suffice to say now that, brewed further by a perverse media-interest, fanned by the media-experts and ratified by the police; the urban-legend continued its onward cruise, unchecked in the local media. Now that the interest has waned, this write-up is to document and reflect on the hysteria surrounding the local-spread of the pandemic.

Global background: 

The Wikipedia uses words like “claimed to exist”, “allegedly” etc while providing basic information about this internet “game”. However the pandemic-spread of the name/fame of the game, which originated in Russia, is evident by the country-wise listing of the case summaries of the players of the game -always teen aged boys and girls- who apparently  put themselves in danger by engaging with it. Suicide of a fourteen year old boy from Mumbai on 30th, July, 2017 is listed there. The page also documents the reactions and responses from across the globe: ministers and mayors expressing concern, state authorities issuing warnings, schools providing lectures are a few of them. And a casual search of online news-websites with readership in different pockets of the globe, throws up reportage on how parents and authorities in that part of the globe are getting-concerned/ should-be concerned about this danger!

Sections of the media do discuss the rumor elements in the story- this one as early as May 9, 2017 in the Indian national media ( The Indian Express);  quotes the Bloomberg View (a US based internet news and views site) columnist Leonid Bershidsky’s  comments that: the blue whale is more of an “urban legend“. He laments that an approach of fighting a legend will take attention away from the real causes of high suicide rates – the “broader societal ills” like family distress, poor support in schools, corruption and anomie in society.  The Indian express report also says….

The hysteria surrounding the Blue Whale “suicide game” needs to be re-focused on issues of adolescent depression that invite it.

Websites that document, research and fact-check memes, viral phenomenon and urban-legends have also not found direct evidence for it and not been able to link  social-media based game groups to increase in suicide rates. Nevertheless, the legend has managed to create some hysteria among media and experts in Kerala. This post is about documenting that phenomenon.

Mass Hysteria:

Talking about mass-hysterias, it has become all too common – the most recent ones are the lesser known ‘mangalsutra rumour‘ in rural Karnataka and the one from rural northern India that has caught the attention of the international media also – the ‘choti cutting’ (braid chopping).

Braid chopping phenomenon has been described as hysteria by a psychiatrist.  It has been qualified as a ‘rural area’ phenomenon with ‘victims who are uneducated’ and who need ‘counseling and explanation that there is no scientific basis to it’. However in another report  a social-commentator says…

It is difficult to say if the hysterical act is ‘deeply significant, just a prank or the domino effect of one event’ and therefore  ‘don’t scoff at the women..we are all suggestible to socially transmitted obsessions’.

In this line the hysteria surrounding the blue-whale in Kerala is explored as the spread of an urban legend/ myth among the educated – experts, media and police of Kerala.


(As an aside, a documented hysterical event surrounding a myth in urban-space in Kerala was back in 2015 about a ‘black man‘. The more recent booing-crowds that followed the actor after his arrest has also been described as a mass-hysteria by a psychologist)                     (illustration from the web)


The Spread of the blue whale in Kerala:

Looks like it all started with this boxed news item in malayala-manorama; on 3rd August announcing the arrival of game in Kerala:

 കേരളത്തിലും വിവദഗെയിം, പോലീസ്സ് പിന്നാലെ . 

It says the police is in hot pursuit! It reports that police have found that the “killer game” has been downloaded 2000 times in Kerala. A few teenagers who went sightseeing to the seashore apparently did it under the influence of the game and their parents found, on checking their mobile phones, that they have played the game. The write up ends with a advisory for vigilance by parents. 

‘കൊലയാളി ഗെയിം’ എന്നറിയപ്പെടുന്ന വിവാദ മൊബൈൽ ഗയിം കേരളത്തിൽ രണ്ടായി മത്തിലധികം പേർ ഡൗൺലോട്  ചെയ്തതായി പോലീസ്സ്.

The Malayalamanorama supported this item with an op-Ed piece on the same day (on 3rd August) by a media-psychiatrist titled 

മരണം മണക്കുന്ന സൈബർ ഗേമുകൾ. 

It  quotes the Mumbai incident and its relations to the blue-whale game. The article doubts such report’s veracity nevertheless underscores the need to be vigilant -should it be true. It dwells on cyber addictions, mental vulnerabilities, environmental and social vulnerabilities and ends on a call for vigil by parents as quite-often mishaps happen due to lack of vigil by parents. It directly addresses the reader in second person and warns that their children can fall into the trap by casually engaging with the game. 

 നാളെ നിങ്ങളുടെ കുട്ടിയും വെറും കൗതുകത്തിനു വേണ്ടിയെങ്കിലും ഇന്റർനെറ്റിൽ അതു തിരഞ്ഞുപോകാം. ഏതു വഴിയിലാണ് അപകടം പതിയിരിക്കുന്നതെന്ന് നമുക്ക് ഉറപ്പുപറയാനാകില്ല. 

The next day on 4th Augustwe see more action in Mathrubhoomi newspaper which contains a reportage.

സാഹസിക ചോരക്കളിയുമായി സ്‌കൂള്‍ വിദ്യാര്‍ഥികള്‍ ഇവിടെയും

വിദ്യാര്‍ഥികളുടെ ജീവനെടുക്കുന്ന ബ്ലൂവെയില്‍ ഓണ്‍ലൈന്‍ കളിക്ക് സമാനമായ പ്രവണതകള്‍ സംസ്ഥാനത്തും റിപ്പോര്‍ട്ട് ചെയ്യപ്പെടുന്നു. ബ്ലേഡ്‌കൊണ്ടും കോമ്പസ്‌കൊണ്ടും കൈയില്‍ ചിത്രങ്ങള്‍ വരയുന്ന വിദ്യാര്‍ഥികളെ… ചില സ്‌കൂളുകളില്‍ കണ്ടെത്തി.

Mathrubhoomi also has a supporting op-Ed⇓ on same day by a cyber forensic expert

 ഓണ്‍ലൈനിലെ മരണക്കളി.

10 മുതല്‍ 14 വയസ്സുവരെയുള്ള കുട്ടികളെ പതുക്കെപ്പതുക്കെ ആത്മഹത്യയിലേക്ക് നയിക്കുക എന്നതാണ് ഈ ഗെയിമിന്റെ പ്രധാന ലക്ഷ്യം…അമ്പതാം ദിവസമാകുമ്പോഴേക്കും ആ പിഞ്ചുമനസ്സ് മരണത്തെ പുല്‍കാന്‍  പാകപ്പെട്ടിട്ടുണ്ടാകും. 

പോലീസ് ഈ അഡ്മിനിസ്ട്രേറ്റര്‍മാരെയാണ് തിരഞ്ഞുകൊണ്ടിരിക്കുന്നത്. പക്ഷേ, ഇവരെ വലയില്‍ വീഴ്ത്തുക എന്നത് എളുപ്പമല്ല…  

എന്നാല്‍, മാതാപിതാക്കള്‍ക്കും അധ്യാപകര്‍ക്കും കുട്ടികളെ ഇത്തരം ഗെയിമുകളില്‍നിന്ന് രക്ഷിച്ചെടുക്കാന്‍ മറ്റൊരു വഴിയുണ്ട്. കുട്ടികളുടെ ദിനചര്യകളില്‍ അടുതത്ത കാലത്ത് പെട്ടെന്ന് വന്നുചേര്‍ന്ന മാറ്റം ശ്രദ്ധിച്ചാല്‍മാത്രം മതിയാകും കുട്ടികള്‍ ഇത്തരം ചതിക്കുഴിയില്‍ പെട്ടിട്ടുണ്ടോ എന്നറിയാന്‍ 

The alarmist pattern gets more set here in the detailed scare elements and parental advisory. Next day,  on 5th August⇓  in a Times of India report comes the refutation,  and it quotes the police IG on the issue of downloads.

2000 downloads of Blue whale game in Kerala? Nope, just a hoax, says cops

“The report claiming 2,000 downloads is a hoax as the police have not confirmed any such cases till date”, he says

However The Hindu report on same day⇓  quotes extensively from a police advisory to the public.

Blue Whale Challenge: Police issue advisory 

Terming the online game ‘extremely dangerous’, the police have said that several children and youths have been deeply influenced by the game.  Under the circumstances, the parents have been advised to monitor the activities of their children and remove such games from their computers and smart phones, the advisory added. 

The actual advisory from the police as circulated in whatsappin fact  copies verbatim factoids about the 50 step process of the game in full fidelity to the legend! It however affirms the spread of the game in India based on media reports only as support!

ചില മാധ്യമങ്ങളിൽ വന്ന വിവരപ്രകാരം നിരവധി ആളുകൾ ഇന്ത്യയിൽ ഈ ഗേയിം ഉപയോഗിക്കുന്നതായാണ് കാണുന്നത്.

This is a circular reversal of where we began this post – the article which first announced the arrival of the game had based itself on police reports! (കൊലയാളി ഗെയിം എന്നറിയപ്പെടുന്ന വിവാദ മൊബൈൽ ഗയിം കേരളത്തിൽ രണ്ടായി മത്തിലധികം പേർ ഡൗൺലോട്  ചെയ്തതായി പോലീസ്സ്.) However the Hindu report on the police advisory and a vernacular news snippet on the same conveniently skips this aspect.

By the time this post is written the blue-whale gets its coverage in at least three TV channels and an FM station.


We are living in an age of accelerations (Thomas L Friedman lists three accelerations: technology, globalization, climatic change). Societal structures/ adaptations/ technologies lag behind and do the catch-up to keep phase with the  accelerating physical technology and globalization changes. This creates a gap spurring anxieties, cultural angst and also a fertile ground for genesis of contemporary-legends (urban myths). Scare and phobia and panic that accompany rapid changes manifests as elements in these myths. The feedback loops in the global connectivity provides the flow channels for their rapid spread too.

In the immediate current scenario, we are experiencing the acceleration from 3G to 4G, our data consumption is moving from GB/year to GB/day. Our/ our children’s constant online presence has come next to unavoidable. We feel we need the reasons to keep us/them away from it. We have witnessed some untoward outcomes around us too – in last one year Kerala witnessed the  recruitment of its  youth (attracted/ self radicalized) to ISIS networks though online channels (Kerala youth who joined ISIS killed in Afghanistan: Reports). Thus the real and the perceived dangers get blurred right before our eyes.It is this that makes the blue-whale look plausible for us.

The media fell for it, rightly gauging the mood of the readership, but the experts and police authorities could have show some restraint. But then experts have their media careers to flourish too. And it is easy for the police to issue a key-jerk advisory than do the difficult job of doing the fact-check. After all, all that the experts and the police felt like doing was to ask the parents to be more vigilant and cautious! Maybe some of them believed it is OK to even ride the wave of hysteria to push some useful information alongside. Everyone loves a good myth! The hysteria this time has gripped the urban and the educated!

But in these changing times, we need better problem solving, problem solving that is “entrepreneurial and hybrid” (Friedman) and not scare tactics and simplistic solutions. We need strategies that build societal resilience and address vulnerabilities.

In this line I liked this advice, though simple,  given by (India today) on August 4  itself in this piece

Blue Whale is not a game, and no it is not making people commit suicide 

There is an adage for the real world: “Don’t talk to strangers”. It applies on the virtual world too. You should tell your kids not to talk to strangers on the web, or on social media sites. 


Just as I was about to post the blog, came across this mention about the blue-whale in the legislative assembly by the Chief minister himself in response to a submission in the assembly! It is not over yet! 

Kerala seeks to drive ‘Blue Whale’ away from India

“The government has issued a warning. Police is also closely monitoring those who have downloaded the game here. Police have asked them to uninstall the games from their gadgets.Since Indian Computer Emergency Response Team is the agency that could do something to halt the availability of the game, the state government would appeal the Centre to take steps and block it in India,” Vijayan said.

reports added later: see malayalam news on the same. warning by Medical college psy dept ; awareness drive by Kerala police ;……………….

Tail piece :  Watch this  Asianetnews video on the blue-whale to see the hysterical aspects of the media hyperbola peppered with some conspiratorial elements too. (Already  crossed 1 lakh youtube views)

(featured image from openclipart.org)
added later: an important blog by NetFamilyNews.org on the fakenews aspect.
Wired article on the same.

DMHP: from the state-level workshop for nodal officers

Thanks to the invite from the state nodal-officer for mental health, Directorate of Health Services, Kerala; Dr Kiran PS, I got the opportunity to participate in the Workshop on District Mental Health Program.

Among the various program related topics, the group-discussion on inter-sectoral/ inter-program-ic coordination was the main activity which I involved with. Over the span of the two day workshop, I got the opportunity to participate in the discussions which the Secretary of Health, GoK and the Director of health services had with the nodal-officers of the programs from all the districts to sort out the implementation issues of the program.

(The specific context in which the workshop was convened was with the objective to facilitate familiarization of the program to the many nodal officers who were newly taking charge. This came about as nodal charges which were till now rested with the medical-college psychiatry departments in many of the districts are being shifted to the health services department because of increasing availability of psychiatrists in the services-arm and also for easier implementation and integration efficiency. I could understand from the concluding session that hosting of the program was taken up by the SHSRC (State Health Systems Resource Centre) as strengthening community based mental health programs was keeping with its mission of attaining the sustainable development health goals set for the state – mental health is part and parcel of the comprehensive primary health approach being strengthened through Family-Health-Centers in the state.)

Brief detailing about the inter-sectoral  discussion:

The inter-sectoral familiarization was facilitated by brief summary of program activities by invited  key members of other vertical programs.

  • The Dial a doctor (DISHA -tele contact) by Ms Gopika,
  • Mahila Samakhya programme– KMSS by Ms Boby
  • NCD(non commicable diseases) – palliative care (absentia)
  • Adolesent health(ARSH) (presented in absentia in another sesssion)
  • RBSK -DEIC (DR Arun in another session)

Incidentally I had looked at this area in a blog  in 2014: Emerging intersectoral health/social programs in Kerala in which I listed a few programs with inter-sectoral scope. The Dial a doctor (DISHA -tele contact), NCD and RBSK (DIET) were listed there, horizontal integration into palliative program was dealt in another blog, while ARSH was listed in my article in Kerala journal of psychiatry on school mental health. So it was familiar area for me except for the new knowledge acquired from the workshop about the KMSS program.

Program with which intersection was discussed Benefit for DMHP Benefit for the program
KMSS – works with women in socioeconomically disadvantaged areas. Was a CSS now under general education department, also has overlap with SJD. Works with nirbhaya centers (nirbhava centres have services of clinical psychologist) The program has workers who have field presence which dmhp does have  drop out cases can be traced by using field workers of program. Case management and such psychosocial care at doorstep could be done through them. In areas they work there are no provisions for mental health care  these could be arranged by DMHP by camp approach.
DISHA1056 program under NHM. Provide telephonic services Could utilize the tele counselors under disha (20-25 MSW trained counselors ) for crisis intervention in distress calls. Many of the calls now are information seeking, Disha will benefit if dmhp can provide database of services /personnel at district level.
RBSK –DEIC CSS with multidisciplinary facility based team and filed level school-health-nurses 50-100 per district. DEIC has services of  clinical psychologist, educator , pediatrician The school-health-nurses have field presence with district spread. Can be utilized for school-mental-health-program. ?LD cetification could be more streamlined by liason with DEIC DEIC could benefit by including psychiatrist services in view of the neurodevelopment and behavioral issues in children that they handle.
Adolescent health program- district facility level councilor (MSW trained ) under RKSK  it is a CSS ? ?
NCD Not discussed Not discussed
Palliative program Not discussed Not discussed

Now moving on the general discussion that happened and some observations:

The health secretary observed that to  keep with the vision of the program the psychiatrist conducting the clinics in DMHP should be the nodal officer of the program too. Wherever this was not the case, it should be rectified.

A second team to be considered in Mallapuram district in view of the case loads. I brought in the idea of evolution to TMHP (further decentalization to thaluk level) citing its early indications in kottayam district. Cost  of it was  discussed. Nevertheless awareness about other programs (eg  the RBSK) with staff pattern 10-25 times more than DMHP (staff of 5/district only ) and more than one mobile unit, should embolden DMHP to expand its staff base to evolve to TMHP.  Current working pattern of thaluk hospitals may not be facilitatory for a specialist from there being freed for community outreach was raised. Thus the idea of TMHP resonated as  premature as many of the districts were yet to have functional IP facilities at district level even. TMHP will have to wait a few more years before it will come to policy attention.  Related ideas were discussed in one of my earlier blog too in 2014: Some health-policy trends worth emulating for DMHP-Kerala.



This post is based on the TOI article Mobocracy: Empathy for the victim or glee at a man falling? by Asha Prakash| Jul 15, 2017 (article)

Context: Leading actor of Malayalam film industry was arrested for alleged conspiracy behind gang-rape of a woman actor. And wherever he was taken to, by the police, for questioning and  collecting  evidence, “gleeful crowds” thronged booing and taking photographs of him. (photo from same article)


This phenomenon was explored by the author by asking the following question to many experts. The responses are synthesized below from the article (adapted for blog presentation).

Question: “Is it outrage at the star for allegedly plotting the assault of a woman, or is it plain joy at seeing the fall of someone rich and famous?”


1. Maala Parvathy, Psychologist and Actor –

“We never knew so many people were concerned about the safety of women!” she says, tongue firmly in cheek. “I notice a kind of joy on the faces of these people, but is it something to be celebrated, the fact that we have a criminal among us? It should be a matter of fear and concern.” Booing the star is part of mass hysteria,  mob psychology. Jealousy about the star-status and  sadistic pleasure in seeing the fall are other feelings involved .

2. Paul Zachariah, Writer –

..there is an inherent blood thirst inside everyone which only surfaces during such incidents. “Saritha Nair was also hounded and booed like this and Dileep is just the new candidate. The average lower middle class and middle class people are a credulous lot, and such incidents only awaken this blood thirst,”

3. Dr C.J John, Psychiatrist –

” What we see is a mental disease, the same kind you see in trolling celebrities who make a slip of the tongue. People are becoming a moral court, just like moral police.”

4. James Vadakkancherry, Criminologist –

..feels that Malayalis seem to have all the time in the world. “Curiosity is human, but in our country, our climatic conditions are favourable for people to hang around outdoors. There are no recreational activities or spots, and a lot of idlers are just waiting for something like this.”

5  Another independent article by  കെ.എ. ജോണി, Journalist titled ‘ആലുവയിലെ ആള്‍ക്കൂട്ടം പറയുന്നത്’ came in Mathrubhoomi newspaper on 13 Jul 2017 (PDF). See excerpt below –

ആലുവയില്‍ നിന്നുയരുന്ന ബഹളങ്ങള്‍, ആള്‍ക്കൂട്ടത്തിന്റെ ഉന്മത്ത നൃത്തങ്ങള്‍ – ഇവയാണ് ഇപ്പോള്‍ നമ്മുടെ അന്തരീക്ഷത്തില്‍ നിറയുന്നത്…ഈ ആള്‍ക്കൂട്ടത്തെ ആരെങ്കിലും സംഘടിപ്പിക്കുന്നതാണെന്നു തോന്നുന്നില്ല. ഒരു സ്വാഭാവിക പ്രക്രിയ പോലെ രൂപപ്പെടുകയാണ്. ഒരു നേതാവിനാല്‍ നയിക്കപ്പെടുന്നവരല്ല ഇവര്‍. അന്നേരത്ത്, ആ നിമിഷത്തില്‍ മുന്നില്‍നിന്ന് മുദ്രാവാക്യം വിളിക്കുന്നവര്‍, ആര്‍ത്തുവിളിക്കുന്നവര്‍ അവരാണ് ഈ കൂട്ടത്തെ നയിക്കുന്നത്

Multiperspective ends.

Psychiatric training needs reform: correcting an overdose of the (neuro)biological to an inclusion of the social, the cultural and the public-mental-health.


A theme which I would call:  inclusion of newer and emerging streams of knowledge into psychiatric training in medical schools; came for deliberation as a cross cutting theme in at least three symposia in the just concluded congress of the WASP.This was expressed as a need in the backdrop of the distortion being created now at the level of teaching of psychiatry in medical schools. The distortion being – an excessive/near-total focus on the (neuro)biological.

The symposia were……….

  1. Teaching Social Psychiatry to Medical Professionals

    [Roy AKallivayalil, RachidBennegadi, JE Mezzich, KS Prabhavathy, RR Gogineni, Michaela Amering,VPPunnoose Chair:Edgard Belfort, VG Watve]


The idea of including person centered care approaches into psychiatric medical training was put forward by one of the speakers. A framework for a person centered diagnostic formulation was felt as useful. The same has already been developed and an internet source to the same provided.


  1. Integrating Social Psychiatry and Global Mental Health in Medical Education: A New Way Forward

    [Amy Gajaria, Anna Fiskin, June Lam, David Matthews, Rani Kotha Chair: F Ferrero, MushtaqMargoob]


One of the speakers spoke of a resident-led program to include cultural-psychiatry into the training in Canada.


  1. Mental Health Care in LMICS: Driving the Paradigm shift, the FAST program

    [A Soghoyan, P Ramachandran, C Szabo, J Fine, DrissMoussaoui (Supported by Sanofi) Chair: Tom Craig, Roy A Kallivayalil]


One of the speakers called for including public-mental-health as a specialization in psychiatric training.

Where upon, a question was raised from the audience about how it would be different from the already existing specialization of social and community psychiatry which was already there in many countries. [like NIMHANS in India has post-doctoral fellowship in community psychiatry in addition to those in addiction, child and adolescent psychiatry, geriatric, liaison psychiatry, schizophrenia, OCD]. The answer to the question is provided as a separate blog post. Click here.


So concluding, these emerging threads of scientific knowledge will definitely need space in the training of psychiatric doctors and professionals in near future.

Community-Psychiatry and Public-Mental-Health: are they the same?


A question was raised from the audience during a symposium@WASP 2016, about the relation between the existing community and social psychiatry specialization in academic psychiatry and the emerging specialization of public-mental-health.

Are the two compatible? Will there be conflict?

 It was well answered by the speaker who had earlier in his talk had called for inclusion of public-mental-health specialization in psychiatric training.

He said community psychiatry has more of clinical involvement i.e it is not just about providing medical care in the community but also involving in daycare, halfway homes, residential homes, rehabilitation etc; while public-mental-health is more conceptually involved i.e about epidemiology, effect of funding priorities on service delivery and outcomes. Thus its focus on funding/resources will basically provide the support for the clinically involved community psychiatry – i.e it will provide the ammunition. There is synergy in that way though there are these distinctions.

They are not the same, he said.