Kerala's mental health centres' rebranding: Doctor explains whether it can help

A few days ago, Kerala decided to rename its mental health centres to 'happiness and wellness centres.' The Kerala High Court also supported the decision, but the state's mental health experts opposed the move. Mental health experts and the Indian Psychiatric Society (IPS), Kerala branch, said the government took the decision without adequate consultation with stakeholders, stating that mental health and wellness are totally different concepts. Dr Elsie Oommen, Consultant Psychiatrist at the Medical Trust Hospital, Kochi, explains.

The background
Kerala High Court Justice Devan Ramachandran's recent visits to state-run mental health facilities threw the spotlight on the dismal conditions patients endure at the centres. Rather than viewing his observations as mere criticism, we can embrace them as an opportunity for comprehensive reform. In response to the scrutiny, the state government proposed rebranding these facilities—initially suggesting 'Behaviour Centres', and now opting for 'Happiness and Wellness Centres'. While the intent to reduce social stigma is commendable, the chosen nomenclature demands closer scrutiny. Both proposed names fail to reflect the medical reality and grave responsibilities of institutions providing tertiary psychiatric treatment and rehabilitation.

Science over euphemism
'Mental health' is not a derogatory term; it is a precise, scientific description of human psychological well-being. Psychiatry is an established branch of medical science. Retaining clinical terms like 'mental health' or 'psychiatry' in the names of these institutions is vital. It establishes the clinical seriousness of the treatment and fosters scientific awareness in society. While 'happiness and wellness' sounds appealing, clinical mental health disorders are not merely a lack of happiness. In conditions like mania, for instance, an excess of euphoria is itself a pathological state that requires medical intervention.

Dignity through quality care, not concealment
Severe conditions such as schizophrenia, bipolar disorder, dementia, and clinical depression require expert diagnosis, pharmacological management, rehabilitation, emergency care, and long-term support. Soft-pedalling these services under the generic umbrella of 'wellness' risks diluting their clinical identity. Stigma is not dismantled by hiding the disease or renaming the cure. Renaming a cancer hospital as a 'happiness centre' will not magically dissolve the fear associated with oncology. Similarly, renaming a psychiatric facility will do nothing to erase deep-rooted social prejudices unless the care experience itself is transformed.

Rebuilding the foundations of psychiatric care
To eradicate stigma, we must stop hiding patients away and start treating them with the dignity they deserve. This begins with physical infrastructure. Kerala's mental health facilities urgently require clean, safe, and patient-friendly environments. We need adequate accommodation, nutritious food, proper sanitation, privacy, and robust security. Equally critical is addressing the severe shortage of multidisciplinary teams, including psychiatrists, clinical psychologists, psychiatric social workers, and nursing staff. Comprehensive care must integrate evidence-based treatment, psychotherapy, occupational therapy, rehabilitation, family counselling, and community reintegration.

A blueprint for genuine transformation
A patient arriving at a mental health facility should feel valued, secure, and cared for, not abandoned. Justice Devan Ramachandran's interventions highlighted the urgent need for a physical and cultural upgrade, not just cosmetic name changes. The Kerala government should seize this opportunity to roll out a comprehensive modernisation master plan for all state-run mental health institutions. If the government feels a name change is absolutely necessary, it should maintain the academic and scientific credibility of these institutions, especially those running postgraduate courses. A designation such as the 'Institute of Psychiatry and Wellness' would strike the right balance between scientific integrity and modern wellness concepts.