Integrated Mental Health Care in Developing Countries: The Bhutan Model

In this episode I am once again joined by Dr Chencho Dorji, Bhutan’s first psychiatrist and the Professor of Psychiatry at Khesar Gyalpo University of Medical Sciences. Dr Dorji reveals the challenges he faced establishing modern psychiatrist in Bhutan, a culture heavily invested in a supernatural model of mental illness. He recounts stories of patients possessed by ghosts, local avatars of Shiva, reincarnations of Padmasambhava and more. Dr Dorji explains the role of religion and superstition in stigmatising mental illness, and considers whether shamanistic rituals and other traditional healing methods can co-exist with modern medical practices. Dr Dorji also warns that mental illness in general, and borderline personality disorder in particular, is on the rise on Bhutan and shares his vision for a greater collaboration between modern medicine, the clergy, shamans, and Sowa Rigpa healers. … Video version: https://www.guruviking.com/podcast/ep245-padmasambhava-psychosis-dr-chencho-dorji-2 Also available on Youtube, iTunes, & Spotify – search ‘Guru Viking Podcast’. … Topics include: 00:00 - Intro 01:04 - Return to Bhutan to establish psychiatry 05:40 - Programme to train primary healthcare staff 06:18 - Advocating for community based mental health services 10:38 - DANIDA funding and mental health survey 12:07 - Collaboration with and educating traditional healers 13:47 - Locating and treating cases in remote communities 18:13 - What kinds of mental illness is commonly found in Bhutan? 19:29 - Challenges identifying depression 21:16 - The stigma of epilepsy 22:50 - Community fear of contagion of mental illness 26:55 - Culture of taboo and about mental illness in Bhutan 29:00 - Impact of the pandemic 30:29 - Using social media to educate 31:22 - Psychological first aid 35:09 - Why is South Asian psychology and psychology training weak? 37:41 - Mental health as a luxury for the rich 40:40 - Borderline personality disorder encounters 43:36 - Rise in cases of BPD in Bhutan 45:05 - Social changes in Bhutan causing rise in mental illness 49:10 - Chronic psychosis and social disturbance 51:26 - Lack of compassion for BPD 52:17 - Economic aspiration and the rat race 54:36 - Overlap and clash with religious professionals 56:21 - Buddhism and shamanism in Bhutan 58:05 - Use of rituals in healing mental illness 59:00 - Personal indifference towards Buddhism 01:00:19 - Challenges engaging with Sowa Rigpa practitioners 01:02:39 - Educating Sowa Rigpa doctors about mental health 01:03:34 - Do traditional healing modalities have a role in modern medicine? 01:04:17 - Different kinds of monk 01:05:41 - Religious control of the population 01:07:33 - Difficulties communicating with clergy 01:09:58 - Karma and the importance of openness 01:10:56 - Navigating patients’ supernatural world views 01:14:42 - Example of a manic patient claiming to be Guru Rinpoche 01:17:18 - Impact on families 01:18:05 - Cases of entity possession and mass hysteria 01:24:38 - Possession by Lord Shiva 01:29:58 - Advice for working with traditional healers and shamans 01:31:01 - Future challenges of mental health in Bhutan 01:34:41 - Explosion of mental illness, obesity, and substance abuse 01:35:43 - Neglect of the elderly 01:37:31 - A model for the third world … Previous episode with Dr Chencho Dorji: - https://www.guruviking.com/podcast/ep237-bhutans-first-psychiatrist-dr-chencho-dorji To find out more about Dr Chencho Dorji, visit: - https://www.facebook.com/profile.php?id=100057403100633 
For more interviews, videos, and more visit: - www.guruviking.com Music ‘Deva Dasi’ by Steve James