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Well known for its powerful deity who heals the mentally ill, the village of Gunaseelam illustrates an interesting example of mental healthcare combining rituals (tīrttam) and medication (tablets). After the Ervadi tragedy, the government forbade the confinement and chaining of the mentally ill in unlicensed places such as in religious institutions as contrary to human rights, so a clinic was established to treat patients. How is the intrusion of psychiatry into the temple and its association with the rituals perceived by priests and psychiatrists, and by patients and caregivers? What are the implications that this therapeutic combination has for the quality of life of patients and caregivers and for the life of the village and the temple? This article attempts to explore these questions through the particular case of Gunaseelam and offers some ways to develop mental healthcare practices that are more acceptable to the people, notably those people from lower social backgrounds.

Acknowledgements

The authors express their deepest gratitude to Dr Gopalakrishna, director of Sowmanasya Hospital, Trichy, and responsible for the rehabilitation Centre, and to the Administrator of Sri Pirasanna Veṅkaṭācalapati at Gunaseelam for their help in facilitating the research. The authors warmly thank all the persons who were always ready to answer their questions, however delicate: patients and caregivers, priests, shopkeepers and villagers.

Conflict of interest

The authors certify that there is no conflict of interest with any organization regarding the material discussed in the manuscript.

Notes

1. The transliteration of vernacular words follows the rules according to the Tamil Lexicon, University of Madras, 1982.

2. The temple's trustee comprises ten Brahmin priests belonging to the same clan (gotra) and one person who belongs to a different gotra so that there is a priest who can perform rituals when the others are affected by symbolic pollution associated with death or birth. In terms of organisation, there is one main priest who controls rituals, an executive trustee and a manager in charge of administration.

3. See the Mental Health Care Bill, 2013 introduced in the Rajya Sabha on August 19, 2013. http://www.prsindia.org/administrator/uploads/general/1376983253∼∼mental%20health%20care%20bill%202013.pdf

4. Veṅkaṭācalapati is assimilated to Veṅkatesvara, in Vishnu form, at the famous temple complex of Tirupati-Tirumalai (Andhra Pradesh). For the myth see (retrieved 14 August 2013): http://en.wikipedia.org/wiki/Prasanna_Venkatachalapathy_Temple; http://prtraveller.blogspot.fr/2009/02/gunaseelam-prasanna-venkatesa-perumal.html

5. Pūcai from puja (Sk) is a main ritual in the temple, which consists of offerings of various substances to the deity, such as vermillion, ash, lamps and flowers, including at Gunaseelam, tulasi leaves (Ocimum tenuiflorum).

6. These drugs include sodium valproate and depakote as mood stabilisers; lorazepam, a benzodiazepine for anxiety and sleep, and quetiapine and olanzapine as antipsychotics.

7. Free medication applies only to the most basic ones. Some medicines are in the form of free samples provided by pharmaceutical companies, and when requested, patients’ families have to buy specific ones.

8. Piracātam (Sk. prasāda) refers to items offered to the deity before being consumed by devotees. The items are flame, vermillion, sacred ashes, flowers, coconut, banana, tulasi, and naivēttiyaṅkaḷ, a range of foods cooked in the temple kitchen. Caṭāri is a crown on the top of which are drawn the tiruvati, Sriman Narayanan's feet (Vishnu), that the priest places briefly upon the head of devotees during the pūcai.

9. A lākh corresponds to 100,000 Rupees (INR). The rate of 1 INR in 2014 is equivalent to around 0.0099 GBP.

10. The annatānam served at Gunaseelam corresponds to the scheme launched in 2009 by Jayalitha, Chief Minister of Tamil Nadu, aiming to provide 100 meals to the poor in temples. At Gunaseelam, the trustee board encourages devotees to give donations at fixed prices for serving 100 basic or festive meals or to contribute by slipping money into the collection box.

11. The notions of cooling and heating associated with Indian traditional medicines are commonly used by Indians to define a substance or a foodstuff. Nevertheless, it would be erroneous to think that each product is clearly defined by a propriety. A product may be varyingly considered as cooling or heating according to the region, the situation, and/or the speaker.

Additional information

Funding

This work was supported by the Institute Universitaire de France (IUF) and by the French Institute of Pondicherry.
 

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