Dinesh Bhugra is the President of the World Psychiatric Association (WPA) as well as a Professor of Mental Health and Diversity at the Institute of Psychiatry at King’s College London and an Honorary Consultant Psychiatrist at the South London and Maudsley NHS Foundation Trust. He was previously the first non-white President of the Royal College of Psychiatrists and currently sits on the board of trustees at the Mental Health Foundation.
In 2014, Professor Bhugra became the first British and openly gay President of the WPA, an organisation which represents and supports more than 200,000 psychiatrists worldwide. On the 4th September 2015, under the leadership of Professor Bhugra, the WPA launched the first ever ‘World Mind Matters Day’, a global campaign that aims to achieve a fair deal in mental healthcare across the world.
In a long and distinguished career, Professor Bhugra has authored and co-authored over 300 scientific papers and chapters, in addition to over 25 books. He is editor of 3 international journals, and has also been a member of the Department of Health’s steering groups in Public Health and Mental Health.
Professor Bhugra currently features on 2014 Independent on Sunday’s Rainbow List: a pioneering list celebrating today’s 101 most influential lesbian, gay, bisexual, transgender people in Britain.
I was lucky enough to interview him to discuss the links between mental health, men’s health, homosexuality and cultural upbringing, especially in a society as multicultural as Britain’s…
Could you tell me about your life as a child growing up in India?
I was born in a relatively small very industrial town in North India which had only 3 big schools at the time. I remember the heat when in the summers school started at 0630 and finished at 1230 followed by lunch and siesta. The school was 3 kms away so used to walk until I got a bicycle when I was 11. It was a quiet childhood, large number of residents had been refugees after the partition of India and I remember being called a refugee in school even though I had been born there so perhaps unconsciously that’s what attracted me to work in cultural psychiatry focusing on migrants and refugee and asylum seekers.
How do you think an Indian upbringing has affected your life in terms of culture, morals and attitudes?
Cultures we are brought up affect our world view, personality traits and attitudes. So although have been in the UK for over 35 years, some of my thinking has changed such as I cannot abide not being punctual and things not happening on time something which irritates me no end when I am in India. But attitudes towards the world view and seeing the role of work and doing the right thing is what I learnt while I was growing up.
What were you like as a child?
Shy, introverted, head in the books. Not many close friends, very limited interest in sports.
What made you want to study psychiatry and especially specialise in mental health?
I remember very clearly, as I was in the early part of second year coming out of the dissection hall and cycling to the hostel, thinking that “We all have the same physiology and similar anatomy so what makes us so different?”. Reading Freud and material about ancient Indian and Egyptian medicine opened my eyes to the perspective of mind-brain so decided that after finishing, I would specialise in psychiatry. Every one including some of my teachers with whom I talked to about this choice, thought I was crazy but have never regretted my choice of subject. It is the best medical speciality.
As you’re openly gay, when and how did you come out?
In the formal sense of ‘coming out’, it was by talking to some friends and peers in medical school who were not particularly fazed by it. Often people go through stages. In those days the general attitudes in most places were that as long as you didn’t rub the idea into people’s face they would put up with most things-whether it was a reflection of the culture is possible. I saw something similar in Eire of the late 1970s and early 1980s.
How has it affected your relationships with friends, family etc. and why do you think they reacted in this way?
There were some strange responses but as by then I had moved away 5000 miles away it did not really matter to me. It was definitely harder for my parents because of social pressures.
Throughout your career, how do you think your sexuality has affected you professionally?
Like most things it moulds your world view so you feel more in tune with marginalised people whether they are stigmatised mentally ill individuals or those who may be homeless or disabled.
What made you want to be President of the World Psychiatric Association? How did you feel when you won?
I was approached by many senior international figures who encouraged me to stand having seen what I had achieved as President of the Royal College of Psychiatrists. I thought about it and felt that at a global level, I may be able to make a difference. I was not expecting to win and it was with a very narrow margin. It was a great feeling but also somewhat scary. Working on various themes about social discrimination, under-served populations such as LGBT, migrants and asylum seekers etc will hopefully raise awareness and also highlight the needs and help bring about changes in policy and service delivery.
As President of the Mental Health Foundation, how do you think current society compares with the past with regards to attitude and stigma surrounding mental health?
Negative attitudes to mental illness, mentally ill individuals and mental health professionals are much more positive than they used to be when I started in psychiatry 35 years ago. More people especially celebrities, public figures, policy makers are beginning to talk about mental health and mental illness. It was a watershed moment when various MPs stood up in the House of Commons in June 2013 and talked about their own personal experiences from obsessive compulsive disorders to post-natal depression and alcoholism and depression. It was an amazing act of public acknowledgement.
How would you describe the association between mental health and homosexuality?
There is clear evidence that LGBT people have higher rates of mental illness and higher rates of suicide. Interestingly it has been shown convincingly in the USA that if the state changes its policy towards equality, the rates drop. Often because of their sexuality and mental illness LGBT individuals face double jeopardy which will prevent them from seeking help early.
Why is there such an interest in men’s health and mental health at the moment?
There are clear gender differences in the rates of mental illness. Men are often not keen to seek help when needed thereby leading to delays and poorer outcome. Increasing awareness is a positive thing and the changes may be due to increasing public knowledge and also due to an increase in celebrities talking about their illnesses especially from sports star who may be performing an important as role models.
What do you think is the future in terms of homosexuality, mental health and society?
As sexual variations are accepted widely and policies change, levels of acceptability will increase and rates of psychiatric disorders may well fall in the group. Large parts of the world still hold homosexuality illegal which is a worrying situation indeed. It is really disheartening and dispiriting to see many countries going backwards ignoring equality of rights.
What do you hope is the future in terms of homosexuality, mental health and society?
As an optimist my hope is that equal rights across nations will make it possible for LGBT individuals to be regarded as equal and not as ‘the other’. With awareness of the mental illness increasing, my hope is that homosexual individuals will not shy away from seeking help when needed and not be ashamed to recognise and seek help. Better education in schools about both sexuality and mental health is an important first step and needs to be introduced urgently where it does not occur.
What would you say to young gay men and women struggling with their sexuality and mental health?
Learn as much as you can about yourself-your strengths and weaknesses and stress points. Take action to deal with stress before it takes over. Sexuality is part of who you are, talk to people if that helps and do not be ashamed to be who you are. Sexual variation is a natural process. Remember sexual fantasy, sexuality/sexual orientation and sexual behaviour are all very different things.
What are your thoughts in terms of the link between mental health, men’s health, homosexuality and cultural upbringing, especially in a society as multicultural as Britain’s?
Cultures affect child-rearing and mould our world views. Coming across other cultures does influence attitudes and behaviours. It is important that information about men’s mental health needs is available in different languages and different settings where people go. The NHS has a major role to play in education and public mental health and services should be available to where men gather whether it is the sports grounds, pubs or religious places, services should be reaching out. Health should be linked across departments of education, employment, justice, culture and other state departments.