Cross-system practice is widely prevalent in Indian settings. The recent policy decisions of the Government of India and the legalisation of cross-system practice in various states have brought this issue into the limelight once again. We aim to critically evaluate this issue from the philosophical, academic, and public health perspectives, as well as with reference to training. On the one hand, students of traditional Indian medicine are being introduced to allopathy without philosophical backing, practice based on the aetiological model and training in modern pharmacology. In addition, pharmaceutical industries are wooing AYUSH practitioners and their prescription patterns have already been "allopathised". As for the allopathic system, it is witnessing enormous scientific advances and growing increasingly complicated. The medicines are risky and also associated with many life-threatening side-effects. Meanwhile, the government is grappling with the humungous problem of ensuring health services for all. The government's intention is to expand the reach of health services by allowing cross-system practice, but the issue has much wider ramifications. The authors believe that before cross-system practice is allowed, there is a need for a comprehensive and deeper understanding of all the benefits and pitfalls of such as system. A few of these are discussed in this article. Specifically, we delve into the philosophical issues, syllabus and training, advances in medical technology, and larger public health perspectives. We end by suggesting a few steps that may help to improve public health in the country.

Background: Digital technology has emerged as a powerful approach to bridge treatment gap in the field of mental health. However, public health impact of e-interventions is unlikely without large scale uptake of such services. Hence it becomes important to understand motives of potential users in order to design programs that address such needs as well as disseminate information about the same in ways that appeal to the users. Methods: Reasons underlying interest in an internet based self-care program for depression were explored through a brief survey of potential users who had explicitly shown interest in such a program. Responses to an online survey were received from 120 respondents out of which about 69% were in 18-35 years of age-range and 12% were above 50 years of age. Results: Preference for flexibility in terms of ‘when I do things to help myself’, ‘not having time to go for face to face counselling/therapy’ and ‘wanting to learn and do something to prevent problems in future even though I am currently on treatment’ emerged as the top 3 reasons underlying interest in internet based self-help programs for depression. Not having the finances to seek face to face mental health consultation emerged as one of the top 3 reasons in the older group. Conclusions: Incorporating maximal flexibility, providing pointers to the most relevant components thereby minimizing time required, and focusing on preventive strategies (even for those who are currently seeking treatment) are aspects that need to be considered in development and dissemination of internet based self-help programs for depression in urban India.

OSF may be associated with considerable psychological morbidity. This morbidity may be significantly more in patients with worst functional staging. It is difficult to determine whether this is the cause or effect of the disease. Further systematic studies are urgently needed to address this issue.

Background: Growing awareness of treatment gap for common mental health problems has provided an impetus to development of a variety of mental health apps. However there is a dearth of literature on potential users of such apps in India. Information of this nature can be vital in efforts at further development and dissemination of such apps for enhancing their public health impact. Methods: The paper focuses on examining the profile of individuals who expressed an interest in a newly developed internet based self-help program, called PUSH-D (Practice and Use Self-Help for depression). The PUSH-D pilot-trial was announced on various platforms and participation was solicited from individuals in the community. All those who communicated an interest were requested to participate in an initial evaluation session. Hundred and two individuals completed the evaluation that involved use of interviews and standardized questionnaires to assess depression severity, well-being, and functional impairment. Results: An average PUSH-D seeker was likely to be a young adult, with at least undergraduate level of education and was equally likely to be a male or a female. PUSH-D seekers were likely to have major depression or dysthymia; with mild to moderate severity of symptoms and significant impairment in functioning. Co-morbidities were evident only in a minority of PUSH-D seekers. Conclusions: About two third of PUSH-D seekers had never sought mental health services. Various barriers to seeking face to face professional consultations were reported. The results highlight the potential role of internet- based self-help programs for addressing treatment gap in India.

Background:Dementia is one of the most disabling disorders afflicting the elderly, with a staggering emotional and economic impact. Antidementia agents have been used for delaying cognitive decline. Antipsychotics are commonly prescribed for behavioral symptoms associated with dementia.Objectives:To explore the use of anti-dementing agents and antipsychotics used in patients with a diagnosis of dementiaMaterials and Methods:A retrospective chart review method; geriatric clinic of tertiary care setting.Results:The study sample included 51 consecutive patients with a diagnosis of dementia. The commonest subtype of dementia that was diagnosed was Alzheimer's disease (45%), followed by Frontotemporal dementia (25%).The commonest antidementia drug that was used was donepezil, which alone was prescribed in 27 patients (52%). The commonest antipsychotic used was quetiapine, which was used in 24 patients (47%).Conclusions:The study found donepezil to be the most commonly prescribed antidementia drug and quetiapine to be the most commonly used antipsychotic in a tertiary care geriatric clinic, in a developing country. There is a need to study the cost-effectiveness of antidementia and antipsychotic drugs in patients with dementia, in developing countries.