Founding and managing a mental health establishment under the Mental Healthcare Act 2017.

The World Health Organization Atlas reveals lower bed and mental health professionals ratio per population in India. This may be due to a poor allocation of funding in the mental health sector by the Government. This resulted in a lack of complete and comprehensive care ranging from acute treatment to long-term rehabilitation throughout the country. The spiral of specialist care needs such as deaddiction, child psychiatric needs, and rehabilitation facility are available only to a handful of the population in metropolitan cities in India. The launching or establishment of new Mental Health Establishments (MHEs) and upgrading mental health service may provide strategies to bridge this gap from the private mental health sector. Following the inception of "Mental Healthcare Act 2017" (MHCA 2017), the process of setting up MHEs and their operations comes with new legal and healthcare aspects that remain debatable and unsettled. We put forth the basic measures that can be considered and undertaken to establish an exemplary MHE under the MHCA 2017.

Rapid Resolution of Grief with IV Infusion of Ketamine: A Unique Phenomenological Experience.

Ketamine, a primarily FDA-approved anaesthetic agent is also used as recreational drug. Based on preclinical findings and later the clinical observations it is noted to have rapid antidepressant effect due to its mechanisms related to NMDA antagonism. In spite of established evidence of ketamine being effective in depression with significant role in treatment resistant cases as well, there was absolute dearth of literature regarding its utility in grief-related disorders. In this context we present a case of 28-year-old graduate male who presented to us in complicated grief following death of his wife due to obstetric complications. With the patient and immediate family members consenting for use of ketamine as off-label use, patient had single IV infusion of ketamine following which he had unique phenomenological experience ultimately resolving his grief in few minutes. Through this case we highlight the enormous therapeutic promise of ketamine in complicated grief.