India has a population of 1.2 billion people – and at least five crore of them live with a mental illness. But the country has a severe shortage of trained mental health professionals – especially psychiatrists. According to the latest data provided by the government of India, there are less than 4000 psychiatrists in the country. That is just about one psychiatrist for over 13,000 people.
So why is it that the country doesn’t have enough mental health professionals? One reason, according to experts, is the inadequate quality of medical education in the country, both at the undergraduate level as well as at the postgraduate level. Another reason is brain drain.
‘Undergraduate education inadequate’
“Undergraduate medical course in India hardly focuses on psychiatry,” says Dr Thara Srinivasan, Director, Schizophrenia Research Foundation (SCARF) in Chennai. There are very few mandatory exams on psychiatry at the undergraduate level, and even then, the courses are not rigorous, say experts.
“Psychiatry as a serious discipline has not received its due attention at the undergraduate level,” says Dr Sandip Deshpande, Consultant Psychiatrist at The People Tree Maarga in Bengaluru.
'Limited number of post graduate seats'
When it comes to post graduate education in psychiatry, there are not enough seats in medical colleges, according to senior psychiatrists. There are currently 21 Centers of Excellence being funded by the Centre in the field of mental health in India, three of which are located in South India – the Institute of Mental Health And Neuro Sciences (IMHANS) at Kozhikode in Kerala, Institute of Mental Health at Hyderabad in Telangana, and the Dharwad Institute of Mental Health and Neuro Sciences, in Karnataka. Tamil Nadu however has no Centers of Excellence yet.
"The super specialization courses are very few in Psychiatry. So far India has only two super specialization courses – Child & Adolescent Psychiatry, and Geriatric mental health," says Dr Thara Srinivasan.
Dr Sandip Deshpande is of the opinion that the country first needs to have enough well trained psychiatrists and only then we can focus on specialisation. “A lot of specialisations have relevance only in urban settings,” Dr Sandip says, which is the reason why he believes we need more trained general psychiatrists who can work across the board.
Too many doctors leaving India?
Another reason India doesn’t have enough psychiatrists is because many of them leave the country for better prospects abroad, say experts. Brain drain occurs due to the lack of good work opportunities in India, they say, which is ironic considering the skewed ratio of psychiatrists in the population
In fact, Dr Sandip says, “According to some anecdotal evidence, there are far more psychiatrists of Indian origin in the western countries than there are psychiatrists in India."
The dearth of psychiatrists in India can only be solved if there is a multi pronged approach. However a mere increase in the number of psychiatrists alone cannot fix the mental health problems of the country.
As Dr Sandip says, “We need a multi-pronged approach to tackle the mental health needs of India. It’s not enough to just churn out more psychiatrists. We don’t have enough mental health professionals – like psychologists, psychiatric nurses, social workers etc – who are well qualified and well trained. We must address this.”