Mumbai: Lack of psychiatrists willing to work in rural areas is posing a major problem to the District Mental Health Programme (DMHP). As a solution, the Directorate of Health Services (DHS) now plans to open the posts to MBBS doctors. Once hired, these doctors will undergo mental health training for a month before they take up their new posting.
Dr. Sadhana Tayade, joint director, DHS and overall in-charge for mental health programmes, said, “We have put out several advertisements, but aren’t getting enough psychiatrists. We now plan to get MBBS doctors who will be trained in mental health issues.”
The DMHP has been rolled out in 16 districts. Additionally, the State also started Prerna Prakalp, a mental health programme solely for farmers in drought-affected Marathwada and Vidarbha, where thousands of farmers have committed suicide over the past 20 years.
The Prerna Prakalp cell is meant to have a psychiatrist, a clinical psychologist, psychiatric social worker, psychiatric nurse, community nurse and an accountant-cum-case registry assistant. However, the 14 cells have only eight psychiatrists between them. The DMHP too has four vacant psychiatrists’ posts. A district typically has 1,200 to 1,400 villages and an average population of 15 to 20 lakh, and just two psychiatrists are woefully inadequate.
Small team, big task
Even if these posts are filled, it shows the mental health programme is almost non-existent. A community nurse with a Prerna Prakalp cell in Vidarbha said, “We’re a small team. Even if we try hard, we can reach out to only a handful of families during field visits. The villages are far from each other. At times, when we reach, most family members are at the farms. There are a lot of problems. If they want the mental health programme to run well, they need staff, on field and in hospitals.”
She added, “Also, most are unaware of the concept of mental health, and it takes time during visits to gauge the problem. Psychiatrist or the clinical psychologists rarely get a chance to visit the village. They have to be in the rural or sub-district hospital, which the patients are encouraged to visit.”
At present, the Accredited Social Health Activists (ASHA) in villages are the principal field workers for the programme, reaching out to farmer families.
If they find something amiss during a routine conversation, the person is convinced to talk to a counsellor on the 104 mental health helpline.
City-based psychiatrist Dr. Sagar Mundhada said an MBBS curriculum touches upon mental health. “If the doctors are trained for a month under psychiatrists, they will definitely be able to screen people. District Hospitals should have psychiatrists, to whom MBBS doctors can refer patients in extreme cases.”
