In a state where only 20 of 89 psychiatrist positions are occupied, the Prerna Prakalp project — a mental health scheme for farmers in 14 districts in drought-affected Vidarbha and Marathwada — was the state government’s ambitious attempt at reducing this glaring gap.
Launched in October last year to help farmers in distress following a spate of suicides that peaked in 2015, the Prerna Prakalp project has managed to fill pyschiatrists’ vacancies in 11 districts in six months, but back-to-back advertisements for the posts in Hingoli, Jalna and Washim are yet to yield any response.
“We have been advertising, but most are unwilling to go to these three districts,” Dr Sadhna Tayde, joint director, Directorate of Health Services, said. She is overseeing the mental health programme.
The three districts are among those reporting high suicide figures: in 2015, 83 farmers in Jalna and 41 in Hingoli committed suicide. Till March 28 this year, the two districts reported 31 and 15 suicides respectively. While the special resolution issued by the government that envisaged one psychiatrist position per district, the project could recruit five psychiatrists by December 2015 and another six by March this year.
However, it doesn’t come as a surprise that three districts still have vacancies, as 18 of 29 positions in state-run mental hospitals are lying vacant since the last two years. The situation is worse in the district hospitals, where only nine of 50 approved posts for psychiatrists have been filled.
Shortage of pyschiatrists
Doctors say there aren’t enough psychiatrists going, and the few there are prefer to work in urban areas. However, demand for their services is high in rural areas. For example, a special column to record farmers’ concerns was added to the government’s mental health cell helpline ‘104’ late last year, which clocked 2,000 calls in six months largely due to efforts by ASHA workers.
To meet the demand, doctors with primary healthcare centres are being trained in basic psychiatry since Prerna Prakalp was launched to supplement the training being provided to MBBS doctors. However, officials admitted that the MBBS doctors’ priority was maternal and child healthcare, and mental health often takes a back seat.
The dearth of mental health professionals isn’t surprising given the few seats for PG courses in psychiatry in the state’s medical colleges. “There isn’t a single PG seat in psychiatry in all four medical colleges Marathwada and the three in Vidarbha. Of the state’s 17 medical colleges, only five offer PG seats for psychiatry and four of these are in Mumbai,” Dr Sagar Mundada, a PG student of psychiatry at JJ Medical College and president, Maharashtra Association of Resident Doctors, said, adding there is only one psychiatrist for every three lakh people in Maharashtra.
Several initiatives have so far remained on paper. For instance, a certificate course in psychiatry was being considered at the Maharashtra University of Health Sciences, but is awaiting approval. The Directorate of Health Services’ bid to start a certificate course too hasn’t taken off.
Until psychiatrist numbers pick up, the state's hunt for professionals for its mental health scheme is likely to continue. Meanwhile, the next advertisement for vacancies in Jalna, Hingoli and Washim will be out soon.
We have been advertising, but most are unwilling to go to these three districtsDr Sadhna TaydeJoint Director, Directorate of Health Services
