The demand for mental healthcare is increasing in India thanks to shifts in attitudes over the years. However, data show that there is no commensurate rise in the number of mental health professionals.
The World Health Organization’s guidelines state that there should be at least three practising psychiatrists per one lakh population. As per the latest National Mental Health Survey (NMHS), which was conducted between 2015 and 2016, India has only 0.75 psychiatrists per 1 lakh population.
In its 2023 report, ‘Mental Healthcare and Its Management in Contemporary Times,’ the Parliamentary Standing Committee on Health and Family Welfare stated that there were 9,000 working psychiatrists in India at the time. If the goal is to have three psychiatrists per one lakh population, India would require 36,000, the report said.
The report also pointed out that about 1,000 psychiatrists enter the workforce every year. Keeping aside factors such as attrition and unemployment, it would take India about 27 years to meet the WHO-recommended goal (Chart 1). If India wants to achieve this mark earlier, it requires a policy intervention with adequate incentives to increase supply.
Chart 1 shows the number of psychiatrists required at the end of every year to meet the WHO recommendation. The red line shows the required ratio of psychiatrists per one lakh population.
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India’s rate of 0.75 is poor compared to other countries. Among the BRICS nations (updated list), India is one of the two countries with the lowest number of psychiatrists per capita; the other is Ethiopia, which employs 0.1 psychiatrists per 1 lakh population. However, India fares better in South Asia (Chart 2).
Chart 2 shows the number of psychiatrists per one lakh population in select countries.
It is important to note here that the 2023 Parliamentary Committee had to rely on the NMHS, conducted almost a decade ago, for its findings. Also, the NMHS was conducted in 12 States, covering about 40,000 people, a considerably “small sample”, according to the Standing Committee. The Committee’s report also highlighted that the NMHS only collected data on specific mental illnesses, overlooking milder manifestations such as emotional breakdowns that also require intervention. Further, the NMHS did not include samples from particularly vulnerable populations such as prisoners, the homeless, and the institutionalised. The second edition of the NMHS is scheduled to be rolled out later next year.
Chart 3 shows the number of psychiatrists per one lakh population in the surveyed States.
Of the 12 surveyed States in the NMHS, Kerala was the only one that employed more than one psychiatrist per one lakh people. Manipur and West Bengal ranked second and third, respectively, with 0.5 psychiatrists per one lakh people. Tamil Nadu ranked 7th with a rate of 0.3. States in north and central India, such as Uttar Pradesh, Chhattisgarh, Rajasthan, and Madhya Pradesh, ranked the lowest.
Although the numbers indicate that accessibility to mental healthcare has become stagnant, there seems to be an increase in awareness and a decrease in stigma towards it. A study conducted by the LiveLoveLaugh Foundation, titled ‘How India Perceives Mental Health 2021’, said that there was a notable improvement in attitudes and treatment-seeking behaviour among Indians when compared to the previous edition of the study in 2018 (Chart 4).
Chart 4 shows the share of respondents who showed various positive behaviour towards mental health in 2018 and 2021.
There was a significant increase (from 32% in 2018 to 65% in 2021) in the share of respondents who said that individuals with mental illnesses can be given responsibilities. More than 90% of the respondents in 2021 said that they would be willing to seek treatment for themselves, or would be supportive of an individual accessing mental healthcare, compared to 54% in 2018. The share of respondents who were aware of mental health increased from 87% to 96%.
Source: National Mental Health Survey 2015-16, World Health Organization, LiveLoveLaugh Foundation
nitika.evangeline@thehindu.co.in
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Published - September 04, 2024 08:00 am IST
