The new Mental Healthcare Act mandates that the government should maintain an internationally accepted ratio of mental health professionals and patients. However, the situation on the ground is far from encouraging. Mental health hospitals run by the State government have insufficient psychiatrists and its District Mental Health Programme (DMHP) is severely understaffed.
DMHP has been rolled out in 34 districts, with each district mandated to have a psychiatrist, a clinical psychologist, a psychiatric social worker, a psychiatric nurse, a community nurse and a accountant-cum-case registry assistant. However, besides nearly five vacant posts of psychiatrists, the programme has many vacancies. While countries such as U.S., U.K., Canada, and Australia have a requirement of one psychiatrist per 10,000 population. DMHP has one psychiatrist to cater to a population of between one lakh and 10 lakh in a district.
The four mental health hospitals in Thane, Pune, Nagpur and Ratnagiri have an insufficient number of psychiatrists and other medical staff to cater to in-patients and out-patients, who come for consultations.
The 1,360-bed Thane hospital has half-a-dozen doctors, the 1,540-bed Pune hospital has 30 doctors, the 500-bed Nagpur hospital has about a dozen doctors and the 250-bed Ratnagiri hospital has two doctors.
Dr. Sadhana Tayade, joint director, Directorate of Health Services, Maharashtra, said doctors are reluctant to work in rural areas. She said, “We are in the process of conducting recruitments and creating additional posts.” Recruitment in the government sector is done through promotions and direct recruitment, she said.
Dr. Prakriti Poddar, a certified mental health counsellor and director of Poddar Wellness Ltd., said the number of mental health experts, psychiatrists and psychological counsellors in the State is abysmally low when compared with the high disease burden. She said, “Not many people opt for psychiatry as a profession. Even psychological counsellors’ training is provided only in a few educational institutions.”
Savitha Kuttan, CEO, Omnicuris, a social enterprise working for improving the quality of healthcare in India, said there should be a curriculum to train primary physicians to play an active role in recognising psychiatric disorders in patients, especially in settings with limited resources such as rural India.
Ms. Kuttan said people in such settings suffer from anxiety and depression and don’t receive care owing to social stigma and lack of trained physicians.