Just 6,000 psychiatrists for all Indians

Despite the World Health Organisation recommending one psychiatrist for 10,000 people, there are only 6,000 psychiatric professionals for a population of 1.2 billion in India.  One in 10 people in the country suffers from some mental health disease. In such a scenario, lack of doctors is a matter of serious concern.

Dr Vidyadhar Watve, former chief of the Indian Psychiatric Society IPS), blames the shortage of doctors on the stigma attached to this branch of medicine.
“The picture projected by the society and media about psychiatry used to be very negative. So much so, that people used to say, ‘Why go to a psychiatrist? They will only give you sleeping pills and electric shocks’.”

Watve says films and media had also played a very negative role to discourage mental health patients from seeking treatment. “Many films showed psychiatrists running after patients to give them a ‘shock’ and that tarnished our image like anything,” he charges.

Dr R N Tandon, finance Secretary of the Indian Medical Association (IMA), echoes his views.

“Unfortunately, mental health ailments were not considered as diseases in Indian perception. When we were in medical school, a densely populated state like Uttar Pradesh only had two major hospitals for mental health diseases — one in Agra, another in Bareilly,” he says.

“Psychiatry has never been given due importance in medical schools. We were also taught one or two chapters on psychiatry in our initial years of study,” Tandon says.

“Somewhere, we are also responsible. We never reached out to the common man to educate them about the benefits of psychiatry. The society needs to be informed that we are also educated doctors — we can also operate stethoscopes and blood-pressure machines,” Watve says. People need to realise that many mental health ailments are very much curable, he adds.

Things, however, may be getting better. “Earlier, prospective doctors used to take up psychiatry as a last choice. Gradually, they have been taking up psychiatry as a first choice. Over the next five to 10 years, we hope to increase from 6,000 to 10,000 (psychiatrists). Still, we are far behind the recommended ratio.”

When asked about the reason for this growth, the experts say that society is accepting psychiatry as an important branch of medicine rather than of philosophy. According to Tandon, people have realised that psychiatry should not be considered as a taboo or stigma.

“It has a scientific base and mental health problems can be treated,” he adds.Watve agrees, “Many films of today have highlighted the role of psychiatrists in the treatment of mental health ailments. It also helps when someone like Deepika Padukone campaigns against social stigma and opens up about the role of psychiatric professionals to help her overcome depression.”

The IPS organises many programmes and conferences on regional, national and international levels for prospective and practising professionals on challenges and advancements in the treatment of mental health ailments. They are also attended by doctors from other branches.

“In western countries, patients of depression and other mental health diseases usually visit a general physician. In our country, physicians are not well versed with the treatment of mental health diseases. We are updating, with the help of Indian Medical Association, the knowledge of general physicians over mental health ailments,” he adds.

Tandon says the IMA too organises similar programmes to educate professionals about mental health diseases.

In fact, at an event organised in the national capital last month, IMA president-elect K K Agarwal said that the Medical Council of India has already mandated that 10 per cent of all credit hours in medical schools must be on mental health. The IMA has also instructed its 2.7 lakh members and office bearers of its 1,700 branches to include mental health as part of every Continuing Medical Education programme organised by them.

“We must address the shortage of trained psychiatric specialists by training general physicians who are the first point of contact for patients,” Agarwal had said.

Tandon also highlights another major reason for the dearth of mental health doctors in India. “Of the small number of psychiatric doctors available in the country, most are situated in metropolitan cities,” Tandon says.

“Many of our psychiatric institutes and hospitals are not up to the mark in terms of amenities, infrastructure and funding. We don’t even have enough beds for psychiatric patients in our hospitals,” he adds.

Watve alleges that there are many super-specialty hospitals that do not encourage the admission of mental health patients. He says many hospitals deny treatment to patients with a history of mental ailment.

“I remember a lady who went to a famous hospital for a fracture but was refused admission because she had a history of a mental health problem,” he say.  The IPS has written to many medical institutes on this issue.

Both the IPS and IMA agree that mental health diseases should not be excluded in mediclaim. Further, families of patients must be made aware of the benefits of seeking treatment in psychiatric diseases. This will not only reduces stigma attached to mental illnesses but also encourages more medical students to enrol in this branch.