Alarming dearth of psychiatrists

There is a serious shortage of psychiatrists in Karnataka. There are only 50 psychiatrists available in the state while there are around four lakh people with serious mental illnesses here. Clearly, there is a huge gap between the demand for and supply of trained psychiatrists. What is more, the number of patients with mental illnesses has soared rapidly from 60,000 in 2015 to four lakh in 2017. Clearly, the number of psychiatrists has not kept up with the rising number of people needing psychiatric care. Interestingly, the National Institute for Mental Health and Neuro Sciences (NIMHANS) produces 36 psychiatrists annually. This should have increased the number of available psychiatrists. That is not the case, however, because many of them prefer to go abroad in search of greener pastures. This is unfortunate, given the enormous need in Karnataka and the rest of India for their expertise. Most of the psychiatrists working in Karnataka are concentrated in Bengaluru. The shortage in rural Karnataka is therefore acute. Apparently, there is no provision for hiring psychiatrists at the 146 taluk hospitals and 2,500 Primary Health Centres in the state. What is stopping the government from amending these provisions to allow for employing psychiatrists in PHCs as well?

The shortage of psychiatrists in other Indian states is more acute.  Mental healthcare is not available or inaccessible in most parts of the country. Indeed, around 90% of patients go undiagnosed or untreated because of the lack of psychiatrists. The situation in our most populous states is dire. Bihar, Uttar Pradesh and Madhya Pradesh have just 31, 30 and 37 psychiatrists respectively in the public sector. There are more psychiatrists in the private sector in many states and this is perhaps because working conditions and salaries are better in private hospitals. While those with mental health problems may prefer going to private hospitals, given the stigma attached to these illnesses, the low number of psychiatrists in government hospitals means that those from economically weaker sections do not get treatment.

India needs to act robustly to tackle the shortage of psychiatrists. There is a need for medical colleges to offer more seats in the psychiatric specialisation. Pay and perks need to be improved so that government hospitals retain skilled psychiatrists.  There have been huge advances in treatment of mentally ill patients. They have opened up opportunities for patients to lead meaningful lives if they have access to trained professionals. New anxieties and addictions are apparent in our society. These cannot be dismissed any more as problems that afflict a few. Mental health is a public health issue.