Stop the quacks

In a shocking case from Maharashtra’s Nagpur district, a self-proclaimed psychologist was arrested for allegedly blackmailing and sexually exploiting over 50 students over 15 years. Operating a clinic and residential programme in Nagpur, the accused lured female students under the guise of offering personal and professional development. The Clinical Psychology Society of India (CPSI) revealed that he was a quack, unregistered with the Rehabilitation Council of India (RCI). While he was charged under the POCSO Act and the SC/ST (Prevention of Atrocities) Act, the case underscores glaring gaps in mental health regulations in India. 

In a country where stigma surrounding mental health remains pervasive, seeking help itself is an act of immense courage. However, such betrayal of trust deters others from seeking care, perpetuating harmful stereotypes about psychology as a field. This breach of confidence not only damages the credibility of mental health professionals but also reinforces societal taboos. 

India has made some progress in addressing mental health concerns, particularly with the Mental Healthcare Act, 2017, which emphasises the rights of individuals with mental illnesses, including the right to access treatment without discrimination. However, when it comes to regulating psychology and its practitioners, the laws remain inadequate. Most existing regulations are designed with medical practitioners and are often applied to psychologists and counsellors without considering the unique nature of their work. 

For instance, the ethical dilemmas surrounding euthanasia for psychiatric patients highlight the inadequacy of India’s legal frameworks. A 2018 Supreme Court ruling allowed passive euthanasia under strict guidelines, primarily for patients in irreversible comas or vegetative states. Psychiatric disorders are not explicitly addressed, leaving a significant gap in the discourse.

India’s healthcare system faces unique challenges, including stigma around mental health, limited access to specialised care, and a lack of mental health professionals. Introducing euthanasia for psychiatric patients in such a context could lead to misuse and ethical violations. For instance, families facing socio-economic pressures might coerce a patient into opting for euthanasia, calling it an act of mercy.

Unlike medical doctors, whose qualifications are relatively straightforward to verify, the lack of robust mechanisms to check the credentials of mental health practitioners exacerbates the issue. 

A widespread misconception in India equates psychologists with medical doctors. In Indian society, doctors are often seen as ultimate authorities, possessing all knowledge and solutions. When psychologists are perceived similarly, it skews the power dynamic between the client and the practitioner, placing therapists on a higher pedestal. Many clients, unaware of the distinctions between different mental health practitioners, often enter therapy with blind faith, rarely questioning the practitioner’s credentials. While trust is essential, this uncritical faith can be dangerous when exploited by unqualified or unethical individuals.

The demand for mental health services in India has surged in recent years, driven by increasing awareness, rising mental health concerns, and global crises like the Covid-19 pandemic. According to the National Mental Health Survey (NMHS) 2015-2016, nearly 14% of India’s population required active mental health interventions. However, the availability of qualified mental health professionals remains abysmally low. The World Health Organisation (WHO) recommends at least one psychiatrist per 10,000 people; India falls far short of this benchmark, with just 0.7 psychiatrists per 100,000 people. This mismatch between demand and supply has allowed untrained individuals and quacks to infiltrate the field. The lack of stringent regulations allows such individuals to operate with impunity. 

India’s mental health landscape demands urgent reforms, including clear guidelines for verifying the qualifications and ethical standards of practitioners, stricter penalties for violations, and robust systems for grievance redressal. Additionally, increasing awareness among the general public about how to choose a mental health professional is essential. This could include public awareness campaigns about the differences between psychologists, psychiatrists, and counsellors, as well as the importance of verifying credentials before beginning therapy. 

According to a 2017 Lancet report, India accounted for 37% of global suicide deaths among women and 24% among men. These alarming figures highlight the consequences of untreated mental health issues and the need for timely interventions. Without a comprehensive framework to address the gaps in regulation, victims of mental health challenges risk being further exploited or neglected by the system meant to protect them.

(The writer is a master’s student of clinical psychology at Christ deemed to be university, Bengaluru)