Concerned about the acute shortage of psychiatrists in the public healthcare system, Maharashtra public health department has decided to train its own MBBS doctors from primary health centres (PHC)s. The doctors will undergo a three-month online course on mental health from the National Institute of Mental Health and Sciences (NIMHANS), Bengaluru.
According to the World Health Organisation (WHO), India has 0.29 psychiatrists and 0.06 psychologists per lakh population in the mental health sector, while countries like Norway have 48 psychiatrists per lakh population and Argentina 222 — the highest globally. In Maharashtra, only 20 of 34 sanctioned district level psychiatrists are filled. Of 85 other sanctioned posts for psychiatrists (class I) in district and mental hospitals, only nine are filled, a senior official in the Directorate of Health Services (DHS) said.
While the Maharashtra government plans to train 100 PHC doctors in batches, only 40 doctors have agreed so far. NIMHANS will conduct exams at the end of the course.
Each doctor will be paid Rs 5,000 as stipend for the course. Dr Radhakishan Pawar, district health officer of Beed, said the course will equip doctors to identify early signs of depression, anxiety and other mental health problems. “Mental health is still not a priority for doctors on the ground...We are trying to sensitise them,” said Dr Sadhana Tayde, director at DHS.
According to Dr Duryodhan Chauhan, head of the mental health cell at DHS, the district mental health programme started by the central government is “like a baby” in the state and will take time to grow strong. “Not all doctors are willing to undergo the training. It is more work for them,” he said. Experts have a mixed reaction to the plan to bring in a pool of semi-qualified psychiatrists. A postgraduate psychiatry degree course takes three years and a diploma course takes two years. But the three months online course may not be adequate enough, experts said.
Psychiatrist Dr Avinash De Sousa, a consultant at the government-run Sion Hospital, said basic training will help identify early symptoms of mental health. “But will they be equipped enough to diagnose and prescribe correctly?” he asked, adding that poor salary and large workload drives away private psychiatrists from government service. “If government hospitals are open to the honorary system of appointing psychiatrists for a few hours while letting them continue private practice, the vacancies can be filled,” he said.