Mental health care in Madhya Pradesh continues to flounder two years after a national policy on the problem was unveiled as insufficient number of psychiatrists and lack of awareness prevent patients from seeking help due to the social stigma.
The state with a population of over 70 million has just 15 psychiatric doctors in government hospitals, as opposed to 700 it requires.
6-7% of the state’s population suffer from some kind of mental health problem
Experts say 6-7% of the state’s population, or around 4.2 million people, suffer from at least some kind of mental health problem in the state, while another 1-2% or 700,000 to 1.4 million people have serious disorders. Yet, lack of awareness often results in misdiagnosis.
The World Health Organisation predicts about 20% of India’s population will suffer from some form of mental illness by 2020. The 2011 Census data for eight categories of disabilities, including ‘mental retardation’ and ‘mental illness’, shows the number of people with mental retardation was 77,803, which is 5% of the 1.55 million disabled people in the state, and 39,513 people with ‘mental illness’, or 2.5%.
“There are over a dozen psychiatrists in the government hospitals and roughly 40 to 50 psychiatrists in the private sector, with most of them based in the urban centres, leaving most of the rural areas without any mental healthcare facilities,” Dr RN Sahu, secretary of MP Mental Health Authority and professor of psychiatry at Gandhi Medical College and Associated Hospitals Bhopal, said.
He added that the shortage of professionals was due to the lack of psychiatry courses in state medical colleges: “...except for the Indore medical college, post graduate courses haven’t been started in any of other five medical colleges in the state. Even at Indore, two seats were introduced for PG in psychiatry two years ago,” he said. “There are no courses even for clinical psychology in any of the medical colleges.”
The National Mental Health Policy unveiled in October 2014 promised fresh funds for modernisation and expansion of mental health care facilities in the country, besides providing universal access to mental healthcare.
There should be one psychiatrist for every 100,000 people
According to proposed norms, there should be one psychiatrist for every 100,000 people, three clinical psychologists for every 200,000 people, two psychiatric social workers for every 100,000 people, and one psychiatric nurse for every 10 psychiatric beds.
However, Dr Sahu said MP has just two psychiatric hospitals — Manasik Arogyasala in Gwalior and psychiatric hospital, Indore. “I must have sent over two dozen requisitions to the government regarding improving mental healthcare in the state, but not much has been done.”
District mental healthcare programme started in just two districts
“The district mental healthcare programme has been started in just two districts — Sehore and Chhindwara — and preparations are on for launching it in five more districts. But in a state with so many districts (51) it is not enough, especially in the backdrop of severe shortage of psychiatrists,” he said.
Experts say that a sufficient number of psychiatrists and psychologists in the state would result in a drop in cases of suicide. State crime records bureau data show that 1,227 of the 10,293 people who committed suicide last year in the state were suffering from mental illness. Unable to handle agrarian stress, between 2001 and 2015, 18,687 farmers took their own life.
In January, World Psychiatric Association president Prof Dinesh Bhugra told HT that instead of playing down farmer suicides, the central government should seek the help of psychiatrists: “If you want a mentally healthy society, a society where farmers don’t commit suicide, you have to deal with the issue in a holistic manner.”
National Health Mission (mental healthcare) deputy director Manish Singh said the health department was working to improve the situation.
“We are talking with the government for increasing number of seats for PG in psychiatry in medical colleges here. We have also provided basic psychiatric training to 49 doctors and 120 nurses to provide basic treatment to psychiatric patients and identify patients with severe mental illness for referral,” he said.
More doctors at primary and secondary level ought to be given basic training in psychiatry so that they can identify mental disorders and refer them to the nearest psychiatrists for treatment.
Increase seats for post-graduation in psychiatry in the medical colleges
MBBS students be taught psychiatry from first year, not just in the last year.
More awareness and education needed to end stigma associated with mental disorders