The number of psychiatrists in India is not enough for building a mentally healthy society. This is a conclusion that has been reached by almost every report or case study that investigates the status of psychiatric care in India. Stats say that there is one psychiatrist for 300,000 people in India. So what is it that is causing this huge gap between requirement and availability? I believe it is quite easy to blame the education system, the medical education or migration of doctors out of India but there is another aspect that hasn’t been looked into at all. It is the stigma associated with being a psychiatrist in India.
There is a lot of visible stigma associated with visiting a psychiatrist. A survey conducted by psychiatrists on 900 people showed that most didn’t even consider psychiatrists for consultation or treatment of mental illness. People just don’t want to visit psychiatrists.
A big problem lies in the fact that even undergraduate medical students aren’t exposed to psychiatry properly. There is a compulsory posting of 15 days in a psychiatric ward but many colleges fulfil that just on paper and it no surprise that there is a low ratio of students willing to be psychiatrists.
When doctors have to choose a specialisation through NEET-PG in India, psychiatry is far behind other branches like paediatrics, orthopaedics and others. It also offers less money than other branches and is, therefore, not the ideal destination for a budding doctor.
There are also lots of misconceptions about psychiatrists. These are further reinforced by inaccurate depiction of psychiatrists in film and media. An analysis of 26 movies was done between 2001-2010, that included 33 psychiatrist characters. 42.4% percent of them were incompetent and 39.4% breached professional ethics. Only 30.3% were shown to have an accurate diagnosis. Psychiatrists are misconstrued in movies often. This inevitably leads to a negative perception among the general public.
There is also a lot of social stigma attached to being a psychiatrist. It is somehow considered that psychiatrists are ‘crazy’. It is a belief that only the ‘crazy’ treat other ‘crazy’ people and this is simply not true. We don’t expect neurologists to have a brain problem and neither do we think our dentists have teeth filled with cavities. Yet, there is a perception that psychiatrists have a problem.
This doesn’t include the belief that psychiatric medicines are money making techniques used by ‘Big Pharma’ to get money. I have discussed that in my article about psychotropic drugs.
This is a big problem which is not discussed very often. Even among advocates of mental health awareness; there is very little appraisal of this situation. We always encourage people to remove the stigma around mental illness but are we willing to de-stigmatise the profession of psychiatry as well?