National Mental Health Survey of India 2015-16

NMHS
role and are key resources in mental health
care delivery. However, there is great
diversity in the availability of such resources
across Indian states. The limited availability
of such mental health personnel has been
a major barrier to guaranteeing essential
mental health care to all. Furthermore, it
must be noted that information on core
mental health personnel and supportive
service providers from the private sector
was not readily available and the numbers
reported across states should be interpreted
with caution.
According to the World Mental Health Atlas
(2014) (12), there were 0.3 psychiatrists per
lakh of population in India. Psychologists and
psychiatric social workers were even fewer.
The average national deficit of psychiatrists
was estimated to be 77% (48). In developing
countries with acute shortages of mental
health professionals, the delivery of mental
health services through general health care
is considered as the most viable strategy
for increasing the access of underserved
populations to mental health care.
The availability of psychiatrists in the NMHS
states varied from 0.05 per lakh population
in Madhya Pradesh to 1.2 per 1,00,000
population in Kerala. Data available for
some of the high income countries indicate
this number to be between 1-2 per 1,00,000
population. Except for Kerala, all the other
states fell short of this requirement.
Among the surveyed states, Kerala had the
highest number of clinical psychologists
(0.63 per lakh population) and Tamil Nadu
had the highest number of nurses trained
in mental health (10.5 per lakh population)
(Table 8). Among the core mental health
professionals, the availability of psychiatric
social workers was relatively low across all
the NMHS states. Clearly, Madhya Pradesh
lagged behind in terms of mental health
human resources among all the surveyed
states.
With an emphasis on integrating mental
health into the general health care system,
mental health training was earlier imparted
to medical doctors in all primary health
centres. Varying degree of progress have
been documented with respect to the training
of medical doctors. This can be noted from
the fact that excepting for Manipur (9.73
per 1,00,000 population), in all other states
there were very few trained medical officers
for treating persons with mental illnesses.
In Jharkhand no such information was
available. Compared to developed countries,
the number of mental health personnel across
the surveyed states was grossly inadequate.
Apart from mental health professionals,
there is a dire need for supportive
manpower because many of the mental
health problems are chronic & recurrent in
nature and need rehabilitative services. In
many states, information on rehabilitation
workers, special education teachers and
paraprofessional counsellors was not
available. Wherever available, it was found
to be grossly inadequate to meet the current
needs.
• Training in mental health
Human resources are the most valuable
assets of mental health services. An optimum
number of personnel and an equitable
distribution of specialists and non-specialists
trained in mental health care are vital for
the delivery of mental health services in
India. The coverage of doctors trained in
mental health was low in all the states, with
a slightly better position in manipur, kerala
and Gujarat (Figure 7)
SMHSA
49