Few psychiatrists to care for many people with mental illness in India

From The Times of India:

CHENNAI, India -- By 7.40 pm on Wednesday, Dr S Nambi, a consultant psychiatrist at the Institute of Mental Health had seen 15 schizophrenia patients at his
private clinic. There were 35 more waiting to see him.

As the Institute of Mental Health observed the International Day for Schizophernia, which comes up on May 24, doctors voice concern about the increasing demand for experts as well as healthcare facilities for people with the mental illness.

There are only 320 psychiatrists in the state to take care of 700,000 people affected by schizophrenia, a mental disorder characterised by abnormalities in perception or expression of reality.

"We have less than 25 students passing out every year. We badly need more doctors," says Dr Nambi. However, he admits that Tamil Nadu fares far better than other states. "Nearly 9% of the doctors are in Tamil Nadu, and 50% of them are in government service," he adds.

What makes things more difficult for patients is lack of hospital services. The state government's ambitious district mental health programme remains a non-starter in several districts. Though several NGOs such as the Banyan offer services, there are less than 3,400 beds in the state.

The century-old 1800-bed Institute of Mental Health is always overcrowded. Worse, the management spends more on the maintenance of the building than on patient care, says its director Dr R Sathianathen. The hospital has century old buildings which were declared unfit for use even by the public health department officials more than seven years ago. The office of the director collapsed and the hospital constructed a new administrative premises. "Every year, we spend Rs 60-80 lakhs on renovation of old buildings, plugging leaks in the toilets. The amount spent on patient care is extremely less," he said.

The lack of facilities leaves patients with the only option of taking drugs to control illness. "Though drugs are an essential part of therapy, patients can't be fettered like this. They hardly have any rehabilitation programme or recreation therapy that can help weave them into society," says Dr Thara, who spearheads SCARF (Schizophrenia Research Foundation), Chennai.

SCARF established a telepsychiatry facility about four years ago. "Studies showed that nearly 80% of chronic mentally-challenged patients in rural areas are not treated. The situation post-tsunami has made it even more difficult. Initially, we began the project to cater to tsunami-affected zones such as Nagapattinam and Cuddalore. We knew several people there would require treatment and it was difficult to send doctors from here every week. So, we started the telemedicine facility," Dr Thara explains. More than 800 people have benefited. The advantage: it does not require a doctor to touch or feel the patient.

"We have been able to detect and treat several illnesses, including schizophrenia, psychosis, mental retardation, behavioural problems, bipolar depression and dementia. If we had not diagnosed these ailments, the patients and their families would have been suffering. The facility has helped us free several people from iron fetters. We have also asked them to visit rehabilitation centres for further therapy," she says.