With the stresses of modern lifestyle putting a lot of strain on mental and emotional health, the services of psychiatrists are now increasingly needed, writes Divay Mangla

Health is a state of complete physical, mental and emotional well-being. But in India, generally the emphasis has been on physical health and the mental aspects of health have been overlooked. But the increasing tension and stress of modern life is shifting the focus to ailments of the mind. A significant percentage of patients visiting physicians are actually suffering from mental problems. Nearly 20 per cent of the Indian population suffers from minor mental disorders and 1-2 per cent from serious mental illness.

The rising incidence of suicides and problems like absenteeism and alcoholism in the industrial sector coupled with ailments arising out of high-stress jobs are increasing the demand for psychiatrists.

Psychiatrists are qualified doctors who diagnose and treat illnesses and problems related to the mind through medication and psychoanalytical techniques. Though in the tradition-bound Indian society, there has always been a general tendency towards denying and concealing emotional and mental disorders for fear of being labelled as ‘mad’, now people have started overcoming their reservations and consulting psychiatrists openly.

Psychiatrists work with patients having mental, emotional and behavioral problems. They review and organise data concerning the patient’s family, medical history, and onset of symptoms and examine the patient to determine the general physical condition, using special diagnostic tests. Once the nature and extent of the mental disorder is determined, they formulate an appropriate treatment plan, using a variety of psychotherapeutic methods and medication. They also work with psychologists, occupational therapists and social workers for the rehabilitation of their patients.

The other areas in which psychiatrists work are: de-addiction, psychosexual and marital problems, relationship problems, child and adolescent psychiatry, stress management etc.

There is high demand for psychiatrist overseas, especially in the UK and Australia. After fulfilling certain terms and conditions, psychiatrists can go to work abroad.

The profession is growing rapidly and new applications are opening up. It has started gaining more thrust in the developing nations also. At present, India has about 3,500 psychiatrists to cater to the needs of its huge population. This means there is one psychiatrist per 3 lakh of population. Looking at the prevalence of mental problems, there will be a need for more and more psychiatrists in the coming years. Also, the demand for these specialists abroad is constantly rising.

Psychiatrists can seek employment in regular hospitals, polyclinics as well as mental hospitals. They can even set up their own private clinics or work as counsellors in big industries or drug de-addiction centres. Those interested in academics and research work can take to teaching or higher studies in medical colleges and psychiatric institutions. The salaries range between Rs 20000-30000 per month in government institutions. In the private sector, the sky is the limit. In polyclinics, income is generated on a share basis.

A good psychiatrist must be emotionally stable and have the ability to listen. Qualities likes perseverance, tolerance, an interest to study human behaviour, genuine concern and sympathy for patients, coupled with an objective approach for understanding their problems are also required. Persons having an interest in philosophy, history, sociology and other related fields can bring wider insights to their work as a psychiatrist.

After completing the MBBS degree, those interested in becoming psychiatrists can go in for a postgraduate degree (MD) or diploma in psychiatry.

Postgraduate training in psychiatry, like most other specialties, comprises a three-year residency system with an exit exam leading to the MD degree. Two-year diploma courses are also run by a few institutions.

The competition to undergo postgraduate training is intense, with limited training posts available. Currently, there are about 300 training places available annually for psychiatry, which is low considering the demand for psychiatric care in such a large population.

Entry into postgraduate training courses in all specialties is through examinations conducted by each state and also through a countrywide common entrance examination. Some central institutions conduct their own entrance examinations. Training posts are spread across various state medical colleges.

In India, the jobs for psychiatrists are limited to hospitals and institutes and are not many in number. The post of psychiatrist does not exist at the district level in many states. Private practice in this field may flourish in a big city, but in small towns people still have to overcome the social stigma about visiting a psychiatrist. Working in a rural setting can be a dry experience for a psychiatrist as people there do not have the required psychological make-up.

Training in sub-specialties of psychiatry is still in its infancy in India. But these situations will change in the years to come and open up more avenues for psychiatrists.

The writer is a psychiatrist in GMCH, Sector -32, Chandigarh