Amidst the vibrant hues of India's progress, there's a silent struggle that demands our attention - the battle for mental well-being.
Join me on a journey through the pages of a compelling narrative as we explore why psychiatrists are the unsung heroes our nation needs, addressing not only the complexities of the mind but also dismantling the barriers preventing a healthier, happier India.
Getting into MBBS
Embarking on the path to becoming a psychiatrist in India presents a formidable challenge right from the outset. The scarcity of seats in the MBBS course, determined by a highly competitive national-level exam, stands as the initial hurdle. With a staggering 13 lakh aspirants vying for admission annually, only a mere thousand succeed in securing a coveted spot.
In this cutthroat environment, the dream of becoming a psychiatrist remains distant, overshadowed by the overarching goal of securing a place in the medical field. The arduous five-year journey through the MBBS course becomes a crucible where aspiring doctors are primarily focused on gaining entry and earning the coveted title of a general practitioner. It is only during this exhaustive period that individuals are first exposed to the medical dimensions of psychiatry and the intricacies of mental illnesses.
Introduction to Psychology
After the 4.5-year MBBS course, there's a mandatory 12-month internship where students rotate through different departments for hands-on experience. While departments like pediatrics and OB/GYN get around a month, psychiatry is allocated just 15 days, often considered a mere formality. Even before this, psychiatry isn't a standalone examination subject, and class attendance isn't mandatory.
A study in a North Indian medical college revealed that only 5% attended over half of the psychiatry classes. Additionally, family and peer discouragement towards psychiatry as a career choice is evident. Interns in the psychiatric ward frequently report feelings of fear and apprehension while interacting with the mentally ill, shedding light on the challenges within the field.
The interesting thing though is that in a study on undergraduate medical students in India, it was discovered that 73% of students believed that we need more psychiatrists in India in order to treat psychiatric patients. Just 13% of them, actually wanted to be psychiatrists themselves.
In the first year of the course, 95.6% (!!!) students said that they felt uncomfortable around mentally ill patients. By the time they came to the fourth year, the number went down to 84%. It is clear to see why psychiatry is seen with such a taboo in today’s times.
Western Psychiatry and a Long Shadow
The historical narrative of Western psychiatry, detailed in 'Shhh! Don’t Talk About Mental Health,' exposes a legacy of cruelty towards the mentally ill. From the infamous asylums of the 1900s, where patients were often chained, to the belief in demonic possession leading to physical abuse, psychiatry's past is marked by fear. Even in modern times, the echoes of the anti-psychiatry movement in the 1960s persist, with figures like Thomas Szasz likening psychiatry to astrology. The enduring shadow of this dark history, coupled with the absence of biological tests for mental illnesses, keeps psychiatry on the periphery of medical sciences.
Unfortunately, this history of violence and mistreatment transcends borders, persisting in contemporary India despite improved legislation and regulations.
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References:
Gupta, A. (2019) Shhh! Don’t Talk About Mental Health, Notion Press, Chennai, India
Kodakandla, Krishna & Nasirabadi, Minhaj & Shahid Pasha, Mohammed. (2016). Attitude of Interns towards Mental illness and Psychiatry: A study from two medical colleges in South India. Asian Journal of Psychiatry. 22. 10.1016/j.ajp.2016.06.008.
Lingeswaran A. (2010). Psychiatric curriculum and its impact on the attitude of Indian undergraduate medical students and interns. Indian journal of psychological medicine, 32 (2), 119–127. doi:10.4103/0253-7176.78509
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