MADURAI: Even as the State machinery is putting more emphasis on the psychological wellbeing of the populace, most government medical college hospitals in the State are reeling under an insufficient number of clinical psychologists (specialists who assess/diagnose psychological, emotional or behavioral disorders) for over a decade.
Difference between a psychiatrist and a clinical psychologist
A psychologist treats social, emotional, and behavioural issues while a psychiatrist treats patients who need medical intervention for the psychological conditions. However, they both work hand-in-hand to bring out desirable changes in the mental well-being of patients. "While the role of a clinical psychologist is manifold, Tamil Nadu is reeling under an insufficient number of clinical psychologists at government medical college hospitals," said president of Tamil Nadu Association of Clinical Psychologists K Rangaswami.
Sources in the association said that, of the 34 sanctioned posts (Assistant Professors) in government medical college hospitals across Tamil Nadu, only 11 have been filled so far and the Tamil Nadu Public Service Commission (TNPSC) that invites applications based on requirements raised by the State Health Department, has not invited applications to fill the remaining vacancies since January 2008.
They added that clinical psychologists are posted in government medical college hospitals in Madurai, Theni, Thanjavur, Tirunelveli, Chengelpet and in Chennai (select hospitals) only. Sources also said that the two sanctioned posts of clinical psychologists at the Rajiv Gandhi Government General Hospital have been lying unfilled for a long time while two out of three sanctioned posts are vacant in Madurai, one out of four at the Institute of Mental Health (Kilpauk, Chennai), and one out of two at the Institute of Child Health and Hospital for Children.
Speaking to TNIE, Secretary to the Department of Health and Family Welfare Beela Rajesh said, "When applications to fill 18 vacancies were last called for by the TNPSC, there were only nine takers. Due to poor response, the vacancies have not been filled." Asked if there were any plan to call for applications through TNPSC in future, she said that the matter has to be studied by taking a wholesome view, now that training and recruitment of postgraduates in psychology (M Sc in Psychology/Clinical Psychology, especially in District Early Intervention Centres (DEIC) and under District Mental Health Programmes) is underway.
Psychometric tests
A clinical psychologist posted at the department of psychiatry at any government medical college hospital conducts psychological assessments to diagnose psychological, emotional or behavioral issues/disorders through psychometric tests like intelligence, memory, personality, psychopathology, neuropsychology and forensic clinical psychological assessments. Following diagnosis, the clinical psychologist provides various forms of psychotherapies like cognitive behavioural therapy (CBT), behaviour therapy, family therapy, counselling.
Role of clinical psychologist
Assessment of mental disabilities and learning disabilities are performed by a clinical psychologist who also gives forensic testimony at Courts and assesses the mental health of hospitalised prisoners. Being a member of the District Disability Board, a clinical psychologist issues the certificate of mental illness (MI) and mental retardation (MR) after due diagnosis of the level of MI or MR (in percentage), besides two other medical experts. These apart, a clinical psychologist, according to the provisions of the Juvenile Justice (Care and Protection of Children) Act, 2015, plays a key role in mental assessment of juveniles coming in conflict with law. The role of a clinical psychologist also extends to District Early Intervention Centres (DEICs) at government hospitals, through their assistance in early diagnosis of mental disabilities.
Ambiguity in the Act
According to Juvenile Justice (Care and Protection of Children) Act, 2015, in case of a heinous offence alleged to have been committed by a child, who is or above the age of sixteen years, a preliminary assessment of his/her mental capacity to commit such offence should be conducted to ascertain his/her ability to understand the consequences of the offence and the circumstances in which he/she allegedly committed the offence. To do so, the Juvenile Justice Board may take the assistance of "experienced psychologists or psycho-social workers", the Act states. Rangaswami stated that the description of the psychologists in the clause of the Act was ambiguous, with no specific mention of the qualification and the years of experience of the psychologist.