Inequity in Distribution of Psychiatry Trainee Seats and Institutes Across Indian States: A Critical Analysis.

Background  The delivery of mental health services largely depends on the adequacy of human resources. In India, the deficit of psychiatrists is more than 90% and is one of the major challenges that needs to be tackled to address the huge burden of mental illness. Psychiatry trainee institutes play a vital role in reducing human resource deficit and inequality in delivering mental health care. However, the distribution pattern of psychiatry trainee seats and institutes across Indian states is unknown. Therefore, we estimated the number of psychiatry trainee seats and institutes in each Indian state and union territory (UT). Materials and Methods  In this cross-sectional study, psychiatry trainee seats and institutes were searched on the official web sites of Medical Council of India and National Board of Examinations. The data available on these web sites until December 2019 were included. State-wise data were compared using proportion and percentages. The psychiatry trainee index (PTI) was calculated and compared across Indian states and UTs. Results  Among 221 Indian psychiatry trainee institutes considered in the present study, 116 (52.48%) were private institutes and 105 (47.51%) were government institutes. Overall, more psychiatry trainee seats were reported in government institutes ( n = 565, 65.89%) than in private institutes. National PTI was considered fair (0.06), and based on their PTIs, Indian states and UTs were classified as follows: worst ( n = 9), poor ( n = 8), fair ( n = 9), average ( n = 7), good ( n = 1), and excellent ( n = 2). Conclusion  A huge deficit of psychiatry trainees and institutes exists in more than two-thirds of Indian states and UTs, along with a huge maldistribution of seats. PTI and its distribution across the states and UTs are a crucial indicator of the need to improve the access and equity of mental health care.