Shortage of psychiatric social workers affects mental healthcare in Kerala government hospitals

The mental healthcare services in Kerala’s government hospitals are reportedly facing challenges due to a significant shortage of psychiatric social workers. These professionals are essential for psycho-social rehabilitation, bridging the gap between clinical treatment and patients’ social environments. Their absence can hamper the recovery and reintegration of individuals with mental health conditions.

Psychiatric social workers hold a postgraduate degree in social work (MSW) and an MPhil in psychiatric social work from a University Grants Commission-recognised university. They provide therapy, manage cases, and ensure comprehensive rehabilitation. Their role includes evaluating a patient’s mental health condition, contributing to medical diagnosis, and delivering psycho-social therapy and rehabilitation. This multidisciplinary approach is vital for holistic mental healthcare.

According to official sources, eight out of fifteen sanctioned posts under the Directorate of Health Services (DHS) and three out of four under the Directorate of Medical Education (DME) remain vacant. Between 2021 and 2025, only four vacancies were forwarded to the Kerala Public Service Commission (PSC) for recruitment. Currently, no temporary arrangements are in place to fill these gaps, and no valid rank lists exist with the PSC.

A key reason for the recruitment delay is the non-implementation of revised qualification criteria as mandated by the Mental Healthcare Act, 2017. In February 2021, the Kerala Administrative Tribunal directed the state government to align the educational requirements for psychiatric social workers with the Act. However, these changes have not been officially notified, stalling the PSC’s hiring process.

Additionally, practising psychiatric social workers point to a wage disparity. K.V. Binumon, who works with the state’s ‘Vimukthi’ de-addiction project, notes that despite holding an MPhil degree in psychiatric social work—equivalent to the qualification of clinical psychologists—these professionals receive lower pay. The anomaly arises because the PSC’s current rules permit candidates with a basic Master of Social Work (MSW) or even an MSc in Psychology or Sociology to apply. Consequently, highly qualified MPhil holders in psychiatric social work, whether on permanent or contract roles in the DHS and DME, are compensated at a lower scale than clinical psychologists.

The shortage and resulting workload can potentially affect the quality of mental healthcare delivery. Psychiatric social workers play a pivotal role in evaluating a patient’s mental state, contributing to medical diagnosis, and providing psycho-social therapy and rehabilitation. Their absence may lead to delays in patient recovery and inadequate community reintegration. The situation underscores the need for a robust mental healthcare workforce as envisaged by the Mental Healthcare Act, which emphasises rights-based care and community living.

Efforts to address the issue would require the state government to notify the revised qualification criteria without further delay, enabling the PSC to resume recruitment. Parity in remuneration for equally qualified mental health professionals would also help attract and retain talent. Until these measures are taken, the mental healthcare system in Kerala’s public hospitals may continue to face operational challenges.