“RCI or NCAHCP? Dilemmas about the recognition of Psychiatric Social Work Professionals”: A Psychiatrist’s Perspective

Psychiatric Social Workers (PSWs), along with Clinical Psychologists (CPs) and Psychiatrists, have long formed a successful multidisciplinary team, while maintaining the uniqueness of their respective roles, in their contribution to the mental health care of the needy.

PSWs find themselves in an unenviable spot—“between a rock and a hard place” at present. Their dilemma is whether they should be under the ambit of the Rehabilitation Council of India (RCI) Act 1992 (amended in 2017) or the National Commission of Allied Healthcare Professions (NCAHCP) Act 2021, neither of which they belong to at present. However, the Mental Health Care Act (MHCA) 2017 recognizes the “Psychiatric Social Worker.”

The RCI Act and its amended version do not find a place for PSWs at present, whereas CPs are included (It does, however, permit universities/institutions that grant qualifications for rehabilitation professionals not included in the RCI schedule to apply to the central government for their registration under it). Interestingly, the RCI Act gives a backdoor entry as Rehabilitation Professionals for Psychiatrists, Orthopedicians, etc., almost as an afterthought.

The RCI Act forbids anyone who is not a “Rehabilitation Professional” to practice rehabilitation. This is a highly exclusionary clause that is possibly difficult to enforce in the real world. There are several such other provisions that are possibly debatable from a Psychiatrist’s perspective.

I find the urge to belong to RCI (for both CPs and PSWs) understandable but a compromise because the work that both these professionals undertake goes far beyond “Psychiatric Rehabilitation” in the traditional sense of the term.

Regarding the NCAHCP, it governs professionals such as Audiologists, Optometrists, Technicians, Engineers, etc. I doubt if PSW would share much conceptual commonality with these profession(s)als. This argument applies even if the matter of 3600 hours of training can be sorted out on the basis of Master’s in Social Work (MSW) Medical & Psychiatric + M Phil in PSW being of five years duration.

It appears to me that from a multidisciplinary treatment team point of view, neither the RCI Act nor the NCAHP Act seems to do justice to PSW (or even to Clinical Psychology). Of the two, the RCI Act is perhaps the lesser of the two evils.

However, one must also remember that mental illness and its management are not all about disability or rehabilitation only. Caught in turf politics, we must not lose sight of mental illness in terms of causation, manifestation, levels of prevention, and bio-socio-cultural contexts. Perhaps the specialties of Clinical Psychology and PSW can function as well under the MHCA as it stands now (had it not been for the RCI Act). Or will it be possible for all mental illness-/health-related specialties to have a separate umbrella Agency/Act? Only time can tell.