The National Commission for Allied and Healthcare Professions Act, 2020

The National Commission for Allied and Healthcare Professions Act, 2020 has been notified in March, 2021, by the Gazette of India published by the Ministry of Law and Justice. An editorial in the latest edition of Indian Journal of Psychiatry deciphers the key changes in the act with relevance to clinical implications for psychiatrists.

Categories of Health Care Professionals

This act has created a category of Health Care Professionals which is defined as:

• Healthcare professional: Includes a scientist, therapist, or other professional who studies, advises, researches, supervises or provides preventive, curative, rehabilitative, therapeutic or promotional health services and who has obtained any qualification of degree under this Act, the duration of which shall not be less than 3600 hours spread over a period of 3 years to 6 years divided into specific semesters.
• Allied health professional: Includes an associate, technician, or technologist who is trained to perform any technical and practical task to support diagnosis and treatment of illness, disease, injury or impairment, and to support implementation of any healthcare treatment and referral plan recommended by a medical, nursing, or any other healthcare professional, and who has obtained any qualification of diploma or degree under this Act, the duration of which shall not be less than 2000 hours spread over a period of 2 years to 4 years divided into specific semesters.
• Behavioural Health Sciences Professional: Defined as "a person who undertakes a scientific study of the emotions, behaviours and biology relating to a person's mental well-being, their ability to function in everyday life and their concept of self." "Behavioural health" is the preferred term to "mental health" and includes professionals such as counselors, analysts, psychologists, educators and support workers, who provide counseling, therapy, and mediation services to individuals, families, groups, and communities in response to social and personal difficulties.

The term "Health Care Professionals" does not include doctors who are registered under National Medical Council, Mental Health Care Act (MHCA), 2017 which includes psychiatrists under the ambit of Mental Health Care Professionals.

Benefits and Shortcomings of the New Act

This step to an extent creates a diverse category of trained workforce in the field of Mental Health (Behavioural Health Science Professionals) and tries to regulate their training although it mainly aims to promote mental wellbeing. However, there is a huge lacuna in the term of "Mental Illness" as defined by MHCA, 2017. It is noticeable that while the term "Health Care Professionals" does not include doctors who are registered under National Medical Council, Mental Health Care Act (MHCA), 2017 includes psychiatrists under the ambit of Mental Health Care Professionals.

• Only severe disorders are included as per definition and there is no clarity regarding inclusion of other psychiatric disorders, namely "common mental disorders" such as anxiety and depression. This perpetuates the stigma and alienation associated with psychiatric patients for centuries.
• There is a strong possibility that the care of common mental disorders may gradually pass on under the care of "behavioural health professionals" as per new act.

Suggested Improvements

Psychiatrists, being another group of medical specialists, should be kept out of the broad umbrella of "Mental Healthcare Professionals." All disorders classified in ICD 10 and DSM 5 should be classified as "Psychiatric Disorders" or "Mental Illness." This will not only help in fighting the stigma associated with psychiatric illnesses but also promote the integration of psychiatry with other specialties.

Source: Singh OP. The National Commission for Allied and Healthcare Professions Act, 2020 and its implication for mental health. Indian J Psychiatry 2021;63:119-20. 10.4103/indianjpsychiatry.indianjpsychiatry_268_21