Key issues and challenges

Before NEP-2020, the primary route was the two-year M.Phil. in Clinical Psychology, evolving from programs from Diplomas in Medical and Social Psychology to the M.Phil. in Medical and Social Psychology, and eventually to the M.Phil. in Clinical Psychology [7]. Over time, the RCI has introduced few accredited training programs, including the Psy.D. in Clinical Psychology, the Professional Diploma in Clinical Psychology. Despite the RCI later introducing new courses, the M.Phil. in Clinical Psychology remained the most esteemed qualification—essential for professional recognition and employment—due to its more rigorous training compared to other accredited programs. Following the discontinuation of all M.Phil. programs under NEP-2020, the RCI currently accredits four new programs for becoming a clinical psychologist, ranging from one to four years [8]. However, these new courses were introduced without clear guidelines on the discontinuation of older programs, creating confusion and disparities in professional competencies. The existence of multiple training paths for the same licensure category allows less rigorous routes to licensure, undermining the quality of training and professionalism in the field, ultimately affecting mental health services [9].

The RCI maintains the Central Rehabilitation Register (CRR), which includes 16 professional categories and provides licensure to various rehabilitation professionals, including Clinical Psychologists [3,8]. With the addition of new accredited courses, the RCI introduced new licensure categories named "Clinical Psychologist (Associate)" and "Counseling Psychologist (Mental Health)" [10], Having multiple licensure categories within the same profession adds confusion regarding roles. Poorly defined responsibilities lead to overlaps and inconsistencies, as shown in Table 1. The overlapping scopes of practice and poorly defined roles among these categories contribute to job dissatisfaction and can negatively impact the quality of services.

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Table 1. Summary of the CRR categories, and course.

https://doi.org/10.1371/journal.pmen.0000188.t001

Clinical psychologists are often narrowly categorized as rehabilitation professionals, despite their broader role in mental health care. Under the Mental Healthcare Act of 2017, they are recognized as mental health professionals with expertise in diagnosing and treating various psychological conditions [11]. Treating them merely as rehabilitation professionals undervalues their expertise and restricts their contributions. This narrow focus undermines their ability to address India’s diverse mental health needs, limiting the quality and scope of care. Recognizing their full skill set is crucial for improving mental health outcomes, rather than confining their roles to rehabilitation [11].

The RCI’s accreditation practices have raised concerns within the clinical psychology community. Although the RCI lists only a few accredited programs on its website [8], the actual list of qualifications registered under the CRR is much broader, including several outdated, inconsistent, non-accredited programs [3,12]. The CRR includes eight different courses for clinical psychologists, and the RCI has licensed professionals with non-accredited qualifications like MA/MSc or Ph.D. degrees in Psychology, which may not meet the rigorous clinical training requirements needed for the field [12]. This inconsistency in licensure practices undermines the credibility of the profession and erodes public trust in mental health services.

Recently, the RCI accredited the delivery of the Post Graduate Diploma in Rehabilitation Psychology (PGDRP) through open and distance learning mode [13]. This decision raises significant concerns regarding the competency of future mental health professionals, as the Clinical psychology training intensive supervised training and hands-on experience—conditions that are challenging to meet through distance learning.

Proposed solutions

To address the challenges arising from recent changes in clinical psychology training and accreditation in India, we recommend several key solutions. First and foremost, consolidating licensure categories is essential. Globally, clinical psychology follows a standardized model, similar to psychiatry, which has one category: psychiatrist. In countries like the U.S., Canada, and Australia, clinical psychologists obtain a doctoral degree, complete supervised practice, and pass licensure exams, without "associate" roles. India’s multiple categories create confusion and dilute professional identity. Consolidating into a single "Clinical Psychologist" category with standardized qualifications like a Psy.D. or Ph.D. will ensure professionals meet rigorous standards, enhancing service quality and credibility.

Second, India should streamline accreditation to one or two pathways, such as Psy.D. or Ph.D., similar to psychiatry’s clear routes: MD or DPM. These psychiatric qualifications maintain rigorous, standardized training, ensuring no confusion. Similarly, clinical psychology programs should be limited to these options, overseen by a dedicated body of clinical psychologists. This will uphold high standards and align training with global best practices.

Third, even if multiple licensure categories are maintained, clearly defined roles and responsibilities are crucial to avoid overlap and confusion. Each category should have a distinct scope of practice, outlining specific duties and limitations. This clarity will streamline resource allocation, improve collaboration among professionals, and ensure that patients receive appropriate care. For instance, clinical psychologists should focus on the assessment, diagnosis, and treatment of mental health disorders, while counseling psychologists should specialize in providing support for life issues through counseling and guidance. Reducing redundant licensure will enhance efficiency and professionalism in the field.

Finally, India needs a unified regulatory body governed by psychologists to oversee accreditation, licensure, and professional standards. This body could integrate organizations like the Indian Association of Clinical Psychologists (IACP) and the Clinical Psychologist Society of India (CPSI) under the Government of India. Such an organization would ensure that all clinical psychologists adhere to high ethical and professional standards, and it would streamline regulatory processes. A centralized regulatory body would also help in monitoring continuing education, providing licensure renewals, and enforcing disciplinary actions when necessary. Countries like the US, Canada, and Australia have implemented similar unified systems with success [11].