Mental Health & Telemedicine

Life post-pandemic is limping back to normal but is still scarred with rising unemployment, remote working and absence of social interactions. The consequences are out there: depression, anxiety, stress, fear and a host of other mental health issues.

 

The ongoing mental health crisis is not only affecting the common people but our COVID warriors too. The health care frontline workers are dealing with life and death in vaccumed environment called Covid-treatment ward, with no time to relax.

On 14th May 2020, WHO stated the urgent need of investment in services of mental health. It stated the figures for rising depression and anxiety rates in countries like China, Canada, Italy, Spain, Ethiopia. In China, anxiety, depression and insomania are rising at an alarming rate of  50%, 45% and 34% respectively among healthcare workers.

 

Undertaking the seriousness of mental issues among professionals, WHO issued guidelines on June 1, 2020, evoking implementation of psychosocial skills for mental well-being of COVID respondents (WHO, 2020). In these guidelines, it enumerated ways in which professionals could undertake these psychosocial practices into their daily routines while maintaining the well-being of people they communicate with. This substantiates the upcoming mental crisis for people at home and for people undertaking their social responsibilities in the era of coronavirus panedamic. Most of the countries have shut their routine physical and mental health check-ups to be tactful with pandemic. This has had major impact on already existing population with mental illness contributing to worsening of symptoms in them. Therefore, it is crucial that the services should resume for the already suffering groups as well as to the ones in urgent need for it. Keeping in mind the precautions against SARS-COV2 and concerning about mental issues, telemedicine could be a NEW NORMAL. Reports suggests that countries like Australia and United States are approaching telemedicine to meet their patients requirements (White, 2020) (Burbank, June 2020).

HISTORY OF TELEPSYCHIATRY

 As per American Psychological Association (APA), roots of telepsychiatry were laid in 1959 when Nebraska Psychiatric Institute employed the use of videoconferencing to administer therapies (American Psychiatric Association), since then telemedicine has grown to a greater extent. Telepsychiatry or telemedicine in mental health as described by APA is the process of providing health care from a distance through technology, often using videoconferencing. Telepsychiatry, a subset of telemedicine, can involve providing a range of services including psychiatric evaluations, therapy (individual therapy, group therapy, family therapy), patient education and medication management (American Psychiatric Association).

In India, stones of Telemedicine were laid by ISRO through a pilot project in 2001 bonding Apollo Hospital Chennai to Apollo Rural hospital in Andhra Pradesh. Since then the network of Telemedicine has received heights in the form of various initiatives vis Integrated Disease Surveillance Project (IDSP), National Cancer Network (ONCONET), National Rural Telemedicine Network, National Medical College Network and the Digital Medical Library Network by the Ministry of Health – Government of India. The ISRO network grew largely to 45 remote and rural hospitals and 15 super specialty hospitals in India. Other than Ministry of health, Department of InformationTechnology (DIT), Ministry of External Affairs and state governments actively contributed to the development of telemedicine. 

Speaking of the Pandemic, India issued guidelines for Telemedicine on March 25, 2020 inclusive of the format of  e-prescriptions (saigal, 2020). With this a lot of  platforms having being actively helping people with mental issues as reported by The Hindu. This clearly states the urge of further advancements in telepsychiatry in India.

But are we aware about the benefits of telepsychiatry? Let’s see below.

Telemedicine has proven to be effective in mental health in ways including:

  • Enabling medical facilities within the comfortable environment of a patient.
  • Enhanced patient participation – By reduced readability time, avoidance of long queues, diminishing delay in providing effective care and more accessibility.
  • Generally better follow-ups
  • In the case of therapies, patients are at ease and comfortable in their homes. For example, dealing with severe psychotic patients would be difficult at the clinics as they might outstress. However, therapies in homely environments would be a better approach.
  • With the advent of technology, people often feel comfortable in a virtual setting.
  • Telemedicine has a potential to discuss large patient groups as compared to traditional psychiatry approaches.
  • Due to the existing stigmas in society for mental health issues, people even in need of urgent care shadow their illness. Telepsychiatry being virtual, can help these patients in need by preventing their exposure.
  • And of course it is cost effective.

CURRENT  CHALLENGES

In the era of COVID, Telemedicine has lower challenges reduced unlike earlier. Due to the fact that people are realising the need for Telemedicine, it is now more of a necessity than a need. Mental health being the crucial area of concern as stated by WHO and governments around the globe, Telepsychiatry is a promising approach. The major challenges are availability of internet facilities, development of advanced software and hardware, effective face-to-face system, empowering artificial intelligence, compatible biosensors and proper bandwidth still needs to be progressed. Apart from this, necessary investments are needed for its potential growth. But for now, the seal on telepsychiatry has broken, doctors and clients will choose where they want to be when receiving the talking cure, whether sitting with pet on sofa with a soothing music in the background or a mocktail

REFERENCES

  1. WHO. (2020, May). Facing mental health fallout from the Coronavirus . Retrieved from https://www.who.int/news-room/feature-stories/detail/facing-mental-health-fallout-from-the-coronavirus-pandemic
  2. WHO. (2020, May). substantial investment needed to avert mental health. Retrieved from https://www.who.int/news-room/detail/14-05-2020-substantial-investment-needed-to-avert-mental-health-crisis
  3. WHO. (2020, June). basic psychological skills -a guide for COVID-19 respondents.
    Retrieved from https://interagencystandingcommittee.org/system/files/2020-05/Basic%20Psychosocial%20Skills-%20A%20Guide%20for%20COVID-19%20Responders.pdf
  4. White, V. (2020). Caring for Australians after the pandemic. Retrieved from Asia & The Pacific Policy Society: https://www.policyforum.net/caring-for-australians-after-the-pandemic/
  5. Burbank, R. B. (June 2020). Even as Washington reopens, telemedicine may be the new normal in a post-coronavirus world. Here’s how it works in six common specialties. The seattle times.
  6. American Psychiatric association. (n.d.). History of Telemedicine. Retrieved from https://www.psychiatry.org/psychiatrists/practice/telepsychiatry/toolkit/history-of-telepsychiatry
  7. American Psychiatric Association. (n.d.). What is telepsychiatry . Retrieved from https://www.psychiatry.org/patients-families/what-is-telepsychiatry
  8. Chellaiyan, V. G. (2019). Telemedicine in India: Where do we stand? .Journal of Family Medicine and Primary Care.
  9. Saigal, k. (2020). How to care for your mental well-being during COVID-19 . Retrieved from Team India Blogs: https://www.investindia.gov.in/team-india-blogs/how-care-your-mental-well-being-during-covid-19
  10.  Afza, P. N. (2019). Opportunities and Challenges of Telemedicine System in Healthcare Sector- A Conceptual Study. International Journal of Management, IT & Engineering

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