Spurred by COVID-19, the field of psychiatry has seen the adoption of videoconferencing and telephone support. Developments in digital psychiatry can allow more patients to have more access readily to major mental health treatments, says Atul Chugh, advisor, Serefe.org and predicts that tele psychiatry will undoubtedly mark the first phase of a broader revolution occurring in psychiatry
Epidemics and pandemics have been threatening the human race time and again. SARS, H1N1, Ebola, and the kind have often bared their teeth in the past. But with every such outbreak, we have been learning novel ways of fighting and managing such unexpected diseases that have the potential to kill a million people with one strike.
Technology cannot help prevent the onset of a pandemic. But it can help prevent the spread, educate, make aware, and empower those on the ground, rendering them capable of dealing with the situation, and noticeably lessen the impact. COVID-19 has been an unseen, unprecedented event and rising demand for mental health services resulting from it cannot be met employing traditional methods.
Undoubtedly, corona virus pandemic has disrupted medical care and there is a dire need for a cure, a vaccine to prevent a second wave. On top of that misinformation about the number of fatalities, diagnosis and treatment options, vaccines available, medicines and government policies to tackle the same creates more anxiety, stress and panic among the populace. The result is widespread chaos, panic buying, hoarding of essential commodities, civil unrest, class discrimination, conspiracy theories and so on.
The global health crisis has especially taken a higher toll on the mental health of people as it has led to alarming levels of stress due to its uncertain nature. Connection to people and good mental health are intrinsically linked, and both things are at risk during this pandemic.
As a consequence, psychiatrists and psychologists have had to immediately pivot to the online model and welcome the digital system. In the wake of the pandemic, the Government of India further released the updated telemedicine guidelines on March 25, 2020, which legalised the practice of tele consultation and telemedicine in India. According to the latest guidelines, patients can now consult with doctors over chat, audio or video for diagnosis.
In the field of psychiatry, the major changes have been the adoption of videoconferencing and telephone support. Since face-to-face contact poses a higher risk in the case of corona virus, the familiarity and convenient scalability of these two options make them a logical step in providing care and support to those struggling with mental health issues. In countries such as the UK, US and even India, these two modes have been adopted easily and quickly. Apps are also on the rise which make it easier for psychologists to be just a click away.
Although the latest technologies have a lot more to offer than these relatively limited options, this adaptation of services nonetheless represents a stark change in the way clinical care has been provided erstwhile. It potentially has opened the door to more advanced forms of digital psychiatry for a post-pandemic world.
China, for instance, is using risk assessment and forecasting through artificial intelligence to enable their medical professionals gain insights into the various facets of corona virus. Using AI platforms, it has become easier for researchers to quickly find relevant studies that can possibly lead to new developments or approaches to address the COVID-19 outbreak. In India, the work on this is still underway.
Presently, the remedial measures suggested for COVID-19 have only empirical evidence. India is having to manage with what is available, but is constantly updating almost daily. Simultaneously, there is a need to engage with non-psychiatric medical professionals to facilitate the psychiatric management of patients with COVID-19 infection and co-morbid physical illnesses. Digital-enabled learning and support for mental health issues are being considered for all non-psychiatric medical professionals and frontline personnel. Online learning is proving equally useful for regular updates for psychiatrists as well.
India is leading in the adoption of digital health technology with 76 per cent of healthcare professionals in the country already using Digital Health Records (DHRs) in their practice. 64 per cent of mental health professionals claim that patients have access to their own mental health data. 80 per cent of professionals have shared their patient information with other professionals inside their health facility. About 67 per cent of Indians say that they feel comfortable seeking consultation and advice from their doctor through a health application on the phone, indicating a higher willingness and openness to further adopt tele health and unlock its benefits.
In US and Belgium, beyond basic videoconferencing, tele psychiatry is further being augmented by decision support systems, that aids diagnosis and provides treatment options; and applications such as monitoring devices that allow a clinician to observe alterations in a patient’s mental state remotely and make contact quickly, thus preventing mental health crises and adverse medication effects. Ultimately, blended approaches of digital and face-to-face contact, guided by patient preference, are likely to be most effective.
Summing it all up
Developments in digital psychiatry can allow more patients to have more access readily to major mental health treatments. Tele psychiatry will undoubtedly mark the first phase of a broader revolution occurring in psychiatry. This will lead to care becoming more preventative, reactive and empathic to the needs of the populace via technology. Serefe.org is one of a few set ups in India who not only offer tele psychiatry but have gone to very different class to provide tele counselling online via video call, text chat or voice call.