Mental health experts switch to teleconsultation mode

BENGALURU: Much has been written about the effects that staying cloistered within four walls for prolonged periods has on the

mental wellbeing

of individuals, and experts have weighed in on how best these problems can be overcome. However, the logistics involved in treating those with psychological disorders have not been given the attention they deserve. Despite lockdown norms being eased, doctors have not been able to see

patients

who come from far-off places. Teleconsultation has, to some extent, helped bridge the distance, but the jury is still out on its efficacy.

Dr Suresh Bada Math, head of telemedicine centre and forensic psychiatry services, National Institute of Mental Health and Neuro Sciences (

Nimhans

), said that telepsychiatry consultation is no less effective than interpersonal sessions. “There is a very large number of patients who need follow-up consultations and will benefit greatly from teleconsultation. Each doctor will perhaps have around 30-40% of patients from distant places for follow-ups and refill of medication,” he said.

His colleague Dr Rajendra HM, assistant professor, department of child and adolescent psychiatry, said: “Nimhans launched a system wherein those seeking a consultation can book an appointment by furnishing their name and patient number. For in-patients, we call parents of kids to get their consent and thenn speak to children over the phone.”

Dr Vinay HR, assistant professor, department of psychiatry, Adichunchanagiri Institute of Medical Sciences, in Bellur, Mandya district, has not been offering teleconsultation. “Patients who had exhausted their medication and were exhibiting violent behaviour, and those unable to cope with the non-availability of alcohol and were displaying severe withdrawal symptoms that included disorientation, hallucination and severe agitation, were among cases we had to treat on priority,” he said.

“Social distancing norms have made our job difficult,” said Dr Shivanand Hiremath, consultant psychiatrist, Aantharya Neuropsychiatric Centre, Hubballi. He uses apps such as Practo and Telearogya to prescribe medicines.

The lack of internet connectivity in rural areas hampers telemedicine. Dr Bada Math says the the Telemedicine Practice Guidelines have legitimised consultation via sms, phone and email. One problem in reaching the unreached is aggressive marketing of IT intermediaries trying to sell products to doctors under the pretext of offering security. Such a commercial mindset will keep quality healthcare out of the reach for rural patients.”

First consultation to be in person’

“Physical examination is very important while we prescribe medication. Teleconsultation can be a boon for followup patients. Often, patients with mental illnesses are required to take medicines for periods lasting months, and sometimes, years. Around 40-50% of patients can have follow-up sessions through teleconsultation,” said Dr Suresh Bada Math, head of forensic psychiatry sciences, Nimhans.

(With inputs from B Kishansingh)