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Shetty SR, Vaddar T, Munoli RN. A qualitative study to assess satisfaction with the Manipal model of telepsychiatry among patients and caregivers. Indian J Psychiatry 2024; 66:43-50. [PMID: 38419921 PMCID: PMC10898534 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_634_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/26/2023] [Accepted: 10/06/2023] [Indexed: 03/02/2024] Open
Abstract
Context Telepsychiatry in India is nearly two decades old and is witnessing rapid adaptation in clinical services. This warrants studying the satisfaction with this mode from healthcare seekers' point of view. Aim This study aimed to study the treatment satisfaction among persons with psychiatric disorders and their caregivers receiving telepsychiatry services via the Manipal model. Settings and Design This was a qualitative cross-sectional study conducted in three centers, which were part of the Manipal model of telepsychiatry, namely community healthcare centers at Hebri, community healthcare centers at Byndoor, and primary healthcare center (PHC) at Kandlur of Udupi District. Methods and Material Semi-structured interview schedule and focused group discussions were conducted to assess the treatment satisfaction. Statistical Analysis Used Descriptive statistics were used to analyze sociodemographic data, and data generated from focused group discussions were qualitatively analyzed. Collected data were coded, and themes were generated from the codes. Results A total of 45 persons with psychiatric disorders and 28 of the caregivers receiving telepsychiatry services were recruited into this study. Results revealed high satisfaction among patients and caregivers with telepsychiatry services provided to them. Qualitative results of this study revealed high satisfaction among patients and caregivers with telepsychiatry services in different domains such as time, cost of treatment, convenience, doctor-patient communication, and healthcare quality. Conclusion This study witnessed that patients and caregivers were highly satisfied with telepsychiatry services provided to them. These findings clearly indicate the importance of telepsychiatry services in the country, where the concept of telepsychiatry and its practice is rising.
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Affiliation(s)
| | - Thippeswamy Vaddar
- Department of Psychaitric Social Work, Institute of Human Behaviour and Allied Sciences (IHBAS), Delhi, India
| | - Ravindra N. Munoli
- Department of Psychiatry, Kasturba Medical College, Manipal Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, India
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Suhas S, Arvind BA, Sukumar GM, Banandur PS, Nirisha LP, Kumar CN, Benegal V, Rao GN, Varghese M, Gururaj G. A bird's eye view of the mental health systems in India. Indian J Psychiatry 2023; 65:1214-1222. [PMID: 38298873 PMCID: PMC10826870 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_845_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 10/25/2023] [Accepted: 11/07/2023] [Indexed: 02/02/2024] Open
Abstract
Background A staggering 85% of the global population resides in low- and middle-income countries (LAMICs). India stands as an exemplary pioneer in the realm of mental health initiatives among LAMICs, having launched its National Mental Health Program in 1982. It is imperative to effectively evaluate mental health systems periodically to cultivate a dynamic learning model sustained through continuous feedback from mental healthcare structures and processes. Materials and Methods The National Mental Health Survey (NMHS) embarked on the Mental Health Systems Assessment (MHSA) in 12 representative Indian states, following a pilot program that contextually adapted the World Health Organization's Assessment Instrument for Mental Health Systems. The methodology involved data collection from various sources and interviews with key stakeholders, yielding a set of 15 quantitative, 5 morbidity, and 10 qualitative indicators, which were employed to encapsulate the functional status of mental health systems within the surveyed states by using a scorecard framework. Results The NMHS MHSA for the year 2015-16 unveiled an array of indices, and the resultant scorecard succinctly encapsulated the outcomes of the systems' evaluation across the 12 surveyed states in India. Significantly, the findings revealed considerable interstate disparities, with some states such as Gujarat and Kerala emerging as frontrunners in the evaluation among the surveyed states. Nevertheless, notable gaps were identified in several domains within the assessed mental health systems. Conclusion MHSA, as conducted within the framework of NMHS, emerges as a dependable, valid, and holistic mechanism for documenting mental health systems in India. However, this process necessitates periodic iterations to serve as critical indicators guiding the national mental health agenda, including policies, programs, and their impact evaluation.
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Affiliation(s)
- Satish Suhas
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Banavaram A. Arvind
- Centre for Public Health, Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Gautham M. Sukumar
- Centre for Public Health, Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Pradeep S. Banandur
- Centre for Public Health, Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Lakshmi P. Nirisha
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Channaveerachari N. Kumar
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Girish N. Rao
- Centre for Public Health, Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Gopalkrishna Gururaj
- Centre for Public Health, Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Gajera GV, Pandey P, Malathesh BC, Nirisha PL, Suchandra KHH, Ibrahim FA, Suhas S, Manjunatha N, Kumar CN, Suresha BM, Jain S. Effectiveness of blended versus fully digital training in primary care psychiatry: A retrospective comparison from India. J Neurosci Rural Pract 2023; 14:91-97. [PMID: 36891122 PMCID: PMC9945417 DOI: 10.25259/jnrp-2022-4-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 12/23/2022] Open
Abstract
Objectives We compared effectiveness of blended mode (consisting of traditional classroom teaching and e-learning sessions) and fully digital mode (e-learning sessions alone) of primary care psychiatry training for primary care doctors in Chhattisgarh. Materials and Methods We retrospectively compared the engagement in training, knowledge (K), attitude (A), and practice (P) in primary care psychiatry, and patient identification by primary care doctors (n = 941) from Chhattisgarh region who underwent training through either blended training mode (n = 546) or fully digital training mode (n = 395) for 16 h each, using Clinical Schedules for Primary Care Psychiatry based modules between June 2019 and November 2020 with a tertiary care center (NIMHANS, Bengaluru) as hub. Statistical Analysis The Statistical Package for the Social Sciences version 27 was used to analyze the data. Continuous variables were analyzed using the independent samples t-test, and discrete variables were analyzed using the Chi-square test. A repeated measures analysis of variance (ANOVA) (two-way mixed design) was used to see the interaction of training type and time of pre- and post-KAP measurement while controlling for years of experience. The number of patients identified by both training groups over 8 months was also compared using the repeated measures ANOVA (two-way mixed design). Results Engagement inferred by the number of participants completing pre-KAP forms (75%), post-KAP forms (43%), post-session assessments (37- 47%), case presentation (33.9%), and certification (32.1%) was better in the blended group (P < 0.05). The mean gain in KAP scores was significantly higher in the blended group controlling for the years of experience as primary care doctor (PCD) (F = 30.36, P < 0.001). PCDs in the blended training group consistently identified a higher number of patients with mental illness over 8 months of follow-up (F = 6.21, P < 0.001). Conclusion The blended mode yielded better results in primary care psychiatry training compared to fully digital mode. In-person interactions while provided for a very brief proportion of the training seem to have an unmistakable imprint on the outcomes and seem critical for better consolidation and assimilation of information, which translates into better practice.
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Affiliation(s)
- Gopi V. Gajera
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Praveen Pandey
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Barikar C. Malathesh
- Department of Psychiatry, All India Institute of Medical Sciences, Hyderabad, Telangana, India
| | - P. Lakshmi Nirisha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - K. Hari Hara Suchandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ferose Azeez Ibrahim
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Satish Suhas
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Narayana Manjunatha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Bada Math Suresha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Sumi Jain
- Department of Non-Communicable Diseases, National Health Mission, Chhattisgarh, India
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4
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Al-Mahrouqi T, Al-Alawi K, Al-Alawi M, Al Balushi N, Al Ghailani A, Al Sabti H, Al Sinawi H. A promising future for tele-mental health in Oman: A qualitative exploration of clients and therapists' experiences. SAGE Open Med 2022; 10:20503121221086372. [PMID: 35371483 PMCID: PMC8969011 DOI: 10.1177/20503121221086372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/17/2022] [Indexed: 12/27/2022] Open
Abstract
Objectives Tele-mental health services can play an important role in overcoming barriers in mental health services in the Eastern Mediterranean Region. However, despite its potential, tele-mental health has not been widely adopted in Oman. This study is an exploratory investigation into the experiences of therapists and their clients in utilizing video-based tele-mental health care during the COVID-19 pandemic. Methods A total of 19 semistructured qualitative interviews were individually conducted, it included 13 adult clients with mental health conditions who received video-based tele-mental health care and six clinical psychologists who provided video-based tele-mental health care during the COVID-19 pandemic. Results The clients reported favorable experiences using tele-mental health, with the primary benefits being convenience, easy accessibility to subspecialized care, reduced absenteeism from work with commuting costs, and alleviated mental health stigma. The therapists also expressed experiencing benefits from tele-mental health, such as reduced risk of intrahospital infection, reduced healthcare costs, and the achievement of work-life balance. Primary concerns were related to the lack of public tele-mental health services, lack of specified tele-mental health guidelines, shortage of trained therapists, limited access to high-speed Internet, electronic devices, privacy, and concerns toward the security of telehealth systems in general. Conclusion Clients and therapists report that tele-mental health offers new opportunities to improve the quality of mental healthcare services in Oman, and that the challenges could be resolved by establishing governmental tele-mental health services along with developing tele-mental health guidelines and implementing local postgraduate clinical psychology programs in universities in Oman.
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Affiliation(s)
- Tamadhir Al-Mahrouqi
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | | | - Mohammed Al-Alawi
- Behavioral Medicine Department, Sultan Qaboos University Hospital, Muscat, Oman
| | - Naser Al Balushi
- Behavioral Medicine Department, Sultan Qaboos University Hospital, Muscat, Oman
| | - Abdullah Al Ghailani
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | | | - Hamed Al Sinawi
- Behavioral Medicine Department, Sultan Qaboos University Hospital, Muscat, Oman
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Abstract
AIMS AND METHOD This review aims to clarify the evidence on the effectiveness of telepsychiatry following the COVID-19 pandemic. We conducted a literature review of three databases (Cochrane Library, PubMed and PsycINFO), using the terms virtual consultation/telepsychiatry/video consultation AND psychiatry/mental illness. RESULTS We identified 325 eligible papers and conducted a thematic analysis resulting in five themes: patient and clinical satisfaction, diagnostic reliability, outcomes, technology and professional guidance. The most significant factors linked to effectiveness of telepsychiatry were patient and clinician satisfaction and adequate technology to facilitate examination of the patient. CLINICAL IMPLICATIONS The consistent diagnostic reliability, satisfactory clinical outcomes and patient satisfaction linked to telepsychiatry favour its continued use once the pandemic ends. The main barrier is reluctance among clinicians and lack of professional guidance. We recommend education on the uses of telepsychiatry among clinicians, and the provision of professional guidance for its use from medical bodies and organisations.
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Kalaivanan RC, Rahul P, Manjunatha N, Kumar CN, Sivakumar PT, Math SB. Telemedicine in Geriatric Psychiatry: Relevance in India. Indian J Psychol Med 2021; 43:S121-S127. [PMID: 34732964 PMCID: PMC8543607 DOI: 10.1177/02537176211033007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Telemedicine has evolved as a novel tool in delivering health care in the modern world. With the advancement in video conferencing technology at an affordable price and innovative digital medical instruments, it has grown from guiding paramedics in managing patients to aiding physicians in providing direct consultation. Delivering care for older adults has always been challenging due to comorbidities that may warrant a multidisciplinary approach leading to frequent visits across specialties. As per the preliminary reports of the Longitudinal Aging Study in India, 55% of this population suffers from any chronic illness, of which 40% have some form of disability and 20% deal with mental health issues. Over the years, telepsychiatry care for older adults has received increasing acceptability. Videoconferencing with improved connectivity and transmission rates has aided in evaluating, assessing, and providing mental health interventions at ease. The recent regulation of telemedicine practice in the country by rolling out the Telemedicine Practice Guidelines 2020 and Telepsychiatry Operational Guidelines 2020 has fast-tracked its utility during the COVID-19 pandemic. Concerns of physical examination, psychological satisfaction of consulting physician in person, confidentiality, and security of information shared are points that need better addressing in the future. However, Telemedicine is recommended to be used judiciously, taking the risk and benefit of older adults on a case basis as it can significantly bring down the financial and emotional burden.
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Affiliation(s)
- Rakesh Chander Kalaivanan
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Patley Rahul
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Narayana Manjunatha
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | | | | | - Suresh Bada Math
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
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7
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Thenral M, Annamalai A. Challenges of Building, Deploying, and Using AI-Enabled Telepsychiatry Platforms for Clinical Practice Among Urban Indians: A Qualitative Study. Indian J Psychol Med 2021; 43:336-342. [PMID: 34385728 PMCID: PMC8327861 DOI: 10.1177/0253717620973414] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Published literature shows the overall challenges associated with artificial intelligence (AI)-enabled medicine and telepsychiatry more from the western perspective, with no specific mention from the perspective of individual stakeholders or Indians. This study was conceptualized to understand the perceived challenges of building, deploying, and using AI-enabled telepsychiatry for clinical practice from the perspectives of psychiatrist, patients, and the technology experts (who build such services) in urban India. METHODS Between February 2020 and April 2020, a semistructured topic guide was drafted for qualitative exploratory study among psychiatrists (n = 14), their patients (n = 14), technology experts (n = 13), and Chief Executive Officers (CEOs) (n = 5) of health technology incubation centers. Interviews were conducted over the phone, recorded, and analyzed using the grounded theory approach. RESULTS Almost all respondents cited ethical, legal, accountability, and regulatory implications as challenges. The major issues stated by patients were privacy/confidentiality, ethical violations, security/ hacking, and data ownership. Psychiatrists cited lack of clinical validation, lack of established studies or trials, iatrogenic risk, and healthcare infrastructure issues as the main challenges. Technology experts stated data-related issues as the major challenge. The CEOs quoted the lack of interdisciplinary experts as one of the main challenges in building deployable AI-enabled telepsychiatry in India. CONCLUSIONS There are challenges to deploy an AI-enabled telepsychiatry platform in India. There is a need to constitute an interdisciplinary team to systematically address these challenges. Deployment of AI-enabled telepsychiatry is not possible without clinical validation and addressing current challenges.
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Affiliation(s)
- Thenral M
- Shri Sathya Sai Medical College and Research Institute, Ammapettai, Kanchipuram, Tamil Nadu, India
| | - Arunkumar Annamalai
- National Institute of Epidemiology, Indian Council of Medical Research, New Delhi, India
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8
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Kulkarni KR, Shyam RPS, Bagewadi VI, Gowda GS, Manjunatha BR, Shashidhara HN, Basavaraju V, Manjunatha N, Moirangthem S, Kumar CN, Math SB. A study of collaborative telepsychiatric consultations for a rehabilitation centre managed by a primary healthcare centre. Indian J Med Res 2021; 152:417-422. [PMID: 33380707 PMCID: PMC8061593 DOI: 10.4103/ijmr.ijmr_676_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background & objectives: Telepsychiatric methods can be used for the purpose of providing clinical care comparable to in-person treatment in various settings including rehabilitation. Previous evidence has shown that clinical outcomes for both are comparable. In view of challenges posed in the implementation of traditional psychiatric care in India, telepsychiatry offers an avenue to provide feasible, affordable and clinically useful psychiatric services. This study was conducted to examine the utility, feasibility and clinical effectiveness of providing collaborative telepsychiatric services with a primary care doctor for inpatients in a rehabilitation centre through a telepsychiatrist of estabilished psychiatry department in a tertiary care centre in south India in a collaborative care model with a primary care doctor. Methods: Patients at the rehabilitation centre attached to an urban primary healthcare centre received collaborative care using telepsychiatry for a period from January 2013 to December 2016. A retrospective review of their charts was performed and sociodemographic, clinical and treatment details were collected and analyzed. Results: The sample population (n=132) consisted of 75 per cent males, with a mean age of 43.8 ± 12.1 yr. Each patient received an average of 7.8 ± 4.9 live video-consultations. Initially, an antipsychotic was prescribed for 84.1 per cent (n=111) of patients. Fifty four patients (40.9%) had a partial response and 26 (19.7%) patients showed a good response. Interpretation & conclusions: The study sample represented the population of homeless persons with mental illness who are often brought to the rehabilitation centre. This study results demonstrated the successful implementation of inpatients collaborative telepsychiatry care model for assessment, follow up, investigation and treatment of patients through teleconsultation.
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Affiliation(s)
- Karishma R Kulkarni
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - R P S Shyam
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Guru S Gowda
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - B R Manjunatha
- Tele Medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Harihara N Shashidhara
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vinay Basavaraju
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Narayana Manjunatha
- Tele Medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Sydney Moirangthem
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Suresh Bada Math
- Tele Medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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9
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Sreedaran P, Beniwal RP, Chari U, Smitha T S, Vidhya Shree S V, Gupta V, Bhatia T, Deshpande SN. A Randomized Controlled Trial to Assess Feasibility and Acceptability of Telephone-Based Psychosocial Interventions in Individuals who Attempted Suicide. Indian J Psychol Med 2021; 43:144-149. [PMID: 34376890 PMCID: PMC8313454 DOI: 10.1177/0253717620939272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Brief contact interventions such as telephone-based contacts appear to be useful in individuals who attempted suicide. Most studies of telephone-based contacts in such individuals typically consisted of frequent phone reminders for adherence to treatment and seeking help for mental health issues. Telephone-based psychosocial interventions that incorporate elements of supportive and problem-solving strategies are of interest in Indian settings due to their potential application in mitigating the wide mental health gap. Feasibility studies of telephone-based psychosocial interventions could help ascertain the difficulties that arise in the implementation of such treatments. METHODS A multicentric randomized controlled trial (RCT) is currently underway in general hospital settings in two Indian cities to study the efficacy of telephone-based psychosocial interventions in individuals with a recent suicide attempt, with routine telephone contacts (TCs) serving as the comparator. Prior to that RCT, this feasibility study was conducted to assess the acceptability of the telephone-based intervention and telephone contacts. Feasibility was assessed using dropout rates. Acceptability was assessed using participant-rated Likert-based visual analog scores from 0 to 10, with higher scores indicating greater acceptability. RESULTS Dropout rates and mean acceptability scores for telephone-based psychosocial interventions were 38.5% and 8.63, while those for TCs were 41.7% and 7.57, respectively. CONCLUSIONS Telephone-based psychosocial interventions are feasible and acceptable in individuals with a recent suicide attempt.
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Affiliation(s)
- Priya Sreedaran
- Dept. of Psychiatry, St John’s Medical
College, Bengaluru, Karnataka, India
| | - Ram Pratap Beniwal
- Dept. of Psychiatry, Centre of
Excellence in Mental Health, ABVIMS & Dr RML Hospital, New Delhi, India
| | - Uttara Chari
- Dept. of Clinical Psychology, St John’s
MEDICAL college, Bengaluru, Karnataka, India
| | - Smitha T S
- Dept. of Psychiatry, St John’s Medical
College, Bengaluru, Karnataka, India
| | - Vidhya Shree S V
- Dept. of Psychiatry, St John’s Medical
College, Bengaluru, Karnataka, India
| | - Varsha Gupta
- Dept. of Psychiatry, Centre of
Excellence in Mental Health, ABVIMS & Dr RML Hospital, New Delhi, India
| | - Triptish Bhatia
- Dept. of Psychiatry, Centre of
Excellence in Mental Health, ABVIMS & Dr RML Hospital, New Delhi, India
| | - Smita N Deshpande
- Dept. of Psychiatry, Centre of
Excellence in Mental Health, ABVIMS & Dr RML Hospital, New Delhi, India
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10
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Pal A. Telepsychiatry: The Tool to Revive National Mental Health Program of India? Indian J Psychol Med 2020; 42:586-588. [PMID: 33354093 PMCID: PMC7735250 DOI: 10.1177/0253717620959775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Arghya Pal
- Dept. of Psychiatry, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
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11
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Abstract
The utilization of telemedicine and telepsychiatry (TP) services in the outpatient department (OPD) has been increasing in recent years. The information about the technological, administrative, and clinical challenges is being addressed by the telemedicine and TP guidelines published by several individual nations. TP aims to address the treatment gaps, barriers for utilization, accessibility, diagnostic validity, financial implications, and individual client preferences. Utilization of TP in the OPD varies from country to country depending upon their healthcare delivery systems. It also varies in populations utilizing the TP services-urban, rural, child and adolescent, geriatric, and differently abled. TP services in the OPDs are being incorporated differentially by government organizations, insurance recognized psychiatric healthcare organizations, private psychiatric group practice deliverers, and individual, standalone psychiatric healthcare deliverers. TP may not replace the traditional in-person consultations completely. Covid-19 pandemic has hastened its utilization across several healthcare delivery systems. Healthcare organizations, clinicians, other healthcare deliverers, and end users are in the process of adapting to the new scenario. Incorporation of the big data, machine learning, artificial intelligence, virtual reality, and other technological advances in the psychiatric healthcare delivery systems into TP services in the OPDs would significantly contribute to the overall quality and efficacy of the psychiatric healthcare delivery systems in the future.
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Affiliation(s)
| | | | - Amala Emani
- Columbus Hospital, Hyderabad, Telangana, India
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12
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Naik SS, Manjunatha N, Kumar CN, Math SB, Moirangthem S. Patient's Perspectives of Telepsychiatry: The Past, Present and Future. Indian J Psychol Med 2020; 42:102S-107S. [PMID: 33354053 PMCID: PMC7736740 DOI: 10.1177/0253717620963341] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Access to mental health care has significant disparities due to treatment gap, more so particularly for the remotely residing, physically vulnerable, aging populations. Adoption of technology will enable more people to receive specialty care addressing distance, transportation and cost-related barriers to treatment engagement from the comfort of home. Telemedicine has been regarded as "electronic personal protective equipment" by reducing the number of physical contacts and risk contamination for patients during COVID-19 crisis. This review aimed to give a broad view of patients' perception of the use of telepsychiatry in terms of clinical outcome, cost-effectiveness, and solutions to address patients' challenges with the adoption of technology. Over the years, telepsychiatry, both in synchronous and asynchronous modalities, had shown to improve patients' adherence to treatment, follow-up rates, and clinical symptoms, overcome stigma and discrimination, and save cost expenses accessing health care with better satisfaction and usability outcomes. Its utility is widespread such as in delivering care emergency evaluation, crisis intervention, conducting neuropsychological assessments, psychotherapy, promoting lifestyle modification, enhancing self-efficacy, and overcoming patients' linguistic and cultural barriers to care. However, patients' privacy and confidentiality and psychiatrists' legal liability remain as matter of major concern in digital platform. To keep up with the pace of technology and patients' expectations, a more agile approach is essential to develop, improve, and evaluate telepsychiatric interventions.
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Affiliation(s)
- Shalini S Naik
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Narayana Manjunatha
- Tele Medicine Centre, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Channaveerachari Naveen Kumar
- Tele Medicine Centre, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Suresh Bada Math
- Tele Medicine Centre, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Sydney Moirangthem
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Dinakaran D, Basavarajappa C, Manjunatha N, Kumar CN, Math SB. Telemedicine Practice Guidelines and Telepsychiatry Operational Guidelines, India-A Commentary. Indian J Psychol Med 2020; 42:1S-3S. [PMID: 33354058 PMCID: PMC7736743 DOI: 10.1177/0253717620958382] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2020] [Indexed: 01/29/2023] Open
Abstract
Recent advancements in technology, access to smartphone, and gains achieved in increased internet speed and data transfer have expanded the scope of health care service delivery through the digital platforms. In India, telemedicine services remain poorly adopted and integrated due to various barriers. The important reasons are lack of legal and administrative clarity in using technology for service delivery and inertia from health service providers to adopt newer developments. However, during coronavirus disease (COVID-19) pandemic, these equations are changing. The Telemedicine practice guidelines released in March, 2020, and Telepsychiatry operational guidelines released in May, 2020, appear to remove these barriers and promote equitable access to health care. In this article, the authors discuss the scope of these guidelines.
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Affiliation(s)
- Damodharan Dinakaran
- Telemedicine Centre, Department of Psychiatry, National Institute of Mental Health And Neurosciences, Bengaluru, Karnataka, India
| | - Chethan Basavarajappa
- Telemedicine Centre, Department of Psychiatry, National Institute of Mental Health And Neurosciences, Bengaluru, Karnataka, India
| | - Narayana Manjunatha
- Telemedicine Centre, Department of Psychiatry, National Institute of Mental Health And Neurosciences, Bengaluru, Karnataka, India
| | - Channaveerachari Naveen Kumar
- Telemedicine Centre, Department of Psychiatry, National Institute of Mental Health And Neurosciences, Bengaluru, Karnataka, India
| | - Suresh Bada Math
- Telemedicine Centre, Department of Psychiatry, National Institute of Mental Health And Neurosciences, Bengaluru, Karnataka, India
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Abstract
This review chronicles the origin of telepsychiatry services started by the Schizophrenia Research Foundation (SCARF) in the community and traces the birth of the Scarf Telepsychiatry in Pudukkottai (STEP) program at Pudukkottai in Tamil Nadu. This paper also examines the trajectory of STEP and highlights other relevant models existing in the country in the last decade.
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Affiliation(s)
- Hema Tharoor
- Dept. of Mental Health and Social Sciences, Schizophrenia Research Foundation, Chennai, Tamil Nadu, India
| | - Rangaswamy Thara
- Research and DEMCARES, Schizophrenia Research Foundation, Chennai, Tamil Nadu, India
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15
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Zhao X, Bhattacharjee S, Innes KK, LeMasters TJ, Dwibedi N, Sambamoorthi U. The impact of telemental health use on healthcare costs among commercially insured adults with mental health conditions. Curr Med Res Opin 2020; 36:1541-1548. [PMID: 32609549 PMCID: PMC7535072 DOI: 10.1080/03007995.2020.1790345] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To determine the impact of telemental health (TMH) use on total healthcare costs and mental health (MH)-related costs paid by a third party among adults with mental health conditions (MHC). METHOD This study employed a pre-post design with a non-equivalent control group. The cohort comprised adults with MHCs identified using diagnosis codes from de-identified claims data of the Optum Clinformatics DataMart (2010 January 01 to 2017 June 30). We identified mental health (MH) service users and TMH users (N = 348) based on procedure codes. Non-users (N = 238,595) were defined as those who only used in-person MH services. A Difference-in-Differences (DID) analysis was performed within a multivariable two-part model (TPM) framework to examine the impact of TMH use on adjusted standardized costs (2018 US $) of all healthcare services and MH services. Patient-level and state-level factors were adjusted in TPM. RESULTS TMH use was associated with significantly higher MH-related costs [Marginal effect = $461.3, 95% confidence interval: $142.4-$780.2] and an excess of $370 increase in MH-related costs at follow-up as compared to baseline. However, TMH use was not associated with an increase in total third-party healthcare costs nor with changes in total costs from baseline to follow-up. CONCLUSIONS Despite having a higher likelihood of MH services use and MH-related costs, TMH users did not have higher total costs as compared to adults using only in-person MH services. Our findings suggest that TMH can increase access to MH care without increasing total healthcare costs among adults with MHC. Future studies exploring whether TMH use can lead to cost-savings over a longer period are warranted.
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Affiliation(s)
- Xiaohui Zhao
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Sandipan Bhattacharjee
- Department of Pharmacy Practice & Science, College of Pharmacy, University of Arizona, Tucson, AZ, USA
| | - Kim K. Innes
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Traci J. LeMasters
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Nilanjana Dwibedi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
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Singh Bhandari S, Joseph SJ, Udayasankaran JG, Konthoujam B, Shoib S, Dutta S. Telepsychiatry: A Feasible Means to Bridge the Demand-Supply Gaps in Mental Health Services During and After the COVID-19 Pandemic: Preliminary Experiences from Sikkim State of India. Indian J Psychol Med 2020; 42:500-502. [PMID: 33414609 PMCID: PMC7750845 DOI: 10.1177/0253717620951282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/28/2020] [Indexed: 12/04/2022] Open
Affiliation(s)
- Samrat Singh Bhandari
- Dept. of Psychiatry, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, Sikkim, India
| | - Shijo John Joseph
- Dept. of Psychiatry, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, Sikkim, India
| | - Jai Ganesh Udayasankaran
- Healthcare Information Technology and Telehealth, Sri Sathya Sai Central Trust, Prasanthi Nilayam, Puttaparthi, Andhra Pradesh, India
| | - Bemma Konthoujam
- Dept. of Community Medicine, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, Sikkim, India
| | - Sheikh Shoib
- Dept. of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, Jammu and Kashmir, India
| | - Sanjiba Dutta
- Dept. of Psychiatry, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, Sikkim, India
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Hazarika M, Math SB. Tele-mental health during the coronavirus disease 2019 (COVID-19) pandemic. OPEN JOURNAL OF PSYCHIATRY AND ALLIED SCIENCES 2020; 11:77-79. [PMID: 33898755 DOI: 10.5958/2394-2061.2020.00023.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This editorial highlights the origin of telemedicine in India, and discusses the present and explores the possibilities in the future in the context of the ongoing coronavirus disease 2019 (COVID-19) pandemic.
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Affiliation(s)
- Mythili Hazarika
- Clinical Psychology, Department of Psychiatry, Gauhati Medical College Hospital, Guwahati, Assam, India
| | - Suresh Bada Math
- Head of Telemedicine Centre and Head of Forensic Psychiatry Services, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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18
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Das S, Manjunatha N, Kumar CN, Math SB, Thirthalli J. Tele-psychiatric after care clinic for the continuity of care: A pilot study from an academic hospital. Asian J Psychiatr 2020; 48:101886. [PMID: 31835142 DOI: 10.1016/j.ajp.2019.101886] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 11/22/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND There is a need of continuity of care research in psychiatric disorders to deal two important issues such as accessibility of psychiatrists, and travel. AIMS This pilot was designed to evaluate the acceptability, feasibility, possible clinical effectiveness and cost benefit of video based tele-psychiatric aftercare (TAC) clinic from an academic hospital. METHODS Fifty selected patients were recruited to provide direct video-consultations (DVC). RESULTS This study shows higher score on acceptability, satisfaction and respect to privacy on these TAC. DISCUSSION AND CONCLUSIONS This is first pilot study as one of the patient friendly and less expensive continuity of care.
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Affiliation(s)
- Soumitra Das
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Narayana Manjunatha
- Digital Psychiatry Program, Tele Medicine Centre, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
| | - C Naveen Kumar
- Digital Psychiatry Program, Tele Medicine Centre, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Suresh Bada Math
- Digital Psychiatry Program, Tele Medicine Centre, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
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Agarwal PP, Manjunatha N, Gowda GS, Kumar MNG, Shanthaveeranna N, Kumar CN, Math SB. Collaborative Tele-Neuropsychiatry Consultation Services for Patients in Central Prisons. J Neurosci Rural Pract 2019; 10:101-105. [PMID: 30765979 PMCID: PMC6337995 DOI: 10.4103/jnrp.jnrp_215_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background: Tele-medicine helps to provide clinical care comparable to in-person treatment in various clinical settings. It is a novel system of healthcare delivery in both low-resource settings and sites where adequate medical care continues to pose greatest challenge like in prison's in India and worldwide. Aim: To study the sociodemographic and clinical profile of patients from Central Prisons, having received collaborative Tele-Neuropsychiatric Care. Methodology: Psychiatry, neurology, and neurosurgery specialists provided tele-neuropsychiatry consultation through Specialist–Doctor–Patient model as part of the state-run program for the two central prisons from July 1, 2014, to June 30, 2016. A retrospective file review was done of the tele-neuropsychiatry case records at Tele-Medicine Centre, Located at Tertiary Neuro Psychiatric centre of South India. Results: A total of 53 patients were provided tele-neuropsychiatric consultation over 2-year period. Of these, 48 (90.6%) were male and 34 (64.1%) were aged more than 30 years. In total, 20.7% of them had severe mental illness, i.e., schizophrenia and mood disorders, 20.7% with substance use disorder (alcohol and cannabis), 17% had anxiety disorders while 17% with seizure disorder. Nearly 81.1% of patients (inmates) were advised pharmacotherapy while 18.9% were suggested further evaluation of illness and inpatient care at the higher center. Conclusion: The collaborative care was successful in delivering psychiatry, neurology, and neurosurgery consultation with a Specialist–Doctor–Patient model to prison inmates.
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Affiliation(s)
- Preethi Pansari Agarwal
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Narayana Manjunatha
- Department of Psychiatry, Tele Medicine Centre, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Guru S Gowda
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - M N Girish Kumar
- Consultant Psychiatrist, Central Jail, Parappana Agrahara, Bangalore, Karnataka, India
| | - Neelaveni Shanthaveeranna
- Department of Psychiatry, Tele Medicine Centre, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Channaveerachari Naveen Kumar
- Department of Psychiatry, Tele Medicine Centre, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Suresh Bada Math
- Department of Psychiatry, Tele Medicine Centre, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
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20
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Etter M, Goose A, Nossal M, Chishom-Nelson J, Heck C, Joober R, Boksa P, Lal S, Shah JL, Andersson N, Iyer SN, Malla A. Improving youth mental wellness services in an Indigenous context in Ulukhaktok, Northwest Territories: ACCESS Open Minds Project. Early Interv Psychiatry 2019; 13 Suppl 1:35-41. [PMID: 31243916 PMCID: PMC6771701 DOI: 10.1111/eip.12816] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
AIM To describe a community-specific and culturally coherent approach to youth mental health services in a small and remote northern Indigenous community in Canada's Northwest Territories, under the framework of ACCESS Open Minds (ACCESS OM), a pan-Canadian youth mental health research and evaluation network. METHODS As 1 of the 14 Canadian communities participating in a 5-year, federally funded service transformation and evaluation project, the arctic Inuit community of Ulukhaktok has undertaken culturally relevant adjustments in their delivery of youth mental wellness services and related community wellness initiatives. These enhancement activities highlight connections to culture and traditional skills, honour youth- and community-expressed desires to incorporate Inuvialuit-specific approaches to wellness, and strengthen the support systems to improve access to mainstream mental healthcare, when needed. The adaptation of a Lay Health Worker model from Global Mental Health to the local circumstances resulting in creation of lay community health workers is central to this approach in meeting contextual needs. RESULTS Community leaders identified key activities for sustainable change, including human capital development, authentic collaboration and diversified engagement strategies. Building around five ACCESS OM objectives, the local site team in Ulukhaktok has identified its youth programming and mental wellness service gaps through an ongoing process of community mapping. CONCLUSIONS Information from service providers, youth and other community members demonstrates attuning of the ACCESS OM framework to Inuit paradigms in Ulukhaktok. It could prove to be a sustainable prototype for delivering youth mental health services in other communities in the Inuvialuit Settlement Region and possibly across the entire Inuit Nunangat. It needs, however, to be further supported by easier access to specialized mental health services when needed.
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Affiliation(s)
- Meghan Etter
- ACCESS Open Minds Ulukhaktok, Ulukhaktok, Northwest Territories, Canada.,Inuvialuit Regional Corporation, Inuvik, Northwest Territories, Canada.,ACCESS Open Minds (Pan-Canadian Youth Mental Health Services Research Network), Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Annie Goose
- ACCESS Open Minds Ulukhaktok, Ulukhaktok, Northwest Territories, Canada.,Inuvialuit Regional Corporation, Inuvik, Northwest Territories, Canada.,ACCESS Open Minds (Pan-Canadian Youth Mental Health Services Research Network), Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Margot Nossal
- ACCESS Open Minds (Pan-Canadian Youth Mental Health Services Research Network), Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Jessica Chishom-Nelson
- ACCESS Open Minds (Pan-Canadian Youth Mental Health Services Research Network), Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Carly Heck
- Department of Nursing, McGill University, Montreal, Quebec, Canada
| | - Ridha Joober
- ACCESS Open Minds (Pan-Canadian Youth Mental Health Services Research Network), Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Patricia Boksa
- ACCESS Open Minds (Pan-Canadian Youth Mental Health Services Research Network), Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Shalini Lal
- ACCESS Open Minds (Pan-Canadian Youth Mental Health Services Research Network), Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Quebec, Canada.,School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada
| | - Jai L Shah
- ACCESS Open Minds (Pan-Canadian Youth Mental Health Services Research Network), Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Neil Andersson
- ACCESS Open Minds (Pan-Canadian Youth Mental Health Services Research Network), Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Family Medicine, Community Information and Epidemiological Technologies (CIET) Institute and Participatory Research at McGill (PRAM), McGill University, Montreal, Quebec, Canada.,McGill Institute of Human Development and Well-being, McGill University, Montreal, Quebec, Canada
| | - Srividya N Iyer
- ACCESS Open Minds (Pan-Canadian Youth Mental Health Services Research Network), Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Ashok Malla
- ACCESS Open Minds (Pan-Canadian Youth Mental Health Services Research Network), Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Quebec, Canada
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21
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Gowda GS, Kulkarni K, Bagewadi V, Rps S, Manjunatha BR, Shashidhara HN, Basavaraju V, Manjunatha N, Moirangthem S, Kumar CN, Math SB. A study on collaborative telepsychiatric consultations to outpatients of district hospitals of Karnataka, India. Asian J Psychiatr 2018; 37:161-166. [PMID: 30278379 DOI: 10.1016/j.ajp.2018.09.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/05/2018] [Accepted: 09/10/2018] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The Indian National Mental Health Survey (NMHS) of 2015-2016 has estimated 13.7% lifetime and 10.6% point prevalence for mental illnesses. It has identified that the treatment gap for mental illnesses ranges between 70% and 92%. Tele-Psychiatric consultations could be an alternative and innovative approach to bridge this gap in low resource settings. AIMS To study the sociodemographic and clinical profiles of patients who have received collaborative Tele-Psychiatric consultations across district hospitals in Karnataka, India. METHODOLOGY We performed a retrospective review of case files of patients who have received collaborative Tele-Psychiatric consultations from January 2013 to June 2017 through video-conferencing. A total of 139 consultations were provided to patients in the state of Karnataka. RESULTS The mean age of the sample is 31 (±15.5) years. 61.8% were male and 79.8% were aged more than 18 years. In total, 25.9% of them had schizophrenia and other psychotic disorders, 14.4% had mental retardation, 13.7% had a mood disorder and 14.4% had a substance use disorder. 67.6% of patients had been advised pharmacotherapy, 7.9% had been advised rehabilitation along with pharmacotherapy and 24.4% were advised further evaluation of illness and inpatient care at a higher centre. CONCLUSION Collaborative tele-psychiatric consultations to district hospitals from an academic tertiary care hospital can be feasible and are likely to benefit patients from rural areas. There is a need for more studies to elucidate their acceptability by patients, caregivers and professionals.
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Affiliation(s)
- Guru S Gowda
- Tele Medicine Centre, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, Karnataka, India
| | - Karishma Kulkarni
- Tele Medicine Centre, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, Karnataka, India
| | - Virupaksha Bagewadi
- Tele Medicine Centre, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, Karnataka, India
| | - Shyam Rps
- Tele Medicine Centre, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, Karnataka, India
| | - B R Manjunatha
- Tele Medicine Centre, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, Karnataka, India
| | - Harihara N Shashidhara
- Tele Medicine Centre, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, Karnataka, India
| | - Vinay Basavaraju
- Tele Medicine Centre, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, Karnataka, India
| | - Narayana Manjunatha
- Tele Medicine Centre, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, Karnataka, India.
| | - Sydney Moirangthem
- Tele Medicine Centre, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, Karnataka, India
| | - C Naveen Kumar
- Tele Medicine Centre, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, Karnataka, India
| | - Suresh Bada Math
- Tele Medicine Centre, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, Karnataka, India
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