Tele-psychiatry averted mental health crisis in Kashmir amidst COVID19

During the COVID19 pandemic, while hospitals became inaccessible to patients, the mammoth burden of mental health in Kashmir continued to be addressed by a dedicated team banking on tele-medicine and innovations.

A 45 year old Kupwara man whose life and livelihood had both improved after he sought treatment at SMHS Hospital’s psychiatry department for a spectrum of mental health issues was suddenly left helpless in March this year. A Government order affected closure of all hospitals across Kashmir, their OPD services and admissions both. Only emergencies had been kept operational and a mental health issue such as depression did not qualify as an emergency.

However, the Institute of Mental Health and Neurosciences (IMHANS) at GMC Srinagar, which has witnessed the massive toll of mental health in Kashmir and documented it for decades, understood that the services could not be closed for patients. “We had to do something unusual to ensure that services are available to patients and we are able to minimize chances of infection,” said Dr Arshid Hussain, professor of psychiatry at GMC Srinagar.

The department opened up various avenues to reduce the need to visit hospital: A telephonic helpline was established, a WhatsApp number was dedicated to seek help about mental health issues and the Facebook page of the department became live with discussions on mental health. Patients were called up for counseling, advice and follow-ups, Dr Hussain said. Records at IMHANS reveal that more than 900 video calls were made for consultations during the past five months, since March till September. In addition, 2500 telephonic consultations were also carried out.

The Kupwara man was able to return to his job after his condition improved through multiple telephonic sessions with a specialist at IMHANS.

However, there were patients that needed to be seen physically or were in need of admission and Electroconvulsive Therapy (ECT). The department put in place several measures to minimize the chances of infection while it kept its premises of IMHANS Rainawari open for patients.

Hospital records reveal that during this period, over 21000 people have availed OPD services in its psychiatry department. Nearly 300 patients were admitted and over approximately 5000 availed de-addiction services.

Although, by numbers it is a decrease from the usual load of the department, the fact that these patients availed the services during COVID19 pandemic makes it remarkable. “This coupled with the fact that not a single patient of ours has tested positive, neither the admitted ones, nor the OPD ones,” said Dr Aijaz A Baba, medical superintendent IMHANS Srinagar said.

“Our roaster was devised in such a manner that none of the team met the other and patient notes were exchanged electronically,” Dr Baba said. He said that patients with mental health have a higher chance of getting infected with all microbes, including COVID19. “Because they are unable to comprehend the SOPs usually,” he said. However, with rigorous testing and distancing in wards, safety of patients is being ensured, he added.