Given the magnitude of the mental health issues and the sparse availability of specialists in mental health care across the country, IIHMR University conducted a webinar on “Mental Health in COVID 19 Era: Public Health Perspectives’. Eminent speakers discussed promoting an inclusive approach of involving non-psychiatric health care professionals- the primary care health professionals for appropriate response and support.
The eminent speakers included Dr. Vimal Kumar Sharma, MD, Ph.D., Professor of Global Mental Health Research, Division of Population Health, School of Health Sciences, University of Manchester, UK; Dr. Chandrakant S Pandav, Former Professor and Head of the Department, Centre for Community Medicine, AIIMS and Member, National Council for India Nutritional Challenges, POSHAN ABHIYAN, South West Delhi, Dr. Sowmya Krishna, Consultant Psychiatrist, Co-Founder, and Head of General Psychiatric Services, The Green Oak Initiative, lead Psychiatrist, Hank Nunn Institute, Bengaluru Dr. Paola Andrea Tejada, MD, Ph.D., Faculty of Health and Social Care, University of Chester. The session was chaired by Dr. S D Gupta, Chairperson, IIHMR University and Dr. Neetu Purohit, Associate Professor (Clinical Psychology) IIHMR University moderated the session.
Dr. Vimal Sharma, discussed the impact of COVID 19 on overall mental health issues. There is a substantial increase in anxiety, substance abuse, post-traumatic stress disorder, and complex grief and suicide. Those hospitalized are at a greater risk of depression, anxiety and post-traumatic stress disorder. The situation has brought focus on the role of social environment and spiritual aspects also.
For managing mental health crisis in COVID 19 era, we need to train general health workers in mental health and raise awareness and skills in detecting mental disorders and develop a sustainable support system using technology so that general health workers can manage mental health problems as well with the advice and guidance of mental health specialists.
He strongly recommended that we have to make the government and higher authorities aware of keeping a certain amount of funds allocated to deal with mental health disorders. All these aspects must be integrated into policies and strategies at national and local levels. We need to train frontline workers, community health professionals in essential aspects of mental health, the use of online services to assess the scope of mental health problems.
Dr. S.D. Gupta said, that there are many studies on the magnitude of mental illness. However, we never realized it as a grave problem. It is not only a psychological issue but also a public health issue. Many populations are affected, but they are not detected, and they are not aware of any such issue.
At first, we need to make people aware of mental disorders and ensure availability and accessibility of care services. We need to integrate public health with mental health. We have enough lessons from various studies and we do not require prevalence surveys but need to expand services by developing implementation standards with the proper use of technology. GMHAT is one assessment tool, but we should move a step further and develop a service delivery mechanism to reach out to the people. There is a need to develop guidelines for Screening and Basic management of Mental health ailments at Health and Wellness Centre and this has to be taken as priority under the banner of Dr S D Gupta School of Public Health, IIHMR.
Dr. Sowmya Krishna, said, “COVID 19 has bought the technology at the forefront. People used to talk about the advantages of technology in assessing mental health. In the last six months, we have seen that accessing of mental health services by people have gone up considerably due to technology.
The mental health workforce in India is 0.3 psychiatrists per 100,000 population. Thus, the use of technology can play an essential role in bridging the gaps in helping people assess mental health services better. More than 6oo mental health-related apps are floating globally but very few offer the overall assessment of individual mental health. She recommended the Global Mental Health Application Technology (GMHAT) assessment tool that looks at all aspects of mental health and allows us to contextualize, which is available in five languages, including English, Hindi, Marathi, Spanish and Arabic.”
Dr. Paola Andrea Tejada said, “the significant psychological impact of health emergency caused by the coronavirus is seen in the high rates of stress and anxiety. As measures like quarantine have emerged, self-harm and suicidal behaviors are also expected to increase. There is an urgent need for adequate training of primary care staff to develop their skills to detect mental health disorders.
The primary health staff can be trained in a few days with other health packages as a part of the local training system.” Dr. Chandrakant S. Pandav, said, “This is the twentieth pandemic in human history. Corona is very easy to treat, but we need right information. People have a stigma due to distorted information, important for pandemic is fear of pandemic. That is where the mental health services have a role to the play. We should talk about wellbeing and not just health.”
Dr. Neetu Purohit moderated the session and said that mental health has got the increased attention due to pandemic, but the disorder was always present. As per the national Mental Health Survey, 2017, in India, 1 person out of 7 person has a mental health disorder and almost 150 million people in India are in need of mental health services but less than 30 million seek the services.
Multiple reasons spanning from unawareness to stigma, to non-availability of services and dearth of mental health experts could be the reasons for this treatment gap. COVID 19 has bought the mental health issues at the forefront and needs to be integrated with public health for ensuring better availability and accessibility of mental health services.