Karnataka relies heavily on teleconsultation to reach out to Covid-19 patients

Despite the Union government’s guidelines that Covid-19 facilities should have provisions for psychiatric consultation, Karnataka relies heavily on teleconsultation to reach out to patients.

The Health Department has just 50 psychiatrists — one each in 30 district hospitals and in District Mental Health Programme (DMHP) teams, while the state has 2,912 government facilities.

Going by the BBMP dashboard, 17 government hospitals in Bengaluru are treating Covid-19 patients. Just a single Bengaluru Rural DMHP psychiatrist covers the Covid patients in Doddaballapur, Nelamangala, Devanahalli and Hoskote government hospitals, while the single Bengaluru Urban DMHP psychiatrist covers Anekal, Yelahanka and KR Puram.

The protocol dictates that all patients in quarantine or isolation should be contacted on a daily basis. The DMHP team consisting of a psychiatrist, a psychologist, a social worker, two nurses and two support staff should make the first call if required and should call everyone once in three days.

“We visit patients in quarantine centres in each taluk donning PPE,” said Dr Girish Kumar D P, the psychiatrist with Bengaluru Rural DMHP. “We counsel asymptomatic Covid patients over the phone. Five clinical psychologists handle 100 to 200 patients every day. If psychological disorders are found after screening, they’re referred to me.”

He said the DMHP team counsels nearly 500 patients a day. About 30% of the patients have anxiety disorders, stress and adjustment disorders followed by depression and substance use. “About 2% of them have suicidal tendencies,” Dr Girish revealed.

Saving PPE

Dr Rajani Parthasarathy, Deputy Director, Mental Health, Department of Health and Family Welfare, told DH that the psychiatrists are made to do more teleconsultation since the department did not want to waste the PPE. “As on November 1, 4,26,314 Covid patients have been counselled and 12,314 have been treated,” she said.

The department’s mental health staff also counselled 4,24,122 home quarantined/isolated patients, while it has treated 11,223 of them. It has also counselled 6,512 doctors and 15,382 health workers as on November 1.

The Health Ministry has cited research which suggests that 30% of diagnosed Covid patients have depression, while symptoms of Post-Traumatic Stress Disorder (PTSD) are seen in 96% Covid patients. Among the psychiatric symptoms found during the pandemic are mild to severe anxiety, worries, non-specific psychological distress, depression, stress symptoms, insomnia, hallucinations, paranoia, and suicidal ideation.