Significant number of patients still prefer online consultation, psychiatrists say | Bombay News

Mumbai: In April 2021, Shailaja* (62), a resident of Surat, called a Mumbai-based psychiatrist for an online consultation to resolve the recurring crying spells and bad temper she had been experiencing for ten years. The retired bank official said she felt uncomfortable going to a psychiatric clinic because of the stigma attached to mental health issues.

“Last year when I saw my family doctor on a cough and cold video call, he advised me to speak to a psychiatrist as he felt I was suffering from depression. He encouraged me to seek help saying that since it’s online I don’t need to worry about others knowing about it and the choice to go for treatment after the consultation will be mine,” said Shailaja, who has also suffered from diabetes and hypertension for two decades.

A month after the medication, she felt much better. “For almost ten years I had these recurring crying spells and felt depressed. After the treatment I felt good for the first time. I don’t think I would have ever seen a psychiatrist if the pandemic had not happened and online consultation was not an option,” she added.

Similarly, Kshitij J* (21), a resident of Chembur, a mechanical engineering student, found the courage to seek help online in early 2021 without his parents’ knowledge.

“When I was in class 12, I had cold feet during exams. I was stressed and had anxiety attacks to the point of having a fever. My parents were reluctant to take me to the psychiatrist saying it’s common and there’s no need to go to a doctor or take medication,” he said.

Kshitij said he had a similar episode of an anxiety attack last year during the pandemic while thinking about exams. “My close friend lost his father to Covid-19. My friend was also hospitalized but recovered. The whole pandemic situation and the uncertainty about exams and the future triggered an anxiety attack. Since there was an online consultation option, I decided to seek help without my parents knowing. They still don’t know,” he said.

With counseling and medication, Kshitij said her anxiety and depression decreased.

While the city has returned to normal with the resumption of educational institutions and offices, and hospitals focusing on non-Covid health care, psychiatrists continue to take 30-50% of their daily consultations online. A big chunk includes first-time help seekers like Shailaja and Kshitij.

Psychiatrists said the pandemic had been a boon in disguise, as many hesitant patients came forward seeking help via teleconsultation.

“There has always been a stigma and a reluctance to go to the clinic of a mental health professional. Many are afraid of being labeled as mentally ill by society. With the pandemic and video consultation becoming an option, many like Shailaja and Kshitij had the courage to seek help from the comfort of their homes,” said Dr Avinash Desousa, President of the Bombay Psychiatric Society, who said that 30% of its current daily consultation is still online.

Psychiatrists say that during the pandemic they have seen a 50% increase in the number of people seeking help from mental health professionals. “Of the total number of patients, more than 20% were first-time asylum seekers,” Dr Desousa said.

Dr Milan Balakrishnan, a psychiatrist at Masina Hospital, said Covid-19 itself had become an equaliser. “Everyone has been through trouble. It has helped people become aware of mental health. And online consultation has allowed many to take the first step towards professional help,” he said.

The Indian Psychiatric Society (IPS) is currently undertaking a study to understand the impact of the pandemic and the availability of online consultation. “The IPS plans to study and understand the experience of patients who have had a video consultation, the reluctance and the stigma attached to mental health”, said a psychiatrist, part of the IPS study .

Speaking to HT, Mpower, a foundation that provides quality mental health care at reasonable rates to underprivileged people, said that although it had a strong online counseling option before the pandemic, this only in the past two years has it seen an increase in the number of people seeking help online for the first time.

During the pandemic, Mpower launched the BMC hotline: Mpower 1-1 (1800-120-820050) — a 24/7 toll-free service — to provide a platform for citizens to speak freely of their mental health issues. Since then, the helpline has received more than 90,000 calls from across the country, including about 50,000 from Maharashtra.

Dr Vinod Kumar, Psychiatrist and Head of Mpower – The Centre, Bengaluru, said, “Before the pandemic, we were worried about the poor response to our digital consultation. During the pandemic we have seen a 4-5x increase in the number of people seeking help as there was no physical consultation option and many went through stress, anxiety and depression.

Even after the Covid-19 restrictions were lifted, Dr Kumar said they were continuing with the hybrid model. “Before the pandemic, there were few takers for online consultation. During the pandemic, offline sessions were not possible and now it’s hybrid. We have almost 40-60, 50-50 online and offline consultation modes. The barrier of whether to seek help for mental health is broken and the stigma has also dropped significantly,” he said.

Psychiatrists are also thanking the pandemic for accepting digitally signed prescriptions. “It was long overdue, but because of the pandemic, regulators and pharmacists have come together to accept digital prescriptions. We scan the prescriptions and send the pdf format by email or whatsapp. In the past, patients, who had been in treatment for a long time, had to physically visit us just for the prescription. Many also stopped treatment,” Dr. Desousa said.

Dr Harish Shetty, Senior Psychiatrist, Dr LH Hiranandani Hospital-Powai, who holds 30% of his consultations online, said a large number of psychiatrists, including himself, would still like to see their patients in person.

“Patients who are asymptomatic, live far away and are comfortable sharing during the online consultation and those whose prescriptions do not change can continue to be seen online. People who are remote and in emergency situations can also benefit from However, patients who are symptomatic, new patients, those with poor adherence to treatment or who require detailed one-on-one counseling, and those who are not comfortable with the online consultation are the candidates for physical consultation,” he said.

*Names changed to protect identity