New Delhi: As India sees a rise in the number of Covid-19-positive patients with each passing day, mental health professionals say they have also witnessed a rise in mental illness cases by upto 50 per cent in just the last two weeks.
During the lockdown, therapists have started taking their sessions online.
At a press conference Sunday, Joint Secretary at the health ministry Lav Agarwal also announced a helpline to deal with mental health impact of the lockdown on individuals.
Agarwal said the National Institute of Mental Health and Neuro-Sciences (NIMHANS) has launched a toll-free number — 08046110007 — for consultation.
“We have got 2,500 calls till now and we have 9 lines, which are answered by doctors and non-doctors trained in mental health,” said B.N. Gangadhar, director, NIMHANS.
Most calls are about people stressed and anxious due to the lockdown but it’s too early to analyse, he said.
‘Corona anxiety and fear’
Neha Mehta, founder of an online therapy platform, My Fit Brain, said she has seen a massive hike in the number of people reaching out to them for therapy support since the lockdown.
Doctors in her team are now calling the anxiety caused due to the pandemic ‘corona fear’. Her team of over 200 therapists are now working at their maximum capacity.
She told ThePrint that since they are registered mental health professionals, the NIMHANS helpline has been directing calls to them. Her platform takes anywhere between 10 and 20 panic calls directed from the helpline on a daily basis.
About the increased number of calls, she said, “People are panic calling with questions about the ongoing pandemic and the lockdown. We are calling it ‘corona anxiety and fear’.”
Not only are people asking them for help, but also seeking to verify information regarding the outbreak, Mehta added.
People are also stressed about their financial situation and the boredom resulting from the time spent at home, she said. For patients of anxiety and depression, coronavirus has entered the list of ‘triggers’ for their mental health problems, she added.
According to a report by the World Health Organization, 7.5 per cent of Indians suffer from mental health problems and the treatment gap in the country is about 70 per cent.
By 2020, the report predicted, 20 per cent of the population in India would suffer from mental health issues. With only 4,000 mental health professionals, the country is not equipped to deal with the onslaught of patients, it said.
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Housewives are worst affected
Rashi Vidyasagar, founder of another therapy service The Alternative Story, said, “With the ongoing uncertainty, people’s long-term plans have been affected. Patients of anxiety and depression have doubled their session hours, but for people who did not have such conditions before are now seeing symptoms of anxiety and depression.”
She explained that since people still don’t know when the lockdown will end, there is too much of uncertainty in people’s minds, and their worries are resulting in anxiety.
With people working from home, activities like brushing and taking a bath, which are signs of first step to recovery for depression patients, have come down in the wake of the lockdown as they don’t need to go out, she said.
Vidyasagar added that even if people are staying at home, it is important for a person’s mental health that they must take care of themselves.
She also said her organisation had shifted all their sessions to the online platform in the beginning of March itself.
Mumbai-based therapist Shamal Jaykar told ThePrint, “People are anxious because of the uncertainty. Activities like going to a park, meeting friends, which were previously coping strategies for anxiety patients, are now restricted.”
People with pre-existing mental health conditions are feeling threatened with the overload of information about coronavirus, he added.
Varun Shreshth, a psychometric assessor working out of Mumbai, said the worst affected in this lockdown are homemakers, or housewives. “I am getting distressed calls from housewives on the verge of breaking down. Their work hours have doubled and with no maids (domestic help) and no help from family members, they are over-exerted.”
Due to these changes, he added, housewives with pre-existing mental health problems are seeking therapy more often than before.
Mehta from My Fit Brain said she has seen a spike of 30 per cent in the number of cases on marriage counselling and parenting on her platform.
Since mental health does not require urgent treatment like physical ailments, couples who had been ignoring their marital issues are seeking therapy now.
On parenting problems, she said, “Parents are themselves stressed due to the pandemic. With children staying at home, parents are unable to keep them engaged at all times. This often leads to frustration and fights.”
Jaykar, meanwhile, said couples are now negotiating their expectations. Through therapy, they are trying to find ways on how to spend time together. They are also taking therapy to communicate better and negotiate gender-wise work distribution in their homes, he added.
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NIMHANS, AIIMS to set up online consultations
Meanwhile, government institutes like NIMHANS and AIIMS are also in the process of setting up online consultations for their patients.
“We are in the process of contacting patients who already have appointments and to give them appointments for a telemedicine consultation (consultation done via video),” said Srinivas Rajkumar, senior resident doctor in psychiatry department, AIIMS.
“We are still figuring out how to get access to the case files so that our doctors can consult patients on telemedicine,” said Gangadhar from NIMHANS, adding it will take a few days.
Digital prescriptions do not work
While therapists and psychiatrists can counsel patients over the phone or video, the patients who are already on medication for their mental health issues are not being able to access them due to the lockdown.
There are two issues, said Mumbai-based psychiatrist Sagar Mundada.
“First, coronavirus has exacerbated their symptoms, and secondly they are not able to procure their medicines.”
Patients are not able to get their medicines because some of the psychiatry drugs fall under Schedule X, which require prescriptions from doctors, and chemists are expected to keep a record of the prescription for two years.
Srinivas Rajkumar from AIIMS said drugs for alcohol cessation, anxiety, insomnia, attention deficit disorders fall under Schedule X.
Since patients are not able to visit their doctors, they are furnishing old prescriptions or e-prescriptions, which are not accepted by the chemists.
“I have been getting only six hours of sleep because I have been arranging medications for my patients,” said Harish Shetty, a psychiatrist working in Dr L.H. Hiranandani Hospital, Mumbai.
He said he is either personally helping patients with prescriptions or getting medications arranged through chemists.
Most of the psychiatry drugs come in the category of drugs that cannot be prescribed through telemedicines under the new telemedicine guidelines released by NITI Aayog.
“I have written to the health minister, tweeted about the problems but they have not responded to me,” said Shetty, who has also written a blog about it.
‘E-prescriptions much-needed’
Not being able to go out and maintain routines have also added to the stress of the patients.
Shetty says one of his patients who was under quarantine could not sleep for days and another patient with bipolar had such severe side-effects that he had to go to the patient’s house with the required drugs.
There are concerns with letting patients use old prescriptions or giving more than a week’s drug supplies because of the risk of overdose and unrestricted use.
“Most chemists are at the moment comfortable with giving a week’s medicine dose based on old prescriptions, which works for patients,” said Mumbai-based psychiatrist Mundada.
Srinivas from AIIMS said the telemedicine guidelines are being revised and they may allow e-prescriptions for mental health cases too.
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