A retrospective chart review of clinical profile of patients utilizing telepsychiatry services during COVID-19 pandemic at a tertiary care centre.

Background: Telepsychiatry as a vehicle for delivering mental health services became evident due to outburst of mental health issues during coronavirus disease 2019 (COVID-19) pandemic and it was found useful in providing mental health care while maintaining social distancing norms and lockdown guidelines. Aim: To study clinical profile and sociodemographic profile of patients utilizing telepsychiatry services during COVID-19 pandemic. Materials and Methods: Total 70 old follow-up and 42 new patients were consulted on telepsychiatry, as per Indian Telepsychiatry Operational Guidelines 2020 given by NIMHANS, during 1st and 2nd wave of COVID-19 pandemic from June 2020 to May 2021. Sociodemographic and clinical data was extracted from all patients who utilized our telepsychiatry services in a semi-structured proforma for retrospective analysis using frequency tables. Results: A total of 102 patients benefitted from our telepsychiatry services. Out of which, 66.7% were adults between 21 and 40 years, with slight female preponderance (55.9%) and majority (78.4%) participants living in urban areas. About 70.6% were graduates with 41.2% participants belonging to either private or public service. One-third of the participants were IT professionals. Around 59.8% participants had past history of psychiatric illness and 40.2% had new onset illness. The diagnostic distribution included depressive disorder (28.4%), anxiety disorder (26.4%), psychotic disorder (21.6%) and obsessive compulsive disorder (9.8%) and others (13.8). Conclusion: Telepsychiatry has emerged as an important consultation modality in this COVID-19 pandemic. Its future use seems promising, which will require mental health practitioners to develop their skills while interacting digitally, conducting assessments, and therapy.

Acceptability, Adaptability, and Feasibility of a Novel Computer-Based Virtual Counselor-Delivered Alcohol Intervention: Focus Group and In-depth Interview Study Among Adults With HIV or Tuberculosis in Indian Clinical Settings.

BACKGROUND: Unhealthy alcohol use is associated with increased morbidity and mortality among persons with HIV and tuberculosis (TB). Computer-based interventions (CBIs) can reduce unhealthy alcohol use, are scalable, and may improve outcomes among patients with HIV or TB. OBJECTIVE: We assessed the acceptability, adaptability, and feasibility of a novel CBI for alcohol reduction in HIV and TB clinical settings in Pune, India. METHODS: We conducted 10 in-depth interviews with persons with alcohol use disorder (AUD): TB (6/10), HIV (2/10), or HIV-TB co-infected (1/10) selected using convenience sampling method, no HIV or TB disease (1/10), 1 focus group with members of Alcoholics Anonymous (AA; n=12), and 2 focus groups with health care providers (HCPs) from a tertiary care hospital (n=22). All participants reviewed and provided feedback on a CBI for AUD delivered by a 3D virtual counselor. Qualitative data were analyzed using structured framework analysis. RESULTS: The majority (9/10) of in-depth interview respondents were male, with median age 42 (IQR 38-45) years. AA focus group participants were all male (12/12), and HCP focus group participants were predominantly female (n=15). Feedback was organized into 3 domains: (1) virtual counselor acceptability, (2) intervention adaptability, and (3) feasibility of the CBI intervention in clinic settings. Overall, in-depth interview participants found the virtual counselor to be acceptable and felt comfortable honestly answering alcohol-related questions. All focus group participants preferred a human virtual counselor to an animal virtual counselor so as to potentially increase CBI engagement. Additionally, interaction with a live human counselor would further enhance the program's effectiveness by providing more flexible interaction. HCP focus group participants noted the importance of adding information on the effects of alcohol on HIV and TB outcomes because patients were not viewed as appreciating these linkages. For local adaptation, more information on types of alcoholic drinks, additional drinking triggers, motivators, and activities to substitute for drinking alcohol were suggested by all focus group participants. Intervention duration (about 20 minutes) and pace were deemed appropriate. HCPs reported that the CBI provides systematic, standardized counseling. All focus group and in-depth interview participants reported that the CBI could be implemented in Indian clinical settings with assistance from HIV or TB program staff. CONCLUSIONS: With cultural tailoring to patients with HIV and TB in Indian clinical care settings, a virtual counselor-delivered alcohol intervention is acceptable and appears feasible to implement, particularly if coupled with person-delivered counseling.

Counseling patients with COVID-19: An experience at dedicated COVID-19 hospital.

COVID-19 pandemic is generating considerable stress in the population. Uncertain prognosis, looming severe shortages of resources for testing and treatment, imposition of unfamiliar public health measures (infringing on personal freedoms), large and growing financial losses, and conflicting messages from authorities are few of the major stressors due to COVID-19. The effect due to COVID varies from individual to individual. Healthcare providers are more vulnerable as there is increased risk of exposure to coronavirus, concern about infecting and caring for loved ones, shortages of personal protective equipment, and longer working hours. Yashwantrao Chavan Memorial Hospital started functioning as Dedicated COVID-19 hospital since April 2020. Psychiatric services were also active and were delivered by means of telepsychiatry outpatient services, consultation-liaison psychiatry for COVID-19 patients, group counseling, supportive counseling, and psychosocial counseling center for relatives. Our experience is briefly described.

The Young Lives Matter study protocol: A case-control study of the determinants of suicide attempts in young people in India.

Suicide is the second leading cause of death among young people in India. Over 40% of all suicides occur in people between 15 and 29 years of age. Suicide attempts are estimated to be 15 times more common than suicides and substantially increase the risk of subsequent death. However, there has been little systematic study of the determinants for suicide attempts in young people, which makes it difficult to design contextually appropriate and comprehensive suicide prevention strategies for this population. The proposed case-control study seeks to address this knowledge gap by studying a range of risk and protective factors for suicide attempts in young people in India. Field work will be in Yashwantrao Chavan Memorial Hospital (YCMH) hospital, in Pimpri-Chinchwad, Pune, India. Cases will be 15-29-year-old individuals admitted to the hospital with self-inflicted non-lethal injuries and poisoning. They will be matched for age and gender with those presenting at the General Medicine outpatient department with other health complaints. In each group, 150 persons will be recruited from YCMH from October 2019 to September 2022 and will undergo a comprehensive semi-structured interview. The primary exposure variable is negative life events over the past 12 months. Secondary exposure variables considered include: demographic characteristics, psychological factors, addictive behaviours, personal resources, adverse experiences over their lifetime, social support, suicidal behaviours in the family and social environment, and exposure to suicide-related information. Data will be analysed using conditional logistic regression. Following completion of the study, workshops will be held with young people, mental health professionals and policy makers to develop a theory of change that will be used to promote suicide prevention. Results will be disseminated via peer-reviewed publications, reports to young people and mental health organisations, and news articles. The study was approved by the Institutional Review Board at Sangath.