Mumbai: In April 2021, Shailaja* (62), a Surat resident, dialled a Mumbai-based psychiatrist for an online consultation to resolve the recurrent crying spells and low mood she had been experiencing for the last ten years. The retired bank official said she felt uncomfortable visiting a psychiatrist’s clinic due to the stigma attached to mental health issues.
“Last year, when I consulted my family physician on a video call for cough and cold, he advised me to speak to a psychiatrist as he felt I was suffering from depression. He encouraged me to seek help saying since it is online, I did not need to worry about others knowing and the choice of opting for treatment post the consultation will be mine,” said Shailaja, who also suffers from diabetes and hypertension for two decades.
A month after medication, she felt much better. “For close to ten years, I had these recurrent crying spells and felt low. Post the treatment, I felt good for the first time. I don’t think I would have ever consulted a psychiatrist if the pandemic had not happened and online consultation was not an option,” she added.
Similarly, Chembur resident Kshitij J* (21), 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 developed cold feet during exams. I was stressed and had anxiety attacks to the point where I got a fever. My parents were reluctant to take me to the psychiatrist saying it is common and there is no need to go for a consultation or take medication,” he said.
Kshitij said he had a similar episode of anxiety attack last year during the pandemic thinking about exams. “My close friend lost his father to Covid-19. My friend too was hospitalised but recovered. The whole pandemic situation and uncertainty about exams and future triggered an anxiety attack. Since there was an online consultation option, I decided to seek help without my parents knowing about it. They still aren’t aware,” he said.
With counselling and medication, Kshitij said his anxiety and depression subsided.
While the city has returned to normalcy with educational institutions and offices resuming, and hospitals focusing on non-Covid healthcare, psychiatrists continue to take 30-50% of their daily consultations online. A major chunk comprises first-time help seekers like Shailaja and Kshitij.
Psychiatrists said the pandemic has been a boon in disguise as many hesitant patients came forward to take help via teleconsultation.
“There has always been a stigma and hesitation in visiting a mental health professional’s clinic. Many are afraid of being labelled as mental health patients by society. With the pandemic and video consultation becoming an option, many like Shailaja and Kshitij got the courage to seek help from the comfort of their home,” said Dr Avinash Desousa, president of Bombay Psychiatric Society, who said 30% of his present daily consultation is still online.
Psychiatrists say, during the pandemic, they saw a 50% surge in people seeking the help of mental health professionals. “Of the total patients, more than 20% were first-time seekers,” said Dr Desousa.
Dr Milan Balakrishnan, a psychiatrist at Masina Hospital, said Covid-19 itself became an equaliser. “Everybody went through some trouble. It helped people become aware of mental health. And online consultation allowed many to take the first step in seeking a professional’s help,” he said.
The Indian Psychiatric Society (IPS) is now undertaking a study to understand the impact of the pandemic and availability of online consultation. “The IPS plans to study and understand the experience of the patients who took video consultation, the reluctance and 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 individuals, said while they had a robust online consultation option pre-pandemic, it was only in the last two years that they saw a rise in people seeking help online for the first time.
During the pandemic, Mpower launched the BMC: Mpower 1-1 helpline (1800-120-820050) — a 24×7 toll-free service — to give citizens a platform where they can speak freely about mental health concerns. Since then, the helpline has received over 90,000 calls from across the country, of which about 50,000 are from Maharashtra.
Dr Vinod Kumar, psychiatrist & head of Mpower – The Centre, Bengaluru, said, “Pre-pandemic, we were worried about the poor response to our digital consultation. During the pandemic, we saw a 4 to 5 fold rise in people seeking help as there was no physical consultation option and many went through the stress, anxiety and depression.”
Even after Covid-19 restrictions were lifted, Dr Kumar said they are continuing with the hybrid model. “Pre-pandemic, there were few takers for online consultation. During the pandemic, offline sessions were not possible and now it is hybrid. We have almost 40-60, 50-50 ratio of the online and offline modes of consultation. The barrier of whether to seek help for mental health is broken and stigma has also reduced significantly,” he said.
Psychiatrists also thank the pandemic for the acceptance of digitally signed prescriptions. “This was long due but because of the pandemic, the regulators, and pharmacists agreed on accepting digital prescriptions. We scan the prescriptions and send the pdf format via email or WhatsApp. In the past, patients, who have been on treatment for a long time, had to visit us physically just for the prescription. Many discontinued the treatment too,” said Dr Desousa.
Dr Harish Shetty, senior psychiatrist, Dr LH Hiranandani Hospital-Powai, who holds 30% of his consultation online, said a large number of psychiatrists, including him, will still like to see their patients in person.
“Patients’ who are asymptomatic, live far and are comfortable in sharing during online consultation and those whose prescriptions don’t change can continue to be seen online. Those who are far off and in an emergency can also benefit from online consultation. However, patients who have symptoms, new patients, those who have poor compliance with the treatment or require a detailed one-on-one interview and those who are uncomfortable with the online consultation are the candidates for physical consultation,” he said.
*Names changed to protect the identity