TELE PSYCHIATRY AND COVID 19 PANDEMIC rebuilding Minds -from silence to hope

1. TELE PSYCHIATRY AND COVID 19 PANDEMIC REBUILDING MINDS—FROM SILENCE TO HOPE The pandemic has accelerated digital transformation in the health sector, which resulted in the emergence of various telemedicine platforms. Telepsychiatry, one of the integral divisions of telemedicine, undoubtedly, has contributed to the progress in the various quarters of life. It has continued its legacy during the pandemic to address the mental health conditions related to the same—the severe impact of the pandemic on the mental well-being of the patients and healthcare workers. As a result, there have been growing cases of the neuropathic effects of the virus –anxiety disorders, depression, sleep disorders, etc. Telepsychiatry has effectively implemented various psychological interventions to help reduce the incidence of mental health disorders and maintain sustained accessibility to mental health services.

2. There has been a high disproportionality factor of an accessible number of psychiatrists/psychologists in our country for patients in semi-urban or rural areas, and telepsychiatry can be used to address this crisis. Pandemic has negatively affected many people's pre-existing deteriorating mental health and created new barriers for them. Social isolations have caused the necessity for people to adapt to new situations swiftly. Due to this unforeseen alternation in the style of living, people eventually discovered that they needed much effort to deal with and understand the volatile circumstances. This situation triggered the disruption in the mental health fabric and further brought inequality in the mental health equilibrium.

3. Implications of COVID-19 on mental well-being in health care workers: Clinicians and paramedical staff working in the hospital setup exhibited moderate to the severe magnitude of the psychiatric symptoms, such as Anxiety disorder Clinical depression PTSD Sleep disorders Some risk factors have been identified that soared the severity of the symptoms amongst health care professionals— Prolonged contact with affected patients. Pre-existing mental health disorder. Prolonged quarantine period Lack of support from the organization. The growing sense of the perception of social stigma toward health professionals.

4. Implications of COVID-19 on mental well-being in patients: It has been observed that, during the acute phase of infection, around 20 to 40 percent and post-COVID, approximately 20 to 30 percent developed neuropsychiatric manifestations: Impaired concentration. Brain fog. Mood fluctuations Anxiety disorders Memory impairment Altered consciousness Confusion. Traumatic distress Substance abuse.

5. The COVID-19 pandemic has led to many changes in our lives. The precarious course of the situation generated uncertainty in many aspects, such as - altered day-to-day routine chores, financial stress, social seclusion, and perplexity about losing a life. Social media and electronic media platforms have fueled pessimistic notions and instilled unrest about the deadly infection's nature, course, and management. These platforms' profusely accessible information, rumors, and disinformation turned the situation worst and uncontrolled periodically. It has been observed that the severe COVID-19 illness was associated with long-term mental health symptomology among recovered patients. These symptoms are observed to last longer even after complete recovery –they may last for weeks, months, or even longer. The literature neuropsychiatric manifestations could result from dysfunction of neurobiological equilibrium as one of the potential effects of viral activity. As telemedicine witnessed a profound revolution during the pandemic, there has been a swift progression in telepsychiatry, which enabled healthcare professionals across the globe to address pre-existing mental health disorders due to the pandemic. Telepsychiatry has facilitated the process of mental health care to drive forward the concepts of management of psychiatric illnesses. It is well complemented conventional mental health care and has played a vital role during the pandemic. A psychiatrist must discover new usual factors in a patient's life, such as – the perception of the new normal trend, duration of illness/ treatment, feeling relationships, dietary habits, sleep pattern, and means of livelihood. It is recommended to have a collaborative approach review suggests that these of isolation, interpersonal

6. before engaging in telepsychiatry consultation for COVID-19- related psychiatric illness. This would help to define the process and to establish the protocol for the management. During the pandemic, various interventions were practiced by mental health caregivers during depending on the severity and risk factors of the illness. Cognitive processing therapy Cognitive-behavioral therapy Psychotherapy Mind fullness therapy Anxiety management strategic therapy When considering all the acknowledge and corroborate patients' symptoms instead of demonstrating that they are suffering, gaining the patient's trust and cooperation for further treatment options. Telepsychiatry, being a virtual mode of consultation, has alleviated the anxiety of the care receiver. Telepsychiatry offer - remote communication to help minimize stigma and allow privacy while engaged in the treatment session, limitation to the disease transmission, seamless accessibility, and management of the chronic psychiatric illness by the provider. A patient with restricted mobility lacks transportation, or scant economic resources may benefit from telepsychiatry services. During COVID 19 pandemic, as the world witnessed an abysmal economic recession, telepsychiatry extended cost-efficient care for the patients with post-COVID psychiatric manifestations. It is also very advantageous for the patients hailing from rural or semi-urban areas where the availability of mental health professionals and accessibility for mental health care is scarce. In addition, telepsychiatry's cost-effectiveness, easy accessibility, and many psychiatric providers are appealing features for situations such as psychological treatment for children and adolescents. telepsychiatry sessions, factors, psychiatrists should

7. During COVID 19 Pandemic peak, workforce constraint was the health fraternity's biggest challenge. Telemedicine platforms such as telepsychiatry helped to ease the workforce problems. Despite its many advantages during the pandemic, it is also imperative to understand the limitations of telepsychiatry services. Factors that may render limitations are: Concerns about the audio and video connectivity disruption due to network fluctuations --leading to distortion in the communication and subsequently misinterpretation by a caregiver Data confidentiality—security of the software Lack of body/limb gestures and direct eye contact—may hamper the quality of the communication Lack of technology competency of patients may be a detrimental factor In situations where providers have to perform a direct physical assessment, this tool is inappropriate Inability to perform an essential neurological examination As the uncertainty of the COVID Pandemic continues, telepsychiatry services would continue to exist as one of the leading platforms to provide robust mental health support—with safety and cost-effectivity. During this uncertain period, the psychiatrists appreciated the transition to telepractice in psychiatry, and this approach has helped bridge the gap between providers, patients, and their families. For telepsychiatry to be successfully integrated, there must be consistent improvisation, particularly in the ethical framework legislative aspects, and more seamless technical adaptability to ensure continued care to the vulnerable population. http://onlinedocs.us/