COVID-19 & psychiatric care: Need of a plan to prevent follow-up discontinuation.

Dear Editor,

The Coronavirus disease-2019 (COVID-19) was declared an international public health emergency by the World Health Organization on 11th March 2020. In recognition of the worldwide threat, numerous countries imposed a lockdown to restrict the spread of the virus. The main priority of health authorities largely consisted of avoiding, controlling, and reducing the transmission of COVID-19. This included modifying the healthcare system through the closure or partial closure of inpatient facilities, with outpatient care often restricted to emergency cases only. This situation resulted in some potential disregard of the mental health and wellbeing of the population, at least during the initial phases of the outbreak.

Along with the mental health needs of the general population, the ones of people with psychiatric diagnosis were also somewhat underestimated. In many parts of the world, psychiatric wards were converted to cater the non-psychiatric COVID patients. The units that remained caring for people with a psychiatric diagnosis promoted physical distancing by using isolation rooms, lowering the overall number of available beds, imposing larger intake restrictions, and minimizing the length of stay. At the same time, impedance to travel to healthcare facilities, largely due to the unavailability of public transit, coupled with the people's unwillingness to visit hospitals due to the fear of getting infected by the virus, were accompanied by a decrease in the number of follow-up patients [1]. In addition, relatives of the hospitalized psychiatric patients also faced difficulties in visiting them due to the lockdown.

There is now a global call to acknowledge and care for the population's mental health wellbeing and take all necessary measures to mitigate the adverse impact of the pandemic. Sustainable modifications in mental health care delivery systems should be created by researchers, practitioners, and service users, and explicitly designed to reduce inequalities in health care delivery. Psychiatric care units, including nurses, physicians, care managers, psychiatrists, and social workers, need to be set up to provide mental wellbeing support to the affected individuals. Governments and health organizations should ensure that safe and interactive knowledge-sharing platforms are used to include and facilitate therapeutic therapy in telepsychiatry, facilitate legal information, and reduce isolation cases [2].

Telepsychiatry has become vital in the ongoing pandemic and many forms of online mental health programs have been introduced to alleviate psychological distress [3]. These include online surveys to allow health authorities to allocate health resources and establish adequate therapies and online mental health education. For example, in Australia, telephone-based screening questionnaires were conducted, and appointments were updated based upon the conditions of emergency, health and risk, and emergency plans were placed in advanced [4]. In India, telepsychiatry has proven to be highly effective and clinically endorsed in managing the follow-up of patients, with more than 80% of clinically stable patients being successfully managed solely through it [5].

To conclude, health policymakers should devise a mechanism to cater the needs of both COVID-19 and non-COVID-19 patients so that no patient should hesitate in reaching out to the concerned source of relief due to the fear of being infected by the virus.

Disclosure of interest

The authors declare that they have no competing interest.

Authors’ contributions

All authors reviewed the manuscript. All the authors agreed on the final draft before submission.

Funding sources

No funding was provided for this work.