From uncertainty to solution: A narrative review on challenges of mental health professionals in India before, during and after the pandemic
DOI:
https://doi.org/10.29120/ijpsw.2023.v14.i2.581Keywords:
Mental health, Community Health, SARS-CoV-2, Mental Health Services, ChallengesAbstract
The current study presents a comprehensive narrative review examining the challenges faced by mental health professionals in India during the COVID-19 pandemic. Prior to COVID-19, India's mental health infrastructure was already under strain, characterized by a substantial treatment gap, scarcity of professionals, and a concentration of services in urban areas. The pandemic exacerbated these challenges, necessitating a swift transition to tele-counselling and online interventions, despite inherent limitations and ethical dilemmas. Increased cases of domestic violence, loneliness, and mood disorders during lockdowns highlighted the urgent need for effective mental health support. The paper discusses pre-existing issues such as stigma, lack of training institutes, and misconceptions about mental health in rural areas. It also explores innovative solutions, including the integration of spiritual and community leaders into mental health initiatives, to address the unique cultural context of India. The study underscores the urgent need for policy reforms, enhanced training, and collaborative approaches to bridge the treatment gap and ensure accessible mental health care in both urban and rural settings.
Keywords: Mental health, community health, pandemic, challenges
References
Dhyani A, Gaidhane A, Choudhari SG, Dave S, Choudhary S. Strengthening Response Toward Promoting Mental Health in India: A Narrative Review. Cureus. 14(10):e30435. doi:10.7759/cureus.30435
Mental Health - PAHO/WHO | Pan American Health Organization. Published 2014. Accessed May 4, 2024. https://www.paho.org/en/topics/mental-health
Galderisi S, Heinz A, Kastrup M, Beezhold J, Sartorius N. Toward a new definition of mental health. World Psychiatry. 2015;14(2):231-233. doi:10.1002/wps.20231
Tomlinson M, Lund C. Why does mental health not get the attention it deserves? An application of the Shiffman and Smith framework. PLOS Med. 2012;9(2). doi:10.1371/journal.pmed.1001178
Shrivastava A, Johnston M, Stitt L, et al. Reducing treatment delay for early intervention: evaluation of a community based crisis helpline. Ann Gen Psychiatry. 2012;11(1):20. doi:10.1186/1744-859X-11-20
Murthy SR. National Mental Health Survey of India 2015-2016. Indian J Psychiatry. 2017;59(1):21-26.
Jena S, Zieger A, Böge K, Salunkhe G, Schomerus G, Patel K, et al. Public Attitudes Toward Psychiatric Hospitals: A Rural-Urban Comparative Public Survey in Odisha State, India. Front Psychiatry. 2021. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.745604
Bayetti C, Jadhav S, Deshpande NS. How do psychiatrists in India construct their professional identity? A critical literature review. Indian J Psychiatry. 2017;59(1):27-38.
Lahariya C. Strengthen mental health services for universal health coverage in India. J Postgrad Med. 2018;64(1):7-9.
Serafini G, Parmigiani B, Amerio A, Aguglia A, Sher L, Amore M. The psychological impact of COVID-19 on the mental health in the general population. QJM. 2020;113(8):531-537. doi:10.1093/qjmed/hcaa201
Al Dhaheri AS, Bataineh MF, Mohamad MN, et al. Impact of COVID-19 on mental health and quality of life: Is there any effect? A cross-sectional study of the MENA region. PLoS One. 2021;16(3):e0249107. doi:10.1371/journal.pone.0249107
Guessoum SB, Lachal J, Radjack R, et al. Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown. Psychiatry Res. 2020;291:113264. doi:10.1016/j.psychres.2020.113264
Codagnone C, Bogliacino F, Gómez C, et al. Assessing concerns for the economic consequence of the COVID-19 response and mental health problems associated with economic vulnerability and negative economic shock in Italy, Spain, and the United Kingdom. PLoS One. 2020;15(10):e0240876. doi:10.1371/journal.pone.0240876
Türközer HB, Öngür D. A projection for psychiatry in the post-COVID-19 era: Potential trends, challenges, and directions. Mol Psychiatry. 2020;25(10):2214-2219. doi:10.1038/s41380-020-0841-2
Bil W, Zeilmaker M, Fragki S, Lijzen J, Verbruggen E, Bokkers B. Risk Assessment of Per- and Polyfluoroalkyl Substance Mixtures: A Relative Potency Factor Approach. Environ Toxicol Chem. 2021;40(3):859-870. doi:10.1002/etc.4835
Das S, Bhowmick S, Tiwari S, Sen S. An Updated Systematic Review of the Therapeutic Role of Hydroxychloroquine in Coronavirus Disease-19 (COVID-19). Clin Drug Investig. 2020;40(7):591-601. doi:10.1007/s40261-020-00927-1
Fiorillo A, Gorwood P. The consequences of the COVID-19 pandemic on mental health and implications for clinical practice. Eur Psychiatry. 2020;63(1):e32. doi:10.1192/j.eurpsy.2020.35
Grover S, Mehra A, Sahoo S, et al. State of mental health services in various training centers in India during the lockdown and COVID-19 pandemic. Indian J Psychiatry. 2020;62(4):363. doi:10.4103/psychiatry.indianjpsychiatry_567_20
Semo BW, Frissa SM. The Mental Health Impact of the COVID-19 Pandemic: Implications for Sub-Saharan Africa. Psychol Res Behav Manag. 2020;13:713-720. doi:10.2147/PRBM.S264286
Shah K, Kamrai D, Mekala H, Mann B, Desai K, Patel RS. Focus on Mental Health During the Coronavirus (COVID-19) Pandemic: Applying Learnings from the Past Outbreaks. Cureus. 2020;12(3):e7405. doi:10.7759/cureus.7405
Kumar A. Mental health services in rural India: Challenges and prospects. Health. 2011;3(12):757-761.
Boge K, Zieger A, Mungee A, Tandon A, Fuchs ML, Schomerus G, Tam Ta MT, Dettling M, Bajbouj M, Angermeyer M, Hahn E. Perceived stigmatization and discrimination of people with mental illness: A survey-based study of the general population in five metropolitan cities in India. Indian J Psychiatry. 2018;60(1):24-31.
Venkatesh TB, Andrews T, Mayya SS, Singh MM, Parsekar SS. Perception of stigma toward mental illness in South India. J Family Med Prim Care. 2015;4(3):449-453. doi:10.4103/2249-4863.161306
Kumar A. Mental health in India: Issues and concerns. J Ment Health Ageing. 2002;8(3):255-260.
Ul Hassan F, Nagavarapu LS, Prasad MK, Raj A, Sekhar K. Homelessness in mental illness: Opportunities & prospects in the Indian context. Asian J Psychiatry. 2020;45:28-32. doi:10.1016/j.ajp.2019.08.011
Ayano G, Tesfaw G, Shumet S. The prevalence of schizophrenia and other psychotic disorders among homeless people: A systematic review and meta-analysis. BMC Psychiatry. 2019;19(1):370. doi:10.1186/s12888-019-2361-7
Institute of Medicine (US) Committee on Health Care for Homeless People. Homelessness, Health, and Human Needs. National Academies Press (US); 1988. Accessed May 4, 2024. http://www.ncbi.nlm.nih.gov/books/NBK218232/
Kumar P. Homelessness and mental health: Challenging issue in an Indian context. Am Int J Res Human Arts Soc Sci. 2014;2(7):160-163.
Kumar D. Contributions and challenges of psychologists in private practice in india and their responses to covid-19. In: Manickam LSS, ed. COVID-19 pandemic: Challenges and responses of psychologists from India. Thiruvananthapuram: Leister Sam Sudheer Manickam; 2020.
Jain S, Jadhav S. A CULTURAL CRITIQUE OF COMMUNITY PSYCHIATRY IN INDIA. Int J Health Serv. 2008;38(3):561-584. Retrieved March 15, 2021, from http://www.jstor.org/stable/45131980
Jassim G, Jameel M, Brennan E, Yusuf M, Hasan N, Alwatani Y. Psychological Impact of COVID-19, Isolation, and Quarantine: A Cross-Sectional Study. Neuropsychiatr Dis Treat. 2021;17:1413-1421. doi:10.2147/NDT.S311018
Sinha SK, Kaur J. National mental health programme: Manpower development scheme of eleventh five-year plan. Indian J Psychiatry. 2011;53(3):261-265. doi:10.4103/0019-5545.86821
Garg K, Kumar CN, Chandra PS. Number of psychiatrists in India: Baby steps forward, but a long way to go. Indian J Psychiatry. 2019;61(1):104-105. doi:10.4103/psychiatry.IndianJPsychiatry_7_18
Kumar P, Jangid P, Sethi S. Undergraduate psychiatry in India: A SWOT analysis. Asian J Psychiatry. 2018;33:46-51. doi:10.1016/j.ajp.2018.02.018
Bedi S, Khan W. Psycho-social impact of covid-19 in India. Indian J Health Sci Care. 2020;7(si1):143. doi:10.5958/2394-2800.2020.00034.6
Grover S, Dua D, Shouan A, Nehra R, Avasthi A. Perceived stress and barriers to seeking help from mental health professionals among trainee doctors at a tertiary care centre in North India. Asian J Psychiatry. 2019;39:143-149. doi:10.1016/j.ajp.2018.12.020
Ransing R, Kar S, Menon V. National helpline for mental health during COVID-19 pandemic in India: New opportunity and challenges ahead. Asian J Psychiatry. 2020;54:102447. doi:10.1016/j.ajp.2020.102447
Cheng Q, Chang S, Yip P. Opportunities and challenges of online data collection for suicide prevention. Lancet. 2012;379(9830):e53-e54. doi:10.1016/s0140-6736(12)60856-3
Cheng Q, Fu KW, Yip PSF. A comparative study of online suicide-related information in Chinese and English. J Clin Psychiatry. 2011;72(3):313-319. doi:10.4088/JCP.09m05440blu
Srivastava K, Chatterjee K, Bhat SP. Mental health awareness: The Indian scenario. Ind Psychiatry J. 2016;25(2):131-134. doi:10.4103/ipj.ipj_68_16
Jain N, Singh H, Koolwal G, Kumar S, Gupta A. Opportunities and barriers in service delivery through mobile phones (mHealth) for Severe Mental Illnesses in Rajasthan, India: A multi-site study. Asian J Psychiatry. 2015;14:31-35. doi:10.1016/j.ajp.2015.01.008
Sreejith G, Menon V. Mobile Phones as a Medium of Mental Health Care Service Delivery: Perspectives and Barriers among Patients with Severe Mental Illness. Indian J Psychol Med. 2019;41(5):428-433. doi:10.4103/ijpsym.ijpsym_333_18
Hazarika M, Das B, Das S, Baruah A, Sharma N, Barua C, et al. Profile of distress callers and service utilisation of tele-counselling among the population of Assam, India: an exploratory study during COVID-19. Open J Psychiatry Allied Sci. 2021;12(1):7. doi:10.5958/2394-2061.2021.00001.x
Joshi S. Telepsychotherapy: The Bridge To Continuity In Care And Mental Health Services In Covid-19 And Post Covid Era. In: Manickam LSS, ed. COVID-19 pandemic: Challenges and responses of psychologists from India. Thiruvananthapuram: LEISTER SAM SUDHEER MANICKAM; 2020:174-175.
Patel V. SUNDAR: mental health for all by all. Bjpsych. Int. 2015;12(01):21-23. doi:10.1192/s2056474000000118
van Ginneken N, Tharyan P, Lewin S, et al. Non-specialist health worker interventions for the care of mental, neurological and substance-abuse disorders in low- and middle-income countries. Cochrane Database Syst Rev. 2013;(11):CD009149. doi:10.1002/14651858.CD009149.pub2
Adwitiya P, Ashwini P, Avinash A, Badri R, Kajal D, Vomsi P, Srividya S. Mutagenesis of Bacillus thuringiensis IAM 12077 for increasing poly (-β) hydroxybutyrate (PHB) production. Turk J Biol. 2009;33(3):225-230. doi:10.3906/biy-0808-10
Graham S, Depp C, Lee EE, et al. Artificial Intelligence for Mental Health and Mental Illnesses: An Overview. Curr Psychiatry Rep. 2019;21(11):116. doi:10.1007/s11920-019-1094-0
Uban AS, Chulvi B, Rosso P. An emotion and cognitive based analysis of mental health disorders from social media data. Future Generation Computer Systems. 2021;124:480-494. doi:10.1016/j.future.2021.05.032
Chatterjee S, Khorana S, Kizgin H. Harnessing the Potential of Artificial Intelligence to Foster Citizens’ Satisfaction: An empirical study on India. Gov Inf Q. 2022;39(4):101621. doi:10.1016/j.giq.2021.101621
Liu RT, Steele SJ, Hamilton JL, Do QBP, Furbish K, Burke TA, et al. Sleep and suicide: A systematic review and meta-analysis of longitudinal studies. Clin Psychol Rev. 2020;81:101895. doi:10.1016/j.cpr.2020.101895
Thirthalli J, Reddy SK, Kare M, Das S, Gangadhar NB. Rural-urban differences in accessing mental health treatment in patients with psychosis. Int J Soc Psychiatry. 2017;63(8):694-698. doi:10.1177/0020764016668046
Kaur R, Pathak KR. Treatment gap in mental healthcare: Reflections from policy and research. Econ Polit Wkly. 2017;52(31):34-40.
Patel V, Copeland J. The great push for mental health: Why it matters for India. Indian J Med Res. 2011;134(4):407-409.
Roy D. China’s Post-Deng Foreign Relations. Int J. 1998;53(1):133-146. doi:10.1177/002070209805300107
Kakuma R, Kleintjes S, Lund C, Drew N, Green A, Flisher AJ, et al. Mental health stigma: What is being done to raise awareness and reduce stigma in South Africa? Afr J Psychiatry. 2010;13(2):116-124. doi:10.4314/ajpsy.v13i2.54357
Betton V, Borschmann R, Docherty M, Coleman S, Brown M, Henderson C. The role of social media in reducing stigma and discrimination. Br J Psychiatry. 2015;206(6):443-444. doi:10.1192/bjp.bp.114.152835
Hasan MT, Thornicroft G. Mass media campaigns to reduce mental health stigma in Bangladesh. Lancet Psychiatry. 2018;5(8):616. doi:10.1016/S2215-0366(18)30219-0
Rabbani F, Akhtar S, Nafis J, et al. Addition of mental health to the lady health worker curriculum in Pakistan: Now or never. Hum Resour Health. 2023;21(1):29. doi:10.1186/s12960-023-00814-8
Rahman S, Kielmann T, McPake B, Normand C. Healthcare-seeking Behaviour among the Tribal People of Bangladesh: Can the Current Health System Really Meet Their Needs?. J Health Popul Nutr. 2012;30(3):353-365. doi:10.3329/jhpn.v30i3.12299
Sathiyaseelan A. Mental Health Professionals View on the Need for Early Intervention for Offspring of Individual With Schizophrenia in India. Biomedical and Pharmacology Journal. 2018;11(3):1309-1315.
Raguram R. Traditional community resources for mental health: a report of temple healing from India. BMJ. 2002;325(7354):38-40. doi:10.1136/bmj.325.7354.38
Kalantri S, Abbasian C, Raguram R. Temple Healing. BMJ. 2002;325(7370):968-969. Retrieved March 1, 2021, from http://www.jstor.org/stable/25452710
Sathiyaseelan A, Sathiyaseelan B, Desai TS. Challenges of Indian Girls with Maternal Schizophrenia. Biomedical and Pharmacology Journal. 2019;12(2):863-873.
Ramakrishnan P, Rane A, Dias A, et al. Indian Health Care Professionals' Attitude Towards Spiritual Healing and Its Role in Alleviating Stigma of Psychiatric Services. J Relig Health. 2014;53(6):1800-1814. doi:10.1007/s10943-013-9781-9
Hays K, Shepard Payne J. Lived Experience, Transparency, Help, and Humility: Four Characteristics of Clergy Responding to Mental and Emotional Problems. J Pastor Care Couns. 2020;74(1):4-11. doi:10.1177/1542305019872437
Iheanacho T, Nduanya UC, Slinkard S, Ogidi AG, Patel D, Itanyi IU, et al. Utilizing a church-based platform for mental health interventions: Exploring the role of the clergy and the treatment preference of women with depression. Global Mental Health. 2021;8:e5. doi:10.1017/gmh.2021.4
Padayachee P, Laher S. South African Hindu Psychologists' Perceptions of Mental Illness. J Relig Health. 2014;53(2):424-437. doi:10.1007/s10943-012-9608-3
Kapoor V, Belk R, Goulding C. Ritual Revision During a Crisis: The Case of Indian Religious Rituals During the COVID-19 Pandemic. J Public Policy Marketing. 2022;41(3):277-297. doi:10.1177/07439156221081485
Sathiyaseelan A, Balasundaram S, Patangia B, R R S. Indian Psychology: Challenges, Strategies, and Prospects in Education. In: Global Applications of Indian Psychology: Therapeutic and Strategic Models. IGI Global; 2023. doi:10.4018/978-1-6684-9778-4.ch001
Thara R, Patel V. Role of non-governmental organizations in mental health in India. Indian J Psychiatry. 2010;52(7):389. doi:10.4103/0019-5545.69276
Hafeez S. 6 NGOs tackling mental health issues head-on. Give’s Blog. Published May 26, 2021. Accessed Mar 4, 2024. https://give.do/blog/6-ngos-tackling-mental-health-issues-head-on/
Gearing ER, Alonzo D, Marinelli C. Maternal schizophrenia: Psychosocial treatment for mothers and their children. Clin Schizophr Relat Psychoses. 2012;6(1):27-33.
Kovess-Masfety V, Karam E, Keyes K, Sabawoon A, Sarwari BA. Access to Care for Mental Health Problems in Afghanistan: A National Challenge. Int J Health Policy Manag. 2021;11(8):1442-1450. doi:10.34172/ijhpm.2021.46
Riley RJ, Burgener S, Buckwalter KC. Anxiety and Stigma in Dementia: A Threat to Aging in Place. Nurs Clin North Am. 2014;49(2):213-231. doi:10.1016/j.cnur.2014.02.008
Murphy J, Goldsmith C, Jones W, Oanh P, Nguyen V. The effectiveness of a Supported Self-management task-shifting intervention for adult depression in Vietnam communities: study protocol for a randomized controlled trial. Trials. 2017;18(1). doi:10.1186/s13063-017-1924-5
Census 2011 India. Accessed May 4, 2024. https://www.census2011.co.in/
Patra S, Anand K. Homelessness: a hidden public health problem. Indian J Public Health. 2008;52(3):165-168.
Khera R, Nayak N. Women Workers and Perceptions of the National Rural Employment Guarantee Act. Econ Polit Wkly. 2009;44(43):49-57. Retrieved July 27, 2021, from http://www.jstor.org/stable/25663707
Banerjee D, Bhattacharya P. “Pandemonium of the pandemic”: Impact of COVID-19 in India, focus on mental health. Psychological Trauma: Theory, Research, Practice, and Policy. 2020;12(6):588-592. doi:10.1037/tra0000799
Kapur R. Homelessness in India. Int J Transform Bus Manag. 2017;7(1):45-49.
Narasimhan L, Gopikumar V, Jayakumar V, Bunders J, Regeer B. Responsive mental health systems to address the poverty, homelessness and mental illness nexus: The Banyan experience from India. Int J Ment Health Syst. 2019;13(1). doi:10.1186/s13033-019-0313-8
Raja T. Vandana Gopikumar | The Banyan | Social Work For Mental Health—VikasAnvesh Foundation. Retrieved December 20, 2023, from https://www.socialworkindia.in/profiles/vandana-gopikumar
Prescilla D. Inclusive Growth — A Solution to Homelessness#. SDMIMD J Manag. 2018;9(2):32-39. doi:10.18311/sdmimd/2018/21685
Satapathy S, Choudhary V, Sharma R, Sagar R. Nonpharmacological Interventions for Children with Attention Deficit Hyperactivity Disorder in India: A Comprehensive and Comparative Research Update. Indian Journal of Psychological Medicine. 2016;38(5):376-385. doi:10.4103/0253-7176.191382
Kombarakaran F. Street Children of Bombay: Their Stresses and Strategies of Coping. Children and Youth Services Review. 2004;26:853-871. doi:10.1016/j.childyouth.2004.02.025
Nair R, Raghavan V. Living on the edge: Scoping study of homeless population in M East ward, Mumbai. Soc Work J. 2014;5(2):35-45.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Anuradha Sathiyaseelan, Bishal Patangia, Layah Liz Jacob, Rajasree Venkatesh
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
