India has a severe shortage of psychiatrists with the result that those with mental illness in rural areas either remain undiagnosed or do not get proper treatment. However, a “virtual psychiatrist” tool developed by Indian researchers can help address this problem.
The tool called clinical decision support system (CDSS) for diagnosis and treatment of psychiatric disorders has been developed at the Department of Psychiatry of the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh. It has been field tested in remote villages in Himachal Pradesh, Uttarakhand, and Jammu & Kashmir.
Findings of study
A study on its use has evaluated the diagnostic accuracy and reliability of the application at remote sites when used by non-psychiatrists who had limited training in it. The knowledge-based, logical diagnostic tool showed “acceptable” to “good” validity and reliability when used by non-specialists. The diagnosis done by non-psychiatrists was compared with that done by specialists.
“Our findings show that [the] diagnostic tool of the telepsychiatry application has potential to empower non-psychiatrist doctors and paramedics to diagnose psychiatric disorders accurately and reliably in remote sites,” researchers have said in a study published in the Indian Journal of Medical Research (IJMR).
Disorders covered
A total of 18 common mental disorders are covered in the tool: delirium, dementia, mania, depression, dysthymia, psychosis, obsessive-compulsive disorder, generalised anxiety disorder, panic disorder, phobias, reaction to severe stress and adjustment disorder, somatoform disorder, dissociative disorder, neurasthenia, sexual dysfunctions, alcohol dependence, substance dependence and mental retardation.
“Mental health care is mostly unavailable or inaccessible in most parts of the country. About 90% of patients in need of psychiatric treatment do not get it due to a lack of psychiatrists. Our system fills that gap by creating a virtual psychiatrist,” says Dr. Savita Malhotra, who led the research team.
The expert system can assist a non-medical person in interviewing a patient with mental disorders, leading to an automated diagnosis, she says. It can also assist a general physician in treating mental disorders in remote areas where there is no mental health care. The ICT technology used is very simple — a computer, broadband Internet, Skype and a telephone line. The application software is online and can be accessed by authorised users using a password.
Spread the word
The researchers hope to disseminate the tool in the country. “We have written to the Central government and State governments to adopt the system. It can be deployed at multiple sites or centres at once and has the potential to quickly solve the problem of deficient mental health care in the country,” says Dr. Malhotra. There are also plans to upscale the system and create mobile platforms so that patients can access services from their homes.
“Telepsychiatry holds the potential to solve the massive and intertwined problems of underdiagnosing and undertreating persons with mental illness and the lack of trained workforce at the grass-root level. In addition, initiatives must be taken to set up procedural guidelines and recommendations as the field advances,” psychiatry experts have said in a commentary published in the same issue of IJMR. — India Science Wire