Focus on mental health as well, say psychiatrists

Doctors said most of the patients surveyed had depression, anxiety and adjustment disorders with other major psychiatric illnesses. Representation pic

In a study at SevenHills Hospital (SHH), one of the largest Covid-19 facilities in Mumbai, doctors have found 7 per cent of the total admitted patients were suffering from psychiatric illness. The recent study involved 17,676 patients who were admitted from January 1, 2021 to July 31, 2021. Doctors have warned that Covid-19 is taking a toll among both patients and non-patients, and urge the government to facilitate screening of people for emotional wellbeing. "The virus has made a psychological impact on both affected and non-infected people," said Dr Rashmi Joshi, psychiatrist, SHH Covid facility. She said quarantine and isolation for a long period of time has made healing difficult for the patients.

As per the study, out of 17,676, at least 1,233 (almost 7 per cent) patients had newly diagnosed psychiatric illnesses along with Covid. Doctors said most of these patients had depression, anxiety and adjustment disorders along with other major psychiatric illnesses - including psychosis, insomnia (sleep related disorders are considered psychiatric illnesses), panic attacks, etc. While 23.8 per cent of them had depression, 20.1 per cent had anxiety disorder, 16.1 per cent had adjustment disorder and 14 per cent had delirium.

Isolation is tough

"In hospitalisation for diseases like typhoid, malaria, dengue, there is no quarantine or isolation. Not even tuberculosis treatment has ever created the kind of catastrophic images that Covid-19 has done for the past one and half years. We are social animals. Staying away from family for a long duration and surrounded with uncertainty about the disease have made it difficult for patients," said Dr Joshi.

"We found patients feeling sadness, lack of interest in routine activities, getting worried, etc. There are many who have the guilt about passing the illness to family members," said Dr Joshi. She said self-prognosis and prognosis of members of family also led to depression and anxiety issues. "Grief-related reactions were also found as many didn't get a proper closure as their loved ones succumbed to the illness. They were not able to perform last rites or rituals. There were many who suffered financial crises because of business or job loss and that triggered mental illness," said Dr Joshi.

The SHH has been keeping in touch with the discharged patients, currently there are 200 of them. "Teleconsultation techniques (video calling through BMC provided tabs) used for the patients to make contact with their relatives have helped significantly to relieve anxiety and depression," she added. Dr Joshi added that prevalence of suicide will increase if timely interventions are not done right now.

Tip of the iceberg

Other psychiatrists said the second wave has multiplied the number of mental health cases that were seen in the first wave, especially of anxiety and depression that need the government's urgent intervention. "We urgently need a ‘Mental Health Task Force' to facilitate screening of people for emotional wellbeing. Surveys in the pandemic all over the world reveal an increased prevalence of emotional disturbances and mental disorders. The mental health disaster across the earth will lead to disturbed family relationships, a rise in mental illnesses, economic distress, loss of man-days at work, violence, and suicide," said Dr Harish Shetty, psychiatrist at Dr LH Hiranandani Hospital.

Dr Avinash De Sousa, president of Bombay Psychiatry Society said post recovery, if a Covid-19 patient feels low, has attention and focus issues, crying spells, he should immediately get evaluated psychologically. "We generally put such patients on month-long antidepressants and they are doing good. One should not overlook these symptoms," he said.

17,676
No. of patients surveyed at SevenHills Hospital