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1.
Curr Opin Psychiatry ; 34(3): 277-286, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1599453

ABSTRACT

PURPOSE OF REVIEW: Direct face-to-face interview between a psychiatrist and a patient is crucial in psychiatric evaluation, however, such traditional interviews are becoming difficult to conduct because of the infection risk in the COVID-19 era. As telepsychiatry, video interviews using internet are suggested to be useful to evaluate and assist individuals with mental disorders. However, some patients especially with social phobia, depression, and autism spectrum disorder (ASD) hesitate to use even such face-to-face-like tools. Communication robots have been proposed as future assistant tools for such patients. Herein, we summarize recent advancements in robot psychiatry, and propose the benefits of communication robots in psychiatric evaluation. RECENT FINDINGS: Recent studies have suggested that communication robots are effective in assisting people with ASD. As a pilot trial, we herein conducted semi-structured interviews to evaluate depression and hikikomori, a form of pathological social withdrawal, using a communication robot and a psychiatrist, respectively. There was almost identical evaluation between the two. Interestingly, a person with hikikomori answered that the robot was easier to disclose. SUMMARY: Robots can reduce the burden of human resources and the infection risk in the COVID-19 era. Robot interview is expected to be implemented for future evaluation system in psychiatry.


Subject(s)
COVID-19 , Communication , Mental Disorders/diagnosis , Psychiatry , Robotics , Humans , Psychiatry/trends , Robotics/trends
2.
Lancet Psychiatry ; 9(1): 8-9, 2022 01.
Article in English | MEDLINE | ID: covidwho-1569159
4.
Psychol Med ; 51(13): 2145-2147, 2021 10.
Article in English | MEDLINE | ID: covidwho-1442671
6.
Int J Environ Res Public Health ; 18(16)2021 08 05.
Article in English | MEDLINE | ID: covidwho-1354951

ABSTRACT

Social distancing and the shortage of healthcare professionals during the COVID-19 pandemic, the impact of population aging on the healthcare system, as well as the rapid pace of digital innovation are catalyzing the development and implementation of new technologies and digital services in psychiatry. Is this transformation a blessing or a curse for psychiatry? To answer this question, we conducted a literature review covering a broad range of new technologies and eHealth services, including telepsychiatry; computer-, internet-, and app-based cognitive behavioral therapy; virtual reality; digital applied games; a digital medicine system; omics; neuroimaging; machine learning; precision psychiatry; clinical decision support; electronic health records; physician charting; digital language translators; and online mental health resources for patients. We found that eHealth services provide effective, scalable, and cost-efficient options for the treatment of people with limited or no access to mental health care. This review highlights innovative technologies spearheading the way to more effective and safer treatments. We identified artificially intelligent tools that relieve physicians from routine tasks, allowing them to focus on collaborative doctor-patient relationships. The transformation of traditional clinics into digital ones is outlined, and the challenges associated with the successful deployment of digitalization in psychiatry are highlighted.


Subject(s)
Psychiatry , Telemedicine , COVID-19 , Humans , Pandemics , Psychiatry/trends , Telemedicine/trends
7.
J Psychiatr Pract ; 27(4): 245-253, 2021 07 28.
Article in English | MEDLINE | ID: covidwho-1348094

ABSTRACT

Telehealth has been rapidly deployed in the environment of the Coronavirus 2019 (COVID-19) pandemic to help meet critical mental health needs. As systems of care use telehealth during the pandemic and evaluate the future of telehealth services beyond the crisis, a quality and safety framework may be useful in weighing important considerations for using telehealth to provide psychiatric and behavioral health services within special populations. Examining access to care, privacy, diversity, inclusivity, and sustainability of telehealth to meet behavioral and psychiatric care needs in geriatric and disadvantaged youth populations can help highlight key considerations for health care organizations in an increasingly electronic health care landscape.


Subject(s)
COVID-19 , Mental Health Services , Patient Safety , Psychiatry , Quality Improvement , Telemedicine , Adolescent , Aged , COVID-19/epidemiology , Humans , Mental Health Services/standards , Mental Health Services/trends , Psychiatry/standards , Psychiatry/trends , SARS-CoV-2 , Telemedicine/standards , Telemedicine/trends
9.
Australas Psychiatry ; 29(4): 423-429, 2021 08.
Article in English | MEDLINE | ID: covidwho-1181060

ABSTRACT

OBJECTIVE: The Australian Federal government introduced new COVID-19-Psychiatrist-Medicare-Benefits-Schedule (MBS) telehealth-items to assist with providing private specialist care. We investigate private psychiatrists' uptake of telehealth, and face-to-face consultations for April-September 2020 for the state of Victoria, which experienced two consecutive waves of COVID-19. We compare these to the same 6 months in 2019. METHOD: MBS-item-consultation data were extracted for video, telephone and face-to-face consultations with a psychiatrist for April-September 2020 and compared to face-to-face consultations in the same period of 2019 Victoria-wide, and for all of Australia. RESULTS: Total Victorian psychiatry consultations (telehealth and face-to-face) rose by 19% in April-September 2020 compared to 2019, with telehealth comprising 73% of this total. Victoria's increase in total psychiatry consultations was 5% higher than the all-Australian increase. Face-to-face consultations in April-September 2020 were only 46% of the comparative 2019 consultations. Consultations of less than 15 min duration (87% telephone and 13% video) tripled in April-September 2020, compared to the same period last year. Video consultations comprised 41% of total telehealth provision: these were used mainly for new patient assessments and longer consultations. CONCLUSIONS: During the pandemic, Victorian private psychiatrists used COVID-19-MBS-telehealth-items to substantially increase the number of total patient care consultations for 2020 compared to 2019.


Subject(s)
COVID-19 , Outpatients , Psychiatry , Referral and Consultation/statistics & numerical data , Telemedicine , Aged , Australia , Humans , Pandemics , Private Practice , Psychiatry/trends , SARS-CoV-2 , Victoria
10.
BMJ Open ; 11(3): e046365, 2021 03 30.
Article in English | MEDLINE | ID: covidwho-1160430

ABSTRACT

OBJECTIVES: The recent COVID-19 pandemic has disrupted mental healthcare delivery, with many services shifting from in-person to remote patient contact. We investigated the impact of the pandemic on the use of remote consultation and on the prescribing of psychiatric medications. DESIGN AND SETTING: The Clinical Record Interactive Search tool was used to examine deidentified electronic health records of people receiving mental healthcare from the South London and Maudsley (SLaM) NHS Foundation Trust. Data from the period before and after the onset of the pandemic were analysed using linear regression, and visualised using locally estimated scatterplot smoothing. PARTICIPANTS: All patients receiving care from SLaM between 7 January 2019 and 20 September 2020 (around 37 500 patients per week). OUTCOME MEASURES: (i) The number of clinical contacts (in-person, remote or non-attended) with mental healthcare professionals per week.(ii) Prescribing of antipsychotic and mood stabiliser medications per week. RESULTS: Following the onset of the pandemic, the frequency of in-person contacts was significantly reduced compared with that in the previous year (ß coefficient: -5829.6 contacts, 95% CI -6919.5 to -4739.6, p<0.001), while the frequency of remote contacts significantly increased (ß coefficient: 3338.5 contacts, 95% CI 3074.4 to 3602.7, p<0.001). Rates of remote consultation were lower in older adults than in working age adults, children and adolescents. Despite this change in the type of patient contact, antipsychotic and mood stabiliser prescribing remained at similar levels. CONCLUSIONS: The COVID-19 pandemic has been associated with a marked increase in remote consultation, particularly among younger patients. However, there was no evidence that this has led to changes in psychiatric prescribing. Nevertheless, further work is needed to ensure that older patients are able to access mental healthcare remotely.


Subject(s)
COVID-19/psychology , Drug Prescriptions , Mental Health Services/statistics & numerical data , Practice Patterns, Physicians' , Telemedicine , Adolescent , Aged , COVID-19/epidemiology , Child , Delivery of Health Care , Electronic Health Records , Humans , London , Pandemics , Psychiatry/trends , SARS-CoV-2
12.
Australas Psychiatry ; 29(2): 194-199, 2021 04.
Article in English | MEDLINE | ID: covidwho-1099852

ABSTRACT

OBJECTIVE: The Australian federal government introduced new COVID-19 psychiatrist Medicare Benefits Schedule (MBS) telehealth items to assist with providing private specialist care. We investigate private psychiatrists' uptake of video and telephone telehealth, as well as total (telehealth and face-to-face) consultations for Quarter 3 (July-September), 2020. We compare these to the same quarter in 2019. METHOD: MBS-item service data were extracted for COVID-19-psychiatrist video and telephone telehealth item numbers and compared with Quarter 3 (July-September), 2019, of face-to-face consultations for the whole of Australia. RESULTS: The number of psychiatry consultations (telehealth and face-to-face) rose during the first wave of the pandemic in Quarter 3, 2020, by 14% compared to Quarter 3, 2019, with telehealth 43% of this total. Face-to-face consultations in Quarter 3, 2020 were only 64% of the comparative number of Quarter 3, 2019 consultations. Most telehealth involved short telephone consultations of ⩽15-30 min. Video consultations comprised 42% of total telehealth provision: these were for new patient assessments and longer consultations. These figures represent increased face-to-face consultation compared to Quarter 2, 2020, with substantial maintenance of telehealth consultations. CONCLUSIONS: Private psychiatrists continued using the new COVID-19 MBS telehealth items for Quarter 3, 2020 to increase the number of patient care contacts in the context of decreased face-to-face consultations compared to 2019, but increased face-to-face consultations compared to Quarter 2, 2020.


Subject(s)
COVID-19/prevention & control , Mental Disorders/therapy , Mental Health Services/trends , Practice Patterns, Physicians'/trends , Private Practice/trends , Psychiatry/trends , Telemedicine/trends , Ambulatory Care/methods , Ambulatory Care/organization & administration , Ambulatory Care/trends , Australia , COVID-19/epidemiology , Facilities and Services Utilization/trends , Health Services Accessibility/organization & administration , Health Services Accessibility/trends , Humans , Mental Health Services/organization & administration , National Health Programs , Pandemics , Practice Patterns, Physicians'/organization & administration , Private Practice/organization & administration , Psychiatry/organization & administration , Telemedicine/methods , Telemedicine/organization & administration , Telephone/trends , Videoconferencing/trends
13.
Curr Opin Psychiatry ; 34(3): 277-286, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1072496

ABSTRACT

PURPOSE OF REVIEW: Direct face-to-face interview between a psychiatrist and a patient is crucial in psychiatric evaluation, however, such traditional interviews are becoming difficult to conduct because of the infection risk in the COVID-19 era. As telepsychiatry, video interviews using internet are suggested to be useful to evaluate and assist individuals with mental disorders. However, some patients especially with social phobia, depression, and autism spectrum disorder (ASD) hesitate to use even such face-to-face-like tools. Communication robots have been proposed as future assistant tools for such patients. Herein, we summarize recent advancements in robot psychiatry, and propose the benefits of communication robots in psychiatric evaluation. RECENT FINDINGS: Recent studies have suggested that communication robots are effective in assisting people with ASD. As a pilot trial, we herein conducted semi-structured interviews to evaluate depression and hikikomori, a form of pathological social withdrawal, using a communication robot and a psychiatrist, respectively. There was almost identical evaluation between the two. Interestingly, a person with hikikomori answered that the robot was easier to disclose. SUMMARY: Robots can reduce the burden of human resources and the infection risk in the COVID-19 era. Robot interview is expected to be implemented for future evaluation system in psychiatry.


Subject(s)
COVID-19 , Communication , Mental Disorders/diagnosis , Psychiatry , Robotics , Humans , Psychiatry/trends , Robotics/trends
14.
J Nerv Ment Dis ; 209(1): 85-87, 2021 01.
Article in English | MEDLINE | ID: covidwho-1066474

ABSTRACT

In the last half of the 20th century, psychiatry lost many of the conditions needed for unhindered practice. I compiled from searches of the literature the 20th century changes in the arenas of psychiatric practice and the sources of these changes. I determined how these changes are shaping 21st century health and well-being. The neglect of the severely mentally ill, first in Bedlams and now on Boulevards, reflects a wide loss of resources. Psychiatry's patients have lost a past of community-based mental health services, interdisciplinary care teams, preventive consultation with social agencies, and, with reimbursements targeted for 15-minute visits, time adequate with the physician to individualize diagnosis and treatment. With the Covid-19 and other epidemics, economic inequalities, an economic crisis, unrest over police violence, and racism, psychiatry can find in its past the resources to engage 21st century psychiatric and other problems.


Subject(s)
Mental Disorders/therapy , Mental Health Services/history , Psychiatry/history , COVID-19/history , COVID-19/therapy , History, 20th Century , History, 21st Century , Humans , Mental Disorders/economics , Mental Health Services/economics , Mental Health Services/trends , Psychiatry/economics , Psychiatry/trends
17.
Australas Psychiatry ; 29(2): 183-188, 2021 04.
Article in English | MEDLINE | ID: covidwho-962349

ABSTRACT

OBJECTIVE: The Australian Commonwealth Government introduced new psychiatrist Medicare-Benefits-Schedule (MBS)-telehealth items in the first wave of the COVID-19 pandemic to assist with previously office-based psychiatric practice. We investigate private psychiatrists' uptake of (1) video- and telephone-telehealth consultations for Quarter-2 (April-June) of 2020 and (2) total telehealth and face-to-face consultations in Quarter-2, 2020 in comparison to Quarter-2, 2019 for Australia. METHODS: MBS item service data were extracted for COVID-19-psychiatrist-video- and telephone-telehealth item numbers and compared with a baseline of the Quarter-2, 2019 (April-June 2019) of face-to-face consultations for the whole of Australia. RESULTS: Combined telehealth and face-to-face psychiatry consultations rose during the first wave of the pandemic in Quarter-2, 2020 by 14% compared to Quarter-2, 2019 and telehealth was approximately half of this total. Face-to-face consultations in 2020 comprised only 56% of the comparative Quarter-2, 2019 consultations. Most telehealth provision was by telephone for short consultations of ⩽15-30 min. Video consultations comprised 38% of the total telehealth provision (for new patient assessments and longer consultations). CONCLUSIONS: There has been a flexible, rapid response to patient demand by private psychiatrists using the new COVID-19-MBS-telehealth items for Quarter-2, 2020, and in the context of decreased face-to-face consultations, ongoing telehealth is essential.


Subject(s)
COVID-19/prevention & control , Facilities and Services Utilization/trends , Mental Health Services/trends , Practice Patterns, Physicians'/trends , Private Practice/trends , Psychiatry/trends , Telemedicine/trends , Australia/epidemiology , COVID-19/epidemiology , Facilities and Services Utilization/organization & administration , Health Services Accessibility/organization & administration , Humans , Mental Health Services/organization & administration , National Health Programs , Pandemics , Practice Patterns, Physicians'/organization & administration , Private Practice/organization & administration , Psychiatry/methods , Psychiatry/organization & administration , Telemedicine/methods , Telemedicine/organization & administration , Telephone , Videoconferencing
19.
Psychiatry Res ; 293: 113429, 2020 11.
Article in English | MEDLINE | ID: covidwho-726822

ABSTRACT

BACKGROUND: COVID-19 pandemic and lockdown has brought about a sense of fear and anxiety around the globe. This phenomenon has led to short term as well as long term psychosocial and mental health implications for children and adolescents. The quality and magnitude of impact on minors is determined by many vulnerability factors like developmental age, educational status, pre-existing mental health condition, being economically underprivileged or being quarantined due to infection or fear of infection. AIMS: This paper is aimed at narratively reviewing various articles related to mental-health aspects of children and adolescents impacted by COVID-19 pandemic and enforcement of nationwide or regional lockdowns to prevent further spread of infection. METHODOLOGY: We conducted a review and collected articles and advisories on mental health aspects of children and adolescents during the COVID-19 pandemic. We selected articles and thematically organized them. We put up their major findings under the thematic areas of impact on young children, school and college going students, children and adolescents with mental health challenges, economically underprivileged children, impact due to quarantine and separation from parents and the advisories of international organizations. We have also provided recommendations to the above. CONCLUSION: There is a pressing need for planning longitudinal and developmental studies, and implementing evidence based elaborative plan of action to cater to the psycho social and mental health needs of the vulnerable children and adolescents during pandemic as well as post pandemic. There is a need to ameliorate children and adolescents' access to mental health support services geared towards providing measures for developing healthy coping mechanisms during the current crisis. For this innovative child and adolescent mental health policies policies with direct and digital collaborative networks of psychiatrists, psychologists, paediatricians, and community volunteers are deemed necessary.


Subject(s)
Adaptation, Psychological , Betacoronavirus , Coronavirus Infections/psychology , Mental Health , Pneumonia, Viral/psychology , Quarantine/psychology , Adolescent , Adolescent Behavior/psychology , COVID-19 , Child , Child Behavior/psychology , Child, Preschool , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Humans , Male , Mental Disorders/epidemiology , Mental Disorders/prevention & control , Mental Disorders/psychology , Mental Health/trends , Mental Health Services/trends , Pandemics/prevention & control , Parents/psychology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Psychiatry/methods , Psychiatry/trends , Risk Factors , SARS-CoV-2
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