Impact of COVID-19 Pandemic on Availability and Utilization Of Mental Health Services: Findings of a Multi-Centric Study

ABSTRACT

Aims: To explore the availability, access and utilization of mental health services during COVID-19 pandemic restrictions (1st wave) in patients registered at psychiatry facilities across India and to assess difficulties faced by caregivers of these patients. Methodology: It was a multi-centric study carried at 4 centres across India, providing mental health services. It used convenience sampling method, wherein we recruited a total of 500 subjects from all centres over a period of 6 months using predefined inclusion and exclusion criteria. A semi structured performa to explore the availability, access and utilization of mental health services and difficulties faced by caregivers during COVID-19 pandemic. Results: Of the 500 subjects recruited, 54.6 % were males, 80.4% were Hindus and 56% were from rural areas. The subjects reported that 75.3% had problems accessing the mental health services, owing to closure of OPD services (83.2%), non-availability of doctors (63.5%), poor availability of transport (61.9%). It was reported that 16.3% changed their psychiatrist and had to contact GPs (16.5%), their illness worsened in 66.1% of the cases, 68.8% faced difficulties in availing psychotropic medications. The caregivers of these subjects reported that 80.3% of them faced difficulties during lockdown which was attributed to non-availability of doctors (67.5%) and medication (33.6%). Discussion: This sub-sample of registered OPD patients at 4 treatment facilities across India, showed that three fourth of subjects had problems accessing OPD, which was largely due to closure of routine OPDs and non-availability of doctors as well as transport facilities due to pan India lockdown. One sixth of patients had to change their psychiatrist and resort to GPs for consultation. In two third of cases the symptoms worsened and around same numbers did not get psychotropic medications during lockdown. Three fourth of caregivers of patients reported difficulties due to non-availability of doctors and medications. Conclusions: COVID-19 pandemic related restrictions affected the availability, access and utilisation of mental health services negatively and lot of difficulties were also faced by caregivers of these patients.