The restrictions due to COVID-19 lockdown have taken a toll on the mental health of many people and those with pre-existing mental illnesses are finding it even tougher owing to the lack of access to counseling and psychosocial rehabilitation.
In an interview with Indianexpress.com, Dr. R Padamavathi, director of Schizophrenia Research Foundation (SCARF India), talks about how people with mental Illness are coping up with stay-home order and what are the measures SCARF is taking to keep the patients in the best spirit.
How hard it is for people with mental health issues to deal with stay-home order and social distancing?
We have received a lot more crisis calls from family members because they are not used to maintaining their wards at home all the time. People who used to commute to the mental health centre are now restricted to stay inside their homes. The caretakers say they are not able to check the person’s restlessness. People who used to visit the daycare ‘ centre (where they have a lot of activities to improve their language comprehension, communication skills, social skills, etc) are finding even more difficult. It is just like how people are stressed about staying at home without having to go to work. But despite the lockdown, our organisation is doing everything they can to keep the patients in the right frame of mind.
We have a programme at SCARF where every patient is assigned a case manager and a consultant psychiatrist. The doctor takes care of the medical interventions and the case manager will look up into rehabilitation. In this lockdown period, all the case managers have been following up with their patients. They have been calling them up regularly and are available anytime for any counseling. One of the mothers called us and said she is not able to manage her son. Sometimes the patients get very desperate, they will be having anxiety issues, etc. Our case manager was on a call with the patient and helped him regain composure.
Unavailability of medication is a serious problem in this period. What kind of steps SCARF is undertaking to overcome it?
Some of the patients are quite severely disabled. Vulnerability is in several contexts. They do need their medication, they do need personal space and that may be a problem during the lockdown. But the most important thing is the medication. Many times, they are not able to get medicines from the local pharmacy and the situation is not allowing them to travel anywhere to buy the required dosage immediately. Many patients have other problems like diabetes, cardiac ailments and other chronic diseases. These diseases cause more trouble for persons with mental illnesses. They are more vulnerable to develop Covid-19 infection. So it’s not just about taking care of the psychiatric problems but also about any kind of physical chronic diseases that the person might have.
We are making sure we are available for our patients. We are running our OPD on alternative days. We do supply free medication to people who are below poverty line. Our doctors and pharmacy staff are present in our centre to assist the people. We are doing this with all precautionary measures in place. We are also teaching our patients how to wash hands, how to wear a mask and so on. We are asking our patients all the screened questions of COVID_19, if we suspect any of our patients are having a symptom of the virus, we assist them for testing in a government hospital or private labs.
How many people visit SCARF on a day-to-day basis?
On an average, 80 people used to visit our center every day. Due to the lockdown, we have closed the centre as it is a crowded place and it will not be possible to maintain social distancing. Close to 40 people stay in our residential centers, even they don’t go to the rehab facility now, they stay in their place.
What are the measures to follow at home to calm down a patient who gets very aggressive in the current situation?
Not all patients are aggressive, most of them understand the situation and we are constantly briefing them why they are told to stay at home. Both the patients and their caretakers are very co-operative with us, thanks to the awareness by the Tamil Nadu government. But in case, if we are not able to calm down the patient, we review the patient’s prescription and probably change the medication that will be more effective for the person, which is step one and that is very critical. We tell the parents and the caretakers not to panic about the situation, and how they could modify their own reactions to the situation. Like avoiding unnecessary arguments that will further agitate the patient. And, most importantly, reassuring them that we are here to help anytime. This has helped them to overcome the tension.
What kind of solutions SCARF offers for people with mental illness?
Disabilities caused by chronic mental illness can be varied. It can range from mild to severe. SCARF provides solutions to people in different areas of disabilities. Largely, personal disability, social disability, and disability related to work. Some of them can even be placed in a job in this competitive world but the ratio is very low. Some of them won’t be having the skillsets to get a job. So they come to the rehab facility to get some inputs to improve themselves. We assess their disability and provide a solution accordingly. The deficit could be even in the domain of personal functioning like taking care of their own personal belongings or it could be even in the area of social functioning. If we take the conversation as an example, these people won’t be known to initiate a conversation or they won’t be having the patience to listen to others. They won’t be knowing when to stop a conversation, etc. We help them overcome these difficulties.
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