Data collated by the state health department shows that 1,442 healthcare workers have, so far, undergone counselling and stress management training to deal with the Covid-19 pandemic in rural and tribal districts of Maharashtra, with most worried over contracting the infection and taking it home to families.
The state is edging close to 17.23 lakh Covid-19 positive cases. This has required the massive support of health workers, some of whom are also working overtime in rural areas. The highly transmissible nature of the novel coronavirus has made health workers prone to stress, anxiety and depression in the last few months.
Dr Praveen Navkhare, attached with a mental health cell in Nagpur, sees four to five health workers a week presenting with stress, depression and anxiety. “The anxiety was high in the May-June period when cases were at a peak. But now health staff are more anxious because they have reached a point of burnout,” Dr Navkhare said. Several health workers have complained of working without breaks, inability to observe quarantine, and fear of infection and re-infection. Many others say they are under pressure from family to quit the service. “It is important to give health workers a non-Covid duty after Covid duty to give them a break from isolation wards,” Dr Navkhare said.
More psychiatrists needed
There are 44 psychiatrists under the district mental health programme providing counselling services to ASHA workers, auxiliary nurse midwifery, doctors, nurses and ward boys working at Covid hospitals and quarantine centers. The state, however, requires more psychiatrists, specialised in childcare and geriatrics, to deal with different issues related to mental health problems that are cropping up now.
The high load of patients and health workers seeking psychiatric care has also put a burden on existing resources. There is a need to appoint more psychiatrists. In the Pune mental hospital, for instance, out of 13 Class I posts, only two for psychiatrists are filled. At the Thane mental hospital, all six Class I posts for psychiatrists are vacant. Medical officers are filling in for Class I specialisations.
Dr Sanjaykumar Kalkutgi, attached with the mental health programme in Ratnagiri, said, “Because cases are declining, this is like a welcome break for health workers and for us to relax. But if a second wave comes, stress levels in health workers will rise. We will have to ensure proper counselling to prevent that.”
A study by University of Oxford found that Covid-19 patients were more at risk of psychiatric diagnosis, mostly depression and anxiety, than other influenza like illness patients. Doctors in the state said even those looking after Covid-19 patients were prone to needing psychiatric support. Most health workers are prescribed a low dose of antidepressants.
On Tuesday, National Health Mission Director Dr N Ramaswamy directed all districts to hold regular out-patient departments for mental healthcare.
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