Designing and implementing an innovative digitally driven primary care psychiatry program in India

Abstract

Background:Primary Care Doctors (PCDs) are the first contact for majority of patients with psychiatric disorders across the world including India. They often provide symptomatic treatment which is naturally inadequate. Absence or inadequate exposure to psychiatric training during undergraduate medical education is one of the prime reasons. Classroom training (CRT), a standard practice to train PCDs is driven by specialist based psychiatric curriculum and inherently lacks clinical translational value.Aim and Context:The ‘Department of Psychiatry’ of ‘National Institute of Mental Health and Neurosciences’, Bengaluru, India has recently come up with an innovative digitally driven modules of ‘Primary Care Psychiatry Program’ (PCPP) for practicing PCDs. Goal of this paper is to provide an overview of all these (five) modules with its various stages of implementation.Methods:Authors briefly discuss the current status of primary care psychiatry in India and also narrate the newly designed five modules of PCPP in this paper.Results and Discussion:An adopted psychiatric curriculum is designed in ‘Clinical Schedules for Primary Care Psychiatry’ (CSP) which is an integral part of PCPP. This is brief clinical schedules contains culturally appropriate screening questionnaire, transdiagnostic classification of 8 core psychiatric disorders, diagnostic, referral and management guidelines. PCPP contains 5 modules named as orientation module, basic module, advanced module [Tele-psychiatric ‘On-Consultation Training’ (Tele-OCT)], videoconference based continuing skill development module, and collaborative video consultation modules which covers all essential areas of primary care psychiatry for practicing PCDs. Last three modules are fully designed digital modules in hub and spoke model of Tele Medicine. In this designed program, the CSP and Tele-OCT are two path braking innovations having inbuilt higher clinical translation value. The challenges and opportunities that could be faced during its implementation across India are also discussed.Conclusion and Future Directions:Innovative PCPP is pragmatic in nature and has potential for higher clinical translational value. Once validated thoroughly, PCPP has potential for pan-India expansion. There is a need for artificial intelligence-based modules for next phase of PCPP in India considering her population and lesser number of available psychiatrists.

Telepsychiatry: The Tool to Revive National Mental Health Program of India?

“…Using telepsychiatry as a mode of training has also been shown to be successful and operationally viable. 10 Telepsychiatric modes of consultation have also been shown to be economically feasible and cost-effective. 11 A major concern about telepsychiatry has been the lack of guidelines regarding its legal aspects and scope of applicability.…”

Collaborative Video Consultations from Tertiary Care Based Telepsychiatrist to a Remote Primary Care Doctor to Manage Opioid Substitution Therapy Clinic

“…Tele Medicine Centre, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, designed the primary care psychiatry program (PCPP) which is a one-year, part-time, modular-based, digitally driven, distance education-based clinical course called "Diploma in Primary Care Psychiatry" (DPCP) for in-service PCDs, especially from resource-poor states of India 3 Along with mandatory modules in DPCP, there is provision of optional module, as per need of PCDs. The aim of PCPP is to integrate basic psychiatric care into primary care by mentoring PCDs at their workplace from an academic hospital.…”

Telemedicine-Based Tobacco Treatment Model in Primary Care from a Low-Resource Setting

“…6 One recent effort by the National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India toward integrating mental health care into general health care is an innovative digital driven four module based primary care psychiatry programs (PCPPs). 7 This involves mentoring the primary care doctors (PCDs) at their working clinic from an academic hospital using digital technology. 7 An primary care adopted all-in-one training tool, namely "clinical schedules for primary care psychiatry" (CSP) is designed for this 1 year PCPP meant only for practicing PCDs.…”

“…7 This involves mentoring the primary care doctors (PCDs) at their working clinic from an academic hospital using digital technology. 7 An primary care adopted all-in-one training tool, namely "clinical schedules for primary care psychiatry" (CSP) is designed for this 1 year PCPP meant only for practicing PCDs. This CSP contains screener, primary care adopted taxonomy, diagnosis, treatment (with brief counseling), as well as follow-up guidelines for highly prevalent six psychiatric disorders at primary care one of which is tobacco addiction.…”