Tele-psychiatry service has reduced inhibition and ensured people seek treatment

Inside the telemedicine room at the Schizophrenia Research Foundation (SCARF) in Anna Nagar, psychiatrists take turns to talk to patients in the villages of Pudukottai, about 375 km from Chennai.

Vikram Arunachalam talks to a senior citizen and resident of coastal Avudaiyarkoil, which is 65 km from Pudukottai town. Though the town has a government-run district headquarters hospital with a psychiatrist, the woman is comfortable coming to the SCARF-run centre. Dr. Arunachalam is satisfied that the woman has answered his questions. He advises trained paramedical personnel to dispense medicines for a fortnight. But, the woman has a request: “It is difficult to make the trip every 15 days. Please give me a month-long supply.” Doctors in Chennai confer and then agree to give her a month's dosage.

SCARF launched counselling service for tsunami-affected people of Nagapattinam and Cuddalore in 2005. “The funding for the programme came from Oxfam and Deutsche Bank. When we finished there, we were left with around 300 patients with mental illness,” recalled its director R. Thara.

The success of telemedicine service by Sankara Nethralaya and Dr. Mohan Diabetes Specialities Centre were the inspiration for her venture. Adding to this was SCARF's survey, which found that at least 40 per cent of patients with mental illness in towns and villages never sought treatment. “We wanted to bridge the gap. We chose Pudukottai because it is the most backward district in terms of mental health programme,” she said.

In an effort to reach less-accessible villages, the mobile tele-psychiatry service was launched a year ago. It caters for four taluks of Gandarvakottai, Avadyarkoil, Thirumayam and Alangudi. Today, over 600 patients in the area are registered with SCARF.

Not being face-to-face with the doctor is no impediment. A shopkeeper in Avudayarkoil, a beneficiary of the free service, said: “I don't find it a problem talking to the doctor this way.”

He is happy that the doctor enquires about his health, checks his vital parameters and dispenses drugs free of cost.

Another patient who has taken up a job under the National Rural Employment Guarantee Scheme said, “My wife and children are working and now that my health has improved, I can come by myself for review and collect medicines.” As the work is less demanding and does not require skills, patients get employment and are not a burden on the family.

Sometimes, a psychiatrist's kind words are enough to tide over depression. A patient who came for review to the mobile telemedicine centre from Kallikottai village in Gandarvakottai taluk on Monday was upset about problems in his family. He told Shantha Kamath that he worked twice a week and went to Pattukottai for masonry work as he could not take up NREGS work.

“Every time I work in the farm, I get palpitations, so I look for construction work,” he told her. Dr. Kamath altered his medications and urged him to work at least three times a week. She also told the assistant at the telemedicine centre to counsel him and his family.

Despite the fluctuations in Anna Nagar and erratic power supply in villages, SCARF is able to send home a handful of patients with hope of a better tomorrow every day. SCARF is looking to expand its services to more villages. “We have been corresponding with Indian Space Research Organisation to provide us connectivity. It would help us reach remoter villages,” Dr. Thara said.

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R. SujathaJune 28, 2012

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