Telepsychiatry Services Research Articles

(203) Stakeholder Assessment for a Remote Perinatal Telepsychiatry Service

(203) Stakeholder Assessment for a Remote Perinatal Telepsychiatry Service

Travel Prevention Using Telepsychiatric Services: A Review

Background: Telepsychiatry is a type of mental health service delivery using information and communication technology for patients living far from psychiatrists It can reduce the number of travelers looking for mental health services. This study aimed to review articles that reported the percentage of prevented travels or referrals using telepsychiatry.Methods: The PubMed database was searched in September 2019 for this review study. Data were extracted from admitted studies based on a series of variables consisting of author, country, modality, referral setting, urgency, study design, sample size, and percentage of prevented travel. Descriptive statistics were used to analyze data.Results: Eight studies were included. Half of these studies were conducted in Australia. Real-time telepsychiatry modality was used in most of the studies (75%). The hospital was the most referral setting in the studies (62.5%). The type of telepsychiatry services delivered in 75% of the studies was elective. The study design of 62.5% of studies was prospective. The number of included participants in the studies ranged from 28 to 1943. The percentage of avoided travels ranged from 12 to 79.Conclusion: Successful telepsychiatry systems could prevent unnecessary referrals and travels. However, the effective use of telepsychiatry services depends on various factors, including the type and period of the disease, the therapist’s efficacy in terms of correct diagnosis and treatment, and patient cooperation.

Telemedicine, Telepsychiatry and COVID-19 Pandemic: Future Prospects for Global Health.

There is no denying that demand for telemedicine and telepsychiatry services has been on the rise, as the COVID-19 pandemic engulfed the world and upset the daily lives and certainties of us all. Such growth, however, calls for a comprehensive analysis and assessment of the strengths and weaknesses inherent in such innovative approaches, which are bound to change and evolve as the fourth industrial revolution unfolds before our eyes. The authors have set out to analyze the complexities and distinctive features of telemedicine and telepsychiatry by focusing on the strengths and weaknesses of such approaches and analyzing research findings, recommendations, and guidelines by scientific societies and institutions, for the ultimate purpose of striking a tenable balance between technological innovations and the ethics and moral imperative of guaranteeing equal access to care for everyone, irrespective of social and financial status. The European regulatory and legislative scenario has been briefly outlined, and the standards for the medicolegal sustainability of such practices have been explored. Ultimately, in order to improve accessibility without compromising the quality of care, new broadly shared ethical standards, best practices, and guidelines need to be prioritized. National legislative initiatives and the international sharing of information need to be encouraged, for the ultimate purpose of optimizing and harmonizing telemedicine-based care for the sake of all patients. As technology moves forward and evolves, so must the normative standards and guidelines on which professionals must be able to rely when delivering telemedicine-based care in an ethically and legally viable fashion. From that perspective, addressing the digital divide means enabling more people to receive care and should therefore be seen as part and parcel of the effort to uphold the universal human right to health.

The Acceptance of Digital Health: What about Telepsychology and Telepsychiatry?

Electronic health is a solution for many issues. This study aims to determine the acceptance level of telepsychology and telepsychiatry services their advantages and disadvantages. The researchers carried out a cross-sectional study. Results indicate that only 13.3% of respondents visited a psychiatrist or psychologist. The majority views telepsychiatry and psychological services as beneficial tools that enhance privacy. According to the survey, 223 respondents believe they have a psychological problem. The most common disorders are general anxiety, social anxiety, and depression. Most of their families accept mental health treatment, and four respondents lack access to electronic devices and the Internet. The security and privacy of patient's information should be investigated further in telepsychology and telepsychiatry. Our research may influence decision-makers to invest in this area for the benefit of society.

EFFECTIVENESS OF AN ONLINE COGNITIVE-BEHAVIORAL COACHING PROGRAM ON CAREGIVER STRAIN AND GOAL ATTAINMENT AMONG CHILDREN IN THE UNITED STATES

There is no easy way for parents to obtain evidence-based mental health care for their children; a primary barrier is the lack of trained pediatric mental health providers. Task shifting the delivery of evidence-based treatment to trained behavioral health coaches can reduce the care gap. This study evaluates the effectiveness, in the context of real-world telepsychiatry services, of an online cognitive behavioral coaching program on caregiver strain and goal attainment.

User Perception of Telephone-Based Telepsychiatry Consultation: A Cross-Sectional Survey.

Objective: To assess user perception regarding different aspects of the telepsychiatry process. Methods: This cross-sectional survey study was conducted between July and September 2020 with follow-up patients attending teleconsultation at a tertiary care center (N = 108). The online survey included questions about the user’s experience such as the appointment process and different aspects of teleconsultation, as well as perceived benefits, difficulties experienced, and suggestions for improvement. The sociodemographic and clinical data were retrieved from the electronic record. Results: The majority of patients expressed satisfaction with teleconsultation. The patients who were living far from the center (> 100 km) and those with psychotic illness favored telepsychiatry. Patients with nonpsychotic illnesses reported significantly less satisfaction with counseling in teleconsultation. Conclusions: The findings substantiate the acceptance of telepsychiatry services and emphasize the need for a tailor-made hybrid form of consultation as per the patient’s profile.

The quality of telepsychiatry in terms of accessibility, appropriateness, effectiveness, and safety among psychiatric patients in King Abdulaziz Medical City: An observational cross-sectional analytical study.

There has been an increasing demand for psychiatric care in recent decades, and “telepsychiatry” was developed to meet these demands. It is a type of telemedicine in which they provide many medical services virtually, such as therapy, counseling, and medication management. Telepsychiatry has numerous advantages, including lower costs, reduced stigma, and improved continuity of care. To the best of our knowledge, no previous studies in the western region of Saudi Arabia addressed patients satisfaction with telepsychiatry. This cross-sectional study aims to assess patient satisfaction in telepsychiatry in terms of accessibility and timeliness, appropriateness, effectiveness, and safety, and to see whether patient satisfaction affects their decision to use the service again in the future. A cross-sectional study was conducted using a prestructured survey on the basis of the Client Satisfaction Questionnaire-18, which is a validated questionnaire used to assess patients’ satisfaction with the services provided to them. From January 2021 to July 2021, all male and female psychiatric patients over the age of 18 years who had psychiatric virtual appointments were included in this study. This study included 182 patients, of whom 106 were female. Patients were generally satisfied with the telepsychiatry services; 56.6%, 81.9%, 86.8%, and 91.2% of the participants were satisfied with the access and timeliness, appropriateness, effectiveness, and safety, respectively, and a total of 58.3% either strongly agree or agree of the overall satisfaction level. Depression and anxiety disorders were the most common psychiatric diseases. The statistical analysis revealed no significant relationships between patients’ satisfaction and demographic characteristics. Telepsychiatry has been evaluated to meet the growing demand for psychiatric care; it also has significant advantages. Patients had an overall positive satisfaction level toward telepsychiatry service, and so the results of this study support the continuity of using telepsychiatry in the future. Further research area could include a comparison between patients’ and providers’ satisfaction levels with telepsychiatry.

A systematic review of the literature on telepsychiatry for bipolar disorder.

ObjectiveBipolar (BP) disorder is a highly morbid disorder that is often misdiagnosed or undiagnosed and affects a large number of adults and children. Due to the coronavirus disease 2019 public health emergency stay at home orders, most outpatient mental health care was provided via telepsychiatry, and the many benefits of virtual care ensure that this will continue as an ongoing practice. The main aim of this review was to investigate what is currently known about the use of telepsychiatry services in the diagnosis and treatment of BP disorder across the lifespan.MethodA systematic literature review assessing the use of telepsychiatry in BP disorder was conducted in PubMed, PsychINFO, and Medline.ResultsSix articles were included in the final review. All included articles assessed populations aged 17 years or older. The literature indicates that BP disorder was addressed in telepsychiatry services at a similar rate as in‐person services, reliable diagnoses can be made using remote interviews, satisfaction rates are comparable to in‐person services, telepsychiatry services are able to reach and impact patients with BP disorder, are sustainable, and patient outcomes can improve using a telepsychiatry intervention.ConclusionsGiven the morbidity of BP disorder, the research addressing the telepsychiatry diagnosis and treatment of BP disorder is sparse, with only emerging evidence of its reliability, effectiveness, and acceptance. There is no research assessing the safety and efficacy of telepsychiatry in pediatric populations with BP disorder. Given the morbidity associated with BP disorder at any age, further research is needed to determine how to safely and effectively incorporate telepsychiatry into clinical care for BP adult and pediatric patients.

Implementation of Pharmacist-led Telepsychiatry Services: Challenges and Opportunities in the Midst of COVID-19.

Over the last few decades, healthcare systems worldwide have seen many transformations, and one of the most significant transformations is the adoption of telemedicine. Its rapid and wide adoption has created an entirely different set of healthcare experiences. The healthcare field has vastly benefited from integrating technology and patient care. Johns Hopkins Aramco Healthcare (JHAH) has implemented several telehealth models as a response measure to overcome challenges in access to patient care due to the COVID-19 pandemic. This article describes the implementation of pharmacist-led telepsychiatry services utilized to provide several psychiatric services such as counseling patients, ensuring the appropriateness of medications prescribed, conducting therapeutic drug monitoring, and making clinical interventions to ensure a safe and effective therapy. By utilizing this newly integrated telepsychiatry model, pharmacists have continued to remain an integral part of improving patients’ health outcomes and overall patient experience for psychiatric patients.

Feasibility and acceptability of a novel telepsychiatry-delivered precision prescribing intervention for anxiety and depression

BackgroundMajor Depressive Disorder and Generalized Anxiety Disorder are pervasive and debilitating conditions, though treatment is often inaccessible and based on trial-and-error prescribing methods. The present observational study seeks to describe the use of a proprietary precision prescribing algorithm piloted during routine clinical practice as part of Brightside’s telepsychiatry services. The primary aim is to determine the feasibility and acceptability of implementing this intervention. Secondary aims include exploring remission and symptom improvement rates.MethodsParticipants were adult patients enrolled in Brightside who completed at least 12 weeks of treatment for depression and/or anxiety and received a prescription for at least one psychiatric medication. A prescription recommendation was made by Brightside’s algorithm at treatment onset and was utilized for clinical decision support. Participants received baseline screening surveys of the PHQ-9 and GAD-7, and at weeks 2,4,6,8,10 and 12. Intent-to-treat (ITT) sensitivity analyses were conducted. Feasibility of the implementation was measured by the platform’s ability to enroll and engage participants in timely psychiatric care, as well as offer high touch-point treatment options. Acceptability was measured by patient responses to a 5-star satisfaction rating.ResultsBrightside accessed and treated 6248 patients from October 2018 to April 2021, treating a majority of patients within 4-days of enrollment. The average plan cost was $115/month. 89% of participants utilized Brightside’s core medication plan at a cost of $95/month. 13.4% of patients in the study rated Brightside’s services as highly satisfactory, averaging a 4.6-star rating. Furthermore, 90% of 6248 patients experienced a MCID in PHQ-9 or GAD-7 score. Remission rates were 75% (final PHQ-9 or GAD-7 score < 10) for the study sample and 59% for the ITT sample. 69.3% of Brightside patients were treated with the medication initially prescribed at intake.ConclusionsResults suggest that the present intervention may be feasible and acceptable within the assessed population. Exploratory analyses suggest that Brightside’s course of treatment, guided by precision recommendations, improved patients’ symptoms of anxiety and depression.

Violence against women (VAW) in Bangladesh and its mental health repercussions

• 53 out of 64 districts of Bangladesh found that 4,622 women had been subjected to mental torture, 1,839 had been physically abused, and 203 had been sexually assaulted. • Adaptation of how services are given, such as the use or increase of remote services, telemedicine, outreach, and group interventions, must also be ensured. • Telepsychiatry's role has become even more critical during Bangladesh's COVID-19 crisis, as telepsychiatry services provide psychological support to victims of gender-based abuse.

Ongoing Disparities in Digital and In-Person Access to Child Psychiatric Services in the United States.

To estimate the number and geographic distribution of children and adolescents in the United States who reside in counties with neither child and adolescent psychiatrists nor sufficient Internet broadband to support telepsychiatry services. This analysis combined data from the Health Resources and Services Administration's Area Health Resource Files on child psychiatrist workforce with Federal Communications Commission information on broadband coverage to generate a composite of in-person and digital access to child psychiatric services throughout the United States. Using multivariable fixed-effects Poisson regression analysis, we estimated the number of children and adolescents (aged 5-19 years) without access to psychiatric services and examined disparities across counties in the United States. We estimate that 6,035,402 children and adolescents in the United States (approximately 10%) have inadequate in-person and digital availability of child psychiatric services within their counties. Although this was true for only 3% of children and adolescents in urban counties, this applied to more than half (51%) in rural counties (adjusted odds ratio [AOR]= 2.71; 95% CI= 1.94, 3.78; p< .001). Likewise, only 3% of children and adolescents in high-income counties had insufficient digital and physical access, compared to more than 4 in 10 children and adolescents (41%) in low-income counties (AOR= 0.43; 95% CI= 0.30-0.61; p< .001). Counties with a higher density of Black and Hispanic residents had greater likelihood of service availability (p< 0.001), potentially a function of living in metropolitan communities. Although telehealth holds promise for promoting access to child and adolescent psychiatric services, large disparities in overall access to services persists in rural and low-income communities.

Telepsychiatry services across an emergency department network: A mixed methods study of the implementation process

BackgroundDue to limited community resources for mental health and long travel distances, emergency departments (EDs) serve as the safety net for many rural residents facing crisis mental health care. In 2019, The Leona M. and Harry B. Helmsley Charitable Trust funded a project to establish and implement an ED-based telepsychiatry service for patients with mental health issues in underserved areas. The purpose of this study was to evaluate the implementation of this novel ED-based telepsychiatry service. MethodsThis was a mixed-methods study evaluating the new ED-based telepsychiatry consult service implemented in five EDs across three rural states that participated within a mature hub-and-spoke telemedicine network between June 2019 and December 2020. Quantitative evaluation in this study included characteristics of the telehealth encounters and the patient population for whom this service was used. For qualitative assessments, we identified key themes from interviews with key informants at the ED spokes to assess overall facilitators, barriers, and impact. Integrating the quantitative and qualitative findings, we explored emergent phenomena and identified insights to provide a comprehensive perspective of the implementation process. ResultsThere were 4130 encounters for 3932 patients from the EDs during the evaluation period. Approximately 54% of encounters involved female patients. The majority of patients seen were white (51%) or Native American (44%) reflecting the population of the communities where the EDs were located. Among the indications for the telepsychiatry consult, the most frequently identified were depression (28%), suicide/self-harm (17%), and schizophrenia (12%). Across sites, 99% of clinician-to-clinician consults were by phone, and 99% of clinical assessments/evaluations were by video. The distribution of encounters varied by the day of the week and the time of day. Facilitators for the service included increasing need, a supportive infrastructure, a straightforward process, familiarity with telemedicine, and a collaborative relationship. Barriers identified by respondents at the sites included the lack of clarity of process and technical limitations. The themes emerging from the impact of the telepsychiatry consultation in the ED included workforce improvement, care improvement, patient satisfaction, cost-benefit, facilitating COVID care, and access improvement. ConclusionsImplementation of a telepsychiatry service in ED settings may be beneficial to the patient, local ED, and the underserved community. In this study, we found that implementing this service alleviated the burden of care during the COVID-19 pandemic, enhanced local site capability, and improved local ability to provide quality and effective care.

Telepsychiatry services during COVID-19: A cross-sectional survey on the experiences and perspectives of young adults with first-episode psychosis.

IntroductionLimited evidence exists on the implementation of telepsychiatry within the context of early intervention services for psychosis, the need for which has become even more relevant during the COVID‐19 pandemic. To address this gap, we investigated the experiences and perspectives of young adults recovering from a first‐episode psychosis (FEP) following their use of telepsychiatry services (i.e. use of video conferencing technology to deliver mental health services to patients in real time).MethodsA cross‐sectional online survey study was implemented between November 19th, 2020 and March 9th, 2021 with young adults recruited from a specialized program for FEP located in an urban Canadian setting. Data were analysed using descriptive statistics, exploratory (Fisher's exact test), and content analysis.ResultsAmong 51 participants (mean age = 26.0, SD = 4.7; 56.9% female), the majority were satisfied with the service (91%, 46/51), perceived that the platform was easy to use (90%, 46/51) and felt secure in terms of confidentiality (82%, 42/51). Satisfaction was related to perceptions regarding ease of use, image quality, and employment/studying status. Several partially or totally agreed that the presence of a third party was essential to login during the first few sessions (35%, 18/51), and some needed technical support (24%, 12/51) throughout the sessions.ConclusionsThis study shows that telepsychiatry is feasible and acceptable to implement for patients in the early phase of psychosis recovery. It also highlights the importance of making technical support available, especially in the first few times of using the service, and addressing patient concerns regarding confidentiality, even when using secured health technologies.

Suicidal behavior in new patients presenting to the Telepsychiatry services in a Tertiary Care center: An exploratory study.

BackgroundThe COVID-19 pandemic has led to expansion of telepsychiatry services and formulation of telemedicine guidelines. However, the telemedicine guidelines are not very clear about psychiatric emergencies, such as suicidal behaviour, resulting in psychiatrists facing dilemma about handling such situations.AimTo evaluate the prevalence of suicidal behaviour in new patients presenting to the Telepsychiatry services in a Tertiary Care centre.Methods1065 new adult patients (aged > 18 years) registered with telepsychiatry services were assessed for suicidal behaviour, in the form of death wishes, suicidal ideations, plans, attempts (lifetime/recent) and non-suicidal self-injurious behaviour (NSSI) (lifetime/recent).ResultsIn terms of suicidal behaviour, in the last few weeks prior to assessment 14.4% of the patients had death wishes, 2.4% had thoughts of killing themselves, 0.9% had attempted suicide in the lifetime and 0.6% in the last few weeks, 1.1% had active suicidal ideations at the time of assessment, 0.6% had active suicidal plan, 1.3% had history of NSSI in the lifetime and 0.5% had NSSI behaviour in the last few weeks. Based on the current suicidal behaviour, 1.3% of the patients were asked to report to the emergency immediately, 0.5% were given an appointment within 72 h for follow-up, and 14.4% were explained high risk management.ConclusionsOverall prevalence of suicidal behavior is relatively low in new patients seeking psychiatric help through telepsychiatry services.

Viability of telepsychiatry - results from an ambulatory academic tertiary care clinic

During the 2020 COVID-19 pandemic, telemedicine became an important method of providing patient care and minimizing person-to-person contact. For example, it has been considered a reasonable option for patients who have been discharged from the intensive care unit (ICU) and other acute settings. Previous studies have indicated that using telemedicine with psychiatry, also known as telepsychiatry, may be preferred by certain patient groups, such as rural patients. This study aims to evaluate the impact of transitioning to telepsychiatry services in response to the pandemic on patient appointment compliance of a university affiliated ambulatory clinic in Lubbock, Texas. Retrospective data on clinic appointment attendance from three separate three-month time periods (March-June 2019, December 2019- March 2020, March-June 2020) were used to determine their respective no-show prevalence. Results were analyzed with chi square testing (

Implementation of telepsychiatry in Kenya: acceptability study.

COVID-19-related restrictions on in-person contact in healthcare, increasing psychiatric illness during the pandemic and pre-existing shortages of mental healthcare providers have led to the emergence of telepsychiatry as an attractive option for the delivery of care. Telepsychiatry has been promoted as economical and effective, but its acceptance in low- and middle-income countries is poorly understood. To explore the acceptance, experiences and perspectives of patients and healthcare providers in the uptake of telepsychiatry services in a middle-income country. Focus group discussions were conducted on the WhatsApp platform with patients and care providers who have engaged in telepsychiatry. Data were analysed using a thematic approach. Three main themes emerged from the five focus groups: (a) technical access, (b) user experience and (c) perceived effectiveness compared with face-to-face (in-person) interactions. Care providers reported challenges establishing rapport with the patient, particularly for initial sessions, maintaining privacy during sessions and detecting non-verbal cues on video. Patients cited internet connectivity problems, difficulty finding private space to have their sessions and cost as major challenges. Patients also felt in-person sessions were better for initial visits. Both patients and providers reported difficulties making insurance payment claims for telepsychiatry services. Overall, participants were mostly positive about telepsychiatry, citing its convenience and overall perceived effectiveness compared with in-person sessions. Telepsychiatry is an acceptable platform for delivery of out-patient psychiatric services in a middle-income country. Patients and providers appreciate the convenience it offers and would like it integrated as a routine mode of delivery of care.

Benefits and challenges of telepsychiatry services in SouthEast Asian nations during the COVID-19 era: An integrative review.

COVID-19's long-term consequences on people's mental health include social isolation, job insecurity, illness and sorrow, physical separation, and disrupted access to normal health and mental treatment. Until recently, telepsychiatry has become increasingly mainstream in the delivery of mental health services under COVID-19 and have grown significantly in Western nations. However, telepsychiatry is not generally provided in Asian countries, particularly that of SouthEast countries. In this study, the reviewer made an integrative review of the available literature, in examining the benefits and challenges of telepsychiatry services of SouthEast Asian countries during the COVID-19 pandemic. This review utilized electronic resources such as PubMED, Google Scholar, Taylor and Francis, SAGE, IEEE, Springer, ScienceDirect, Wiley, and ACM. The review covered publications published from December 1, 2019, to December 1, 2021, as well as articles published in English and translated into English. Two (2) articles were included in this review. All the papers studied are classified as having a level of evidence VI. Both publications were based on research done in the Philippines. The total sample size for all papers analyzed was 149 respondents. The telepsychiatry platforms or systems employed in investigations vary. There was no continuous usage of a single telepsychiatry platform. Each research employed a different telepsychiatry service or system, depending on the technology available in the nation where the study was done. Findings in this review show that the concept or notion of telepsychiatry services within SouthEast Asian countries is exceptionally novel and needs further research in the medical and allied health discipline. For countries that are part of the SouthEast Asia, the critical issue today is how to sustain progress and how to increase and maintain care standards, at the same time utilizing telepsychiatry services in this aspect.

PATIENT SATISFACTION WITH TELEPSYCHIATRY CONSULTATIONS IN THE TIME OF COVID19: DATA FROM A TERTIARY CARE HOSPITAL IN PAKISTAN

OBJECTIVES: To assess the patient satisfaction with telepsychiatry consultations, and whether time and money was saved by patients availing the service. METHODS: Anonymous internet survey using Google Form method, was conducted between April 2020 and September 2020 to collect data from patients using teleconsultation in out-patients psychiatry clinic. The google form consisted of patient satisfaction questionnaire, demographic details, and additional questions about the money and time saved by patients using the service. RESULTS: Out of 260 participants, 152, (58.5%) were males, 148 (58.3 %) were married and majority (n=157: 60.4%) of patients were &lt;40 years of age. About 62.7% (n=163) were highly educated. Majority (n=108; 41.5%) of the survey participants were from Khyber Pakhtunkhwa province. The average cost saving was Pakistani Rupees 3000 for the consultation whereas the average time saved was 1.5 days. Patients were happy during communication with doctor including seeing doctor on screen (85.7%), hearing to doctor (90.4%), talking to doctor (84.6%) and discussion of their care plan (81.6%). Majority (79.2%) of the survey participants were happy with the meeting of care needs and 86.5% were happy to avail the service in future. CONCLUSION: The study underscores the importance of telepsychiatry as mode of service delivery during the pandemics. The findings demonstrated a high level of patient satisfaction, considerable amount of time and money saving indicates the effectiveness of telepsychiatry consultation. It needs to expand the telepsychiatry service both in public and private hospitals and also test this model on a representative sample of patients in Pakistan.

India’s path towards better mental health in a pandemic

COVID-19 has wide-ranging effects on population health including mental health, particularly in low-and-middle-income countries (LMICs). Outbreak and interventions such as quarantine and isolation against it have contributed to psychosocial adversities. We aimed to review the state of India’s mental healthcare planning, identify the gaps in the health systems and policies, and present cost-effective and scalable solutions. Necessary background information was triangulated through an iterative literature review of the policy, preprint, and peer-reviewed research literature. We focused on the following themes-a) health system capacity, policy, and law for India, b) psychological impact of COVID-19 outbreak in India, c) psychological impact of interventions against COVID-19, and d) best practices across countries for mental health management during the pandemic. We used qualitative synthesis to identify health systems and policy gaps to generate short- and long-term solutions supported by high-grade evidence for effectiveness, cost-effectiveness, and adaptation feasibility in India. The Indian health system has several shortcomings in its mental health care that became pronounced during the current COVID-19 pandemic. To overcome these, long-term goals should include increased public financing, increased human resources production, integration of health emergency and mental health policies and legislation. Immediate needs could be met by scale-up of task-shifting initiatives and telepsychiatry services in rural regions. In the ongoing pandemic, employing school-based psychosocial interventions, public awareness campaigning, subverting misinformation through broadcast legislations, and stigma reduction for general mental illnesses are pertinent. These solutions can help bridge the gaps in mental health care in India.