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Year : 2020  |  Volume : 36  |  Issue : 5  |  Page : 16-17

Impact of COVID-19 on day-care centers for persons with psychiatric disability

Department of Psychiatry, Psychiatric Rehabilitation Services, NIMHANS, Bengaluru, Karnataka, India

Date of Submission16-Sep-2020
Date of Acceptance21-Sep-2020
Date of Web Publication02-Oct-2020

Correspondence Address:
Dr. Thanapal Sivakumar
Department of Psychiatry, Psychiatric Rehabilitation Services, NIMHANS, Bengaluru - 560 029, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijsp.ijsp_322_20

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How to cite this article:
Sivakumar T. Impact of COVID-19 on day-care centers for persons with psychiatric disability. Indian J Soc Psychiatry 2020;36, Suppl S1:16-7

How to cite this URL:
Sivakumar T. Impact of COVID-19 on day-care centers for persons with psychiatric disability. Indian J Soc Psychiatry [serial online] 2020 [cited 2020 Oct 21];36, Suppl S1:16-7. Available from: https://www.indjsp.org/text.asp?2020/36/5/16/297167

Worldwide, the COVID-19 pandemic has disrupted normal life. Day-care centers for persons with psychiatric disability have been closed since lockdown.[1] The closure of day-care facilities has resulted in the loss of daily routine, gainful engagement, and familiar social milieu of patients.[1] Due to lockdowns and social-distancing norms, many patients are confined to their homes. Physical activity has reduced which may worsen comorbid medical conditions. For some patients, increased face-to-face contact has led onto a corresponding increase in negatively expressed emotions.[1]

Due to economic constraints, families face the tough choice of prioritizing competing needs, including patient's treatment and rehabilitation. Some patients have relapsed as they ran out of medicines and could not get the prescriptions refilled. Elderly caregivers who are sole caregivers of patients are anxious about “what after me?” issues.

Many day-care centers are run by nongovernmental organizations who depend on revenue generated from the fees and donations. It is a challenge to raise funds to pay the staff their salaries, ensure well-being, and uplift morale.

Some families and patients have requested for day-care centers to reopen. It is a tough task to balance the benefits of helping patients versus the risk to staff and patients from contracting the infection. Most day-care centers have not reopened the facilities. Despite the physical distance, day-care staff are socially connected with patients through technology.[2] Video meetings have been made possible by software tools (such as Zoom, Google Meet), messaging platforms (such as WhatsApp), smartphone penetration, and cost-effective data.

In the context of rehabilitation, teleconsultations go beyond the traditional clinical follow-up consultations. Patients and families feel reassured to hear the information from familiar people whom they trust. A teleconsultation for rehabilitation involves exploring patient's activity schedule at home, challenges faced by the family, coping strategies used, encouragement for efforts, and common sense inputs on what patient can do at home based on what patient did at the day-care center. Families have been sensitized about the precautions to be adopted during COVID-19.[2] Some patients have been helped with medical consultations, e-prescriptions, lab investigations, and procurement of medications.

However, the wide repertoire of activities at a day-care center cannot be implemented by teleconsultations. Within the constraints, home-based rehabilitation activities supervised by day-care staff are being tried. This involves offering activities for which raw material and expertise is available at the patient's home. Some centers are also sending raw materials for home-based activities. Patients have been offered personally appropriate incentives (by family or the day-care center) for following a daily routine and reaching personalized targets.

The crisis has made teleconsultations acceptable to day-care staff, patients, and families. For the future, the experience gained during the COVID-19 pandemic can help us offer home-based rehabilitation inputs for many patients, and reach out to a larger number of people than ever possible before.

  References Top

Chaturvedi SK. COVID-19, coronavirus and mental health rehabilitation at times of crisis. J Psychosoc Rehabil Ment Health 2020;7:1-2.  Back to cited text no. 1
Sivakumar T, Angothu H. Mental Health Rehabilitation in times of covid19. In: Reddy YC, Jaisoorya TS, editors. Mental Health in the times of COVID-19 Pandemic: Guidelines for General Medical and specialized Mental Health Care Settings. Bengaluru: NIMHANS; 2020. Available from: https://nimhans.ac.in/wp-content/uploads/2020/04/MentalHealthIssuesCOVID-19NIMHANS.pdf. [Last accessed on 2020 Sep 16].  Back to cited text no. 2


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