|Year : 2020 | Volume
| Issue : 5 | Page : 18
Psychosocial rehabilitation: Pre-COVID, during COVID, and Post-COVID era
Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
|Date of Submission||20-Sep-2020|
|Date of Acceptance||20-Sep-2020|
|Date of Web Publication||02-Oct-2020|
Ms. Shikha Tyagi
Department of Psychiatry, Government Medical College and Hospital, Chandigarh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Tyagi S. Psychosocial rehabilitation: Pre-COVID, during COVID, and Post-COVID era. Indian J Soc Psychiatry 2020;36, Suppl S1:18
The COVID-19 pandemic has come like a storm in the lives of people world over. The pandemic brought sea changes in lives of almost every genre of people. Before COVID and after COVID is the new and just nomenclature for giving reference to the similarities and differences that existed in the two eras.
Like everyone else, persons with mental illness (PMI) with disabilities are equally, if not more, and badly affected by the pandemic. The closure of outpatient departments and rehabilitation centers has further increased their torment and limited the already meager existing opportunities for them.
Disability Assessment, Rehabilitation and Triage (DART) model running under the aegis of Mental Health Institute comprised a package of day care services, social skills training, cognitive enhancement therapy, vocational training, placement services at both outpatient and inpatient levels, and promised PMI hope. It unfortunately underwent closure for an indefinite period at start of the lockdown in end-March 2020, with no signs of reopening till date. The corresponding lack of peer group interaction that often emerged at such rehabilitation centers left a void in the lives of these PMI. Gradually, human-to-human contact in a safe and risk-managed environment for this already vulnerable and marginalized population stopped as “keeping safe” during the new pandemic took precedence. Correspondingly, the dependence on family for all sort of needs grew; those with difficult family circumstances suffered more and started to relapse.
Gradually, employers started calling us in order to communicate their inability to continue with the job of patients who had undergone rehabilitation and subsequently got placed through DART (MHI) services. The impact was so severe that more than 50% of the patients lost their placement (job) in a span of two month, the severest loss ever faced by the placement cell of DART. The professionals who had worked extremely hard to bring about those changes in some of the PMI with negative symptoms have felt extremely disheartened and at a loss as for them months and years of hard work has been adversely impacted.
Further at the receiving end were the families of PMI who not only had to deal with the economic, social, psychological impact of the pandemic for themselves but also now had to full time handle PMI at home. Due to these issues, the number of calls to DART services started increasing.
None of the rehabilitation centers across the country had any readymade or evidence-based models available to handle the challenges that COVID-19 brought with it, thus giving way to new individual, family, and community-based modes/models and/or interventions. Although telemedicine emerged (with guidelines), nothing on those lines was developed in detail and made available in the field of psychosocial rehabilitation. The rehabilitation staff, on their own accord, have started catering to the varying needs of their respective patients using telemedicine and largely relying on smart phone technology and the strength of the respective families. This approach has worked reasonably well so far!
Will telemedicine be the “new normal” in terms of management in psychosocial rehabilitation for PMI and disability? This will need to be evaluated through proper research framework. Till then, in my opinion, PMI and their caregivers (family and staff) should not be deprived of whatever ways by which suffering can be mitigated.