Telepsychiatry-Based On-Consultation Training: Acceptability and Feasibility from Primary Care Doctors and Psychiatrists

Abstract

Background: There is a gross mismatch between the available psychiatry services and the prevalence of psychiatric disorders in our country, leading to a large treatment gap. Integrating mental health into primary care through innovative methods to combat the same is imperative. The traditional classroom training fails to translate into adequate clinical skills, which led to the design and development of the Telepsychiatry-based On-Consultation Training (Tele-OCT) method for Primary Care Doctors (PCDs). This paper assesses this model’s ease, feasibility, advocacy, and acceptability. Methodology: This study was conducted in the Mandya district of Karnataka, 100 km southwest of the training hub. The institutional ethical committee approved the study. Tele-OCT was conducted with a pair of PCDs in each session at the Spoke side, tagged with a tele-psychiatrist at Hub center. Patients were randomly selected from their general outpatient clinic for video live streaming screening, diagnosing, and managing mental illnesses. After the training, trainees and trainers filled out their respective online feedback forms created to assess the levels of acceptability and technical feasibility of the Tele-OCT program. A total of 27 PCDs and seven psychiatrists completed their separate feedback forms. Results: The mean age of the PCDs and psychiatrists was 37.67 ± 9.46 years and 31.63 ± 4.66 years, respectively. The majority of the participants were male. The PCDs reported the audiovisual clarity and comfort of using the technology as easy. They preferred the one-to-one technology-based sessions over traditional classroom training, with a high recommendation to their colleagues. The psychiatrists also quickly chose continuous handholding and technology-based learning at the primary care level. However, tele-psychiatrists rated rapport levels with patients the least compared to other domains. Conclusion: Despite a few internet connectivity-related hurdles, the acceptability and feasibility of Tele-OCT are high among trainees PCDs and trainer tele-psychiatrists. This Tele-OCT method of training PCDs by a tele-psychiatrist on a virtual platform may help overcome hurdles in human resources development, decentralize expertise in mental health and successful integration of mental health in primary health care and reduce the treatment gap.

Keywords

• india
• on-consultation training
• primary care
• telepsychiatry