Designing and implementing an innovative digitally driven primary care psychiatry program in India

• Published in: Indian journal of psychiatry Vol. 60; no. 2; pp. 236 - 244
• Main Authors: Manjunatha, Narayana, Kumar, Channaveerachari, Math, Suresh, Thirthalli, Jagadisha
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.04.2018; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd
• Subjects: Analysis; Artificial intelligence; Behavior disorders; Classrooms; Clinical medicine; Collaboration; Curricula; Family physicians; Innovations; Mental disorders; Mental health; Neurosciences; Original; Physicians; Practice; Pragmatism; Primary care; Psychiatry; Public health; Telemedicine; Training; Translation; Wellness programs; India; on-consultation training; tele-psychiatry; psychiatry; Clinical schedules; primary care physicians; India
• ISSN: 0019-5545; 1998-3794
• DOI: 10.4103/psychiatry.IndianJPsychiatry_214_18

Background: Primary Care Doctors (PCDs) are the first contact for majority of patients with psychiatric disorders across the world including India. They often provide symptomatic treatment which is naturally inadequate. Absence or inadequate exposure to psychiatric training during undergraduate medical education is one of the prime reasons. Classroom training (CRT), a standard practice to train PCDs is driven by specialist based psychiatric curriculum and inherently lacks clinical translational value. Aim and Context: The 'Department of Psychiatry' of 'National Institute of Mental Health and Neurosciences', Bengaluru, India has recently come up with an innovative digitally driven modules of 'Primary Care Psychiatry Program' (PCPP) for practicing PCDs. Goal of this paper is to provide an overview of all these (five) modules with its various stages of implementation. Methods: Authors briefly discuss the current status of primary care psychiatry in India and also narrate the newly designed five modules of PCPP in this paper. Results and Discussion: An adopted psychiatric curriculum is designed in 'Clinical Schedules for Primary Care Psychiatry' (CSP) which is an integral part of PCPP. This is brief clinical schedules contains culturally appropriate screening questionnaire, transdiagnostic classification of 8 core psychiatric disorders, diagnostic, referral and management guidelines. PCPP contains 5 modules named as orientation module, basic module, advanced module [Tele-psychiatric 'On-Consultation Training' (Tele-OCT)], videoconference based continuing skill development module, and collaborative video consultation modules which covers all essential areas of primary care psychiatry for practicing PCDs. Last three modules are fully designed digital modules in hub and spoke model of Tele Medicine. In this designed program, the CSP and Tele-OCT are two path braking innovations having inbuilt higher clinical translation value. The challenges and opportunities that could be faced during its implementation across India are also discussed. Conclusion and Future Directions: Innovative PCPP is pragmatic in nature and has potential for higher clinical translational value. Once validated thoroughly, PCPP has potential for pan-India expansion. There is a need for artificial intelligence-based modules for next phase of PCPP in India considering her population and lesser number of available psychiatrists.