(Pilot) Bridging the Mental Health Treatment Gap through Tele-psychiatry - 'REACH' a Formative Research Project from Goa, India. (360G-Wellcome-202978_Z_16_Z)

The main objectives of REACH are to determine the:1. Feasibility of delivering psychiatric consultation services via tele-psychiatry to patients with mental health problemsidentified in primary care. Vast number of patients in India access health care at the primary level however availability ofmental heath care is poor in these settings. This is largely due to lack of trained mental health manpower. Further thehealth personnel at primary level are poorly trained to identify and treat mental health issues. It will not be possible tobridge this mental health treatment gap in the near future hence this innovative use of tele-psychiatry viavideoconferencing is being considered. Though telepsychiatry has been used in some settings it remains to be seen if it can be integrated into the primary health system, which if found to be possible would have significant impact on mentalhealth care delivery in India. We aim to demonstrate that it is feasible to integrate such services into routine primary healthcare.2. Acceptability of tele-psychiatry services to various stakeholders including the delivery agents, patients, and their familymembers. One of the challenges would be engaging the end user and the peripheral health team in delivering care in asafe and acceptable manner. Besides feasibility and acceptability there are other concerns in delivering such a servicesuch as issues of privacy, confidentiality, record-keeping, ethical and legal implications as well as duty of care andhandling of emergencies. The study will delve into these issues through in-depth interviews with all stakeholders.3. Preliminary impact of psychiatric consultation services delivered via tele-psychiatry on various outcomes in patients with mental health problems identified in primary care. We will recruit patients identified with Depression, Alcohol use disorders and Severe Mental Illness; before-after assessments of symptom burden and disability levels will be done to determine the impact of the tele-psychiatric consultations. We hope to demonstrate that providing mental health care through telepsychiatry has a positive effect on the outcomes.