Mumbai: Maharashtra Government on Tuesday released comprehensive guidelines for remedies of mental problems faced by the Covid 19 patients. It proposes regular counselling of Covid 19 patients with a focus on understanding their issues and symptoms of mental disorder.
Patient’s relative/ guardian/ caregiver will be screened for any mental health issues and they will be informed about the basic concept of Covid 19, isolation, quarantine and importance of personal hygiene, diet, respiratory etiquette and proper mask wearing.
Upon successful screening, a patient should be classified as having no mental health issue, mild, moderate or severe psychiatric disorder and should be managed accordingly. Patient and caregiver, both must be screened for psychological health problems, a registry should be maintained with contact details, clinical impression and management plan and follow ups should be taken online or on telephones during phase of isolation and quarantine and updated in the registry.
Those patients who are admitted indoor should be psycho-educated by the in-house psychiatrist, trained psychiatric staff nurse or other trained staff. Considering existing manpower for psychiatry, psychiatrists and clinical psychologists working privately can be hired by paying them suitable honorarium.
In case of patients with high risk of suicide with symptoms of acute stress, feeling isolated or rejected and helplessness and suicidal plans, they should be kept under constant supervision by staff. The bed should be located close to the nursing station with an easy view. Scissors, razors and other potentially lethal objects should be removed. No medication should be kept with the patient and medication must be handed over to the patient under strict supervision. The staff nurse on duty must ensure that patients swallow medication and do not spit out.
Yoga sessions should be conducted every morning for the patients. AV recordings and live demonstrations on internet platforms by the AYUSH cell can be used too.
According to the guidelines, distress, anxiety, exhaustion, shift work, substance use can all present with sleep disturbances. It is important to clarify these aspects when frontline personnel report with sleep disturbances. Further, counselling should be held for frontline workers including doctors, paramedic staff and ASHA workers who are working hard during Covid 19 crisis.