Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Tele-mentoring on Integrated Mental Health and Addiction for DMHP counsellors in Chhattisgarh: A Feasibility Study

55 views

Published on

A pilot from the VKN NIMHANS

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

Tele-mentoring on Integrated Mental Health and Addiction for DMHP counsellors in Chhattisgarh: A Feasibility Study

  1. 1. Tele-mentoring on Integrated Mental Health and Addiction for DMHP counsellors in Chhattisgarh: A Feasibility Study Presenter: Kanika Mehrotra Clinical Psychologist Kanika Mehrotra, Prabhat Chand, Mrunal Bandawar, Mallikarjun Rao Sagi, Sandeepa Kaur, Aurobind, Aravind Raj, Sumi Jain**, Pratima Murthy, Miriam Komaromy*, Sanjeev Arora* *Project ECHO, University of New Mexico ** State Health Society, Chhattisgarh National Addiction Conference AIIMS 2017
  2. 2. Introduction National Addiction Conference AIIMS 2017
  3. 3. Disease burden of SUD & Mental Illness in Chhattisgarh Substance use disorders : 655005 Schizophrenia and other psychotic disorders: 10916 Neurotic and stress related disorders: 54584 Mood disorders: 38209 Total mental illness: 2183350 National Addiction Conference AIIMS 2017
  4. 4. Treatment Gap National Mental health Survey, 2016 Report of Technical Committee on Mental health, National Human Rights Commission, 2016 11 psychiatrists 2 psychiatric social workers 1 Clinical Psychologist National Addiction Conference AIIMS 2017
  5. 5. To bridge the significant GAP Need for Innovating health care delivery solution Geographical Distance and Cost should NOT be a barrier for Quality Addiction & Mental health Care Struminger et al., Lancet 2017National Addiction Conference AIIMS 2017
  6. 6. Virtual NIMHANS ECHO Amplify the Capacity to provide Best Practice Care in Addiction mental Health in Community by Leveraging Technology VKN NIMHANS Physicians/Health Provider National Addiction Conference AIIMS 2017
  7. 7. Method National Addiction Conference AIIMS 2017
  8. 8. VKN NIMHANS ECHO: Core components • Sharing “best practices” to reduce disparities • “Case based learning” & “Wisdom” to master complexities • “Co-management” of remote patients • Immersive, Deep & Continued Learning • “Web based” database to monitor outcomes • Using “Technology” to leverage scarce resources • Linked to an “Accreditation” certificate and course National Addiction Conference AIIMS 2017
  9. 9. Sharing “Best Practices” to reduce treatment disparities ▪ SOP ▪ Guidelines ▪ Algorithms ▪ Expert consensus * Delivered through mobileapp National Addiction Conference AIIMS 2017
  10. 10. Case Based Learning & Wisdom to share complexities NIMHANS ECHO National Addiction Conference AIIMS 2017
  11. 11. Objectives OBJECTIVES – • Identification, screening for Addiction and Mental health disorders and factors influencing it • Ability to decide and provide “best practices” in psychosocial intervention • Decision making about what type of psychosocial intervention to be provided by psychologist and psychiatry social workers. • Maintaining follow up using contemporary technology • Fortnight discussion with NIMHANS team at VKN tele-ECHO clinics National Addiction Conference AIIMS 2017
  12. 12. Spokes from Community: Chhattisgarh District DMHP counselors National Addiction Conference AIIMS 2017 Easy to access anywhere: No cost to participants Secured, encrypted, HIPAA compliant
  13. 13. Anatomy of fortnight virtual ECHO clinic Counsellor send the anonymous case three days prior He/she mentions specific question about the case for the HUB multi- disciplinary team Presents the case during the fortnightly virtual tele-ECHO clinic The Hub facilitator invites other connected doctors/counsellor for clarifications Hub Experts compiles and at the end give their “recommendations” Also advise to present the case again after 2-4 wks Ends with a “brief didactic” as per Curriculum National Addiction Conference AIIMS 2017
  14. 14. Case Recommendations and follow-ups (shared by secured mobile platform to remote treating doctor/counsellor) National Addiction Conference AIIMS 2017
  15. 15. Blended Certification and Accreditation: Mobile learning National Addiction Conference AIIMS 2017
  16. 16. CGH IMA counsellors NIMHANS ECHO • 11 DMHP districts nominated by the State Health Society • Clinical Psychologists, Psychiatric social workers and specialist counsellors (HIV, tobacco cessation) • 12 participants (several unrecruited seats in chosen DMHP centres) n=7 (2-5 year s) n=2 (<5 year s) n=3 (>2 years) N=8 (M.A) N=2(M. Phil) N=2(P.hD ) Females =2 Males=10 n=3 (>2years) National Addiction Conference AIIMS 2017
  17. 17. Implementation National Addiction Conference AIIMS 2017
  18. 18. Implementation Step 1: Needs Assessment and Pre-test 01 Step 2: Building curriculum 02 Step 3: Fortnightly Synchronous tele- ECHO clinic & asynchronous learning 03 Step 4: Outcome assessments and post-tests 04 National Addiction Conference AIIMS 2017
  19. 19. CURRICULUM Relapse prevention Motivational Interviewing Suicide assessment and interventionPsychiatric & Addiction related Disorders Brief Interventions History taking and MSE Childhood related disorders National Addiction Conference AIIMS 2017
  20. 20. Video clip (LIVE tele-ECHO) National Addiction Conference AIIMS 2017
  21. 21. Results National Addiction Conference AIIMS 2017
  22. 22. No. of counsellors participated No. of districts No. of Counsellors attending at least one virtual tele-ECHO clinic out of six No. of Counsellors attending 3 or more virtual tele-ECHO clinics (>50%) out of six No. of Counsellors attending 4 or more virtual tele-ECHO clinics (>80%) out of six No. of Counsellors who presented patient cases 12(100%) 11 12 (100%) 12 (100%) 7 (58%) 10 (83%) Synchronous virtual tele-ECHO half-way through (3 Months) 100% join through Smartphone Participant Engagement National Addiction Conference AIIMS 2017
  23. 23. Nature of cases Number Substance Use disorders 3 Severe Mental Disorders 9 Common Mental Disorders 5 Co-management with NIMHANS multidisciplinary team N=17 Total number of patients benefited National Addiction Conference AIIMS 2017 N=17 N=88
  24. 24. Conclusion Lessons learnt • Feasible, sustainable, replicable and easy to implement • Ability to increase capacity in the form of “local experts” at the community level • Ubiquitous - combination of formal and informal methods of learning • Smartphone with 4G gamechanger in leveraging resources through technology Challenges • Language related challenges • Difficult to customize acc. to individual needs • Local leadership • Making the environment more conducive to peer led learning • Sustaining engagement and motivation National Addiction Conference AIIMS 2017
  25. 25. Thank You vlc.nimhans.ac.in kanika@vknnimhans.in National Addiction Conference AIIMS 2017

×