The covid-19 outbreak was a public health emergency of international concern. It was when people had isolated themselves in fear of a virus outbreak. It has profoundly impacted people with existing mental disorders, augmenting the ongoing inequalities in mental health. Many studies showed that pandemics have paved the way for many stress disorders similar to SARS.

People who isolated themselves for longer periods precipitated severe cases of depression and social anxiety. In addition, the pandemic has affected the environment and people’s healthy lifestyles as social distancing led to an alteration in their daily habits and livelihood, resulting in frustration, stress, depression, boredom and anxiety.

The circumstances led to the cancellation of psychiatry services, which exacerbated the existing barriers like stigma, religious beliefs, socio-cultural factors, low literacy, unavailability of services, etc. This was one of the reasons for an increased number of post-traumatic stress disorders after the pandemic. Hence, these humungous mental health issues, spoken or unspoken, make it practically difficult to address this, especially at the level of psychiatrists alone or to use the traditional approaches.

Here, digital health has become viable and a valuable opportunity to handle epidemics as real-time results emerge continuously. According to a study, the prevalence of mental health disorders in India has doubled in the period between 1990 and 2017, where one in seven Indians got affected by psychiatric disorders of varying severity. It was again worsened by the average national deficit of psychiatry of 77%.

AI and telepsychiatry

Artificial Intelligence is vital in the fourth industrial revolution, which is a critical nonmedical intervention for overcoming the present global health crisis, preparing for next generation pandemic and regaining resilience. Telehealth has a broader scope of providing remote healthcare services than telemedicine. Various terminologies are used to denote telemedicine or telehealth, such as digital health, electronic health, mHealth (Mobile Health), teleconsultation, and tele-triage. In addition to this, there are some specialities like telepsychiatry, teleneurology and telecardiology.

Telemedicine has been actively used since the early 1960s by the military and space technology departments due to their inability to get in touch with healthcare professionals at times. Now, telemedicine is easily available for everyone in digital stores, and the mHealth apps are accessible through smartphones, tablets and computers. Such apps help to have remote communication with healthcare professionals and their patients effortlessly.

In India, as per the change in patterns of health-seeking behaviour, the technology associated with mental health care also evolved from simple teleconsultation models to asynchronous models with AI. The implementation of synchronous telepsychiatry in India can be traced to the time when Tsunami struck India in 2004. While asynchronous models have limited feasibility, they have improved access, are low in cost, and supplement the existing care. Studies prove that the tele-enabling model, the digital technology coupled with AI, can be used for the potential of medical informatics in conventional telepsychiatry. As per studies, AI is extensively used for patient monitoring, intelligent assistance diagnosis, health care information technology and information analysis collaboration.

How Covid 19 impacted psychiatry in India

The COVID-19 pandemic has caused an unexpected burden on the existing limited healthcare resources. When it comes to psychiatry, it has widened the already existing gap between mental health professionals and seekers. As we could not see an end or cure for the pandemic, AI-enabled telepsychiatry can be an alternative for providing mental health care in the present and future.

The technology of telepsychiatry used in India was evolved from a simple synchronous teleconsultation model which enables you to use video conferencing, telephone, online chatrooms, etc., to the deployment of asynchronous models using AI-enabled telepsychiatry. Deploying AI in mental health has enabled to automate the evaluation of various clinical parameters. There are many ways the potential of Artificial Intelligence can be leveraged in the area of telepsychiatry.  

Application of telepsychiatry and AI

Studies prove that telepsychiatry and AI can be used to automate the evaluation, especially imaging and behaviour analysis, acoustic signals, evaluating bio-signals, knowledge-based methods and retinal examination and assessing language use in mental disorders. Other uses include online information exchange and support services using social media and networking, asynchronous psychotherapy and psychiatric consultation in primary care and emergency rooms. Home care and other interventions for elderly people are also feasible with this technology. Such possible applications enable the psychiatrist to collect as much data as for effective clinical decisions.  

Temporal data will be available, which can be effectively summarised using AI, which acts as a potential tool for psychiatrists in the clinical decision-making process. Psychiatrists can rely on this data for making clinical decisions. Such big data with temporal characteristics analysed using AI will be a better tool for diagnosis, patient monitoring and follow-ups. Psychiatrists will have valid data for enhancing their clinical decisions. But the absence of a uniform data collection pattern will make this evaluation process less possible immediately. Yet it can be considered a time when ethical guidelines on alternate data collection practices are boosted in psychiatry.

Challenges involved in using AI technology in psychiatry in India

As far as we enjoy the vast amount of opportunities put forward by technology, there are also challenges that we may face, especially in mental health areas. However, it is important to understand that there are issues related to privacy, security, biases, validation, language barriers, financial constraints, technical issues, better patient-professional relationships etc., that will affect better treatment.