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LETTERS TO EDITOR  
Year : 2020  |  Volume : 62  |  Issue : 6  |  Page : 750-751
Medical Council of India module on pandemic management: Neglecting mental health training a major lacuna


1 Department of Psychiatry; Department of Medical Education, KLE Academy of Higher Education's JN Medical College, Belagavi, Karnataka, India
2 Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education, Mysore, Karnataka, India

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Date of Submission27-Aug-2020
Date of Decision23-Oct-2020
Date of Acceptance29-Oct-2020
Date of Web Publication12-Dec-2020
 

How to cite this article:
Tekkalaki B, Kishor M. Medical Council of India module on pandemic management: Neglecting mental health training a major lacuna. Indian J Psychiatry 2020;62:750-1

How to cite this URL:
Tekkalaki B, Kishor M. Medical Council of India module on pandemic management: Neglecting mental health training a major lacuna. Indian J Psychiatry [serial online] 2020 [cited 2021 Jan 22];62:750-1. Available from: https://www.indianjpsychiatry.org/text.asp?2020/62/6/750/303155




Sir,

The Medical Council of India (MCI) recently rolled out the new module on pandemic management,[1] with the intention to train Indian medical graduates to tackle the situation of a pandemic. While this is a welcome step, it is indeed a matter of great concern and disappointment that mental health component has been neglected. The forward of the draft mentions that it is designed to ensure that the MBBS graduate acquires competencies required to handle not only the illness but also the social and other problems arising out of the illness. Ironically, there is not even a single session in 80-h module on the mental health aspects of the pandemic in the module.

Pandemic poses special challenges that significantly affect mental health of the community. The challenges are even more difficult if it is communicable and infectious condition, such as the ongoing novel coronavirus pandemic (COVID-19). Various reasons that might affect the psychological health during such pandemic are: uncertainty about the incubation period, nonavailability of definitive diagnostic and treatment options, fear of getting infected or death, fear of loosing the near and dear ones, financial loss, loneliness during quarantine and isolation, misleading information in media etc.[2]

The emerging research on the mental health impact of COVID-19 suggests high prevalence of symptoms of anxiety and depression among the general public. The prevalence of psychological distress is reported to be ranging from 7% to around 50% globally. Apart from the symptoms mentioned above, insomnia, indignation, phobias, compulsive behaviors, and impaired social functioning have been also reported.[3] The Indian data suggest that about two-fifths of the population are facing common mental health issues such as anxiety, stress, and depression during lockdown.[4]

The pandemics such as COVID-19 greatly affect the mental health of healthcare workers. Poor working conditions, poor resources, work burden, continued violence on doctors, pressure from the bureaucrats, fear of getting infected and transmitting infection to immediate family members, infection and death among colleagues, all might affect the mental health of the healthcare workers. A recent meta-analysis reported a pooled prevalence of 23.2% for anxiety and 22.8% for depression among the healthcare workers. Female gender and nursing professionals had higher risk of developing anxiety and depression. Further, around 40% of healthcare professionals suffered from insomnia.[5]

The WHO guidelines on the clinical management of COVID-19 illness have incorporated the identification and management of psychological complications of COVID-19. A separate chapter is dedicated to the management of neurological and mental manifestations of COVID-19, laying down the guidelines for the management of common syndromes such as delirium, anxiety, depression, and insomnia in patients with COVID-19. The guidelines suggest that basic mental health and psychosocial support should not only be provided to all patients but also be continued even after discharge to ensure continued wellbeing.[6] The revised guidelines for the management of COVID-19 by the Government of India, Ministry of Health and Family Welfare (MoHFW), also advocated counseling services for patients reporting anxiety and depression.[7]

The new competency-based medical curriculum has already received criticism for not having a single skill in the psychiatry mandatory for certification.[8],[9] This is a major lacuna in the undergraduate medical training in the country, in which one in seven persons are suffering from one or other mental health illnesses. Quality psychiatry training for undergraduates becomes even more important, given the severe scarcity of trained mental health specialists in India.[9] Added to these ground realities, the new developments in the form of pandemic pose additional challenges for the healthcare professionals to not only manage the mental health problems of the general public but also maintain their own mental health. However, paradoxically, the MCI, contrary to the World Health Organization guidelines and that of the Government of India, MoHFW emphasis on mental health, has completely overlooked mental health in the module on pandemic management.

MBBS training is a crucial component in delivery of health services in India; a revision in module of pandemic management is needed to incorporate essential skills in identification and management of common psychological ailments such as anxiety, depression, and suicidal ideation. The lack of training for MBBS students in the crucial domains of knowledge and skills of mental health will lead to serious deficits in public health services in the management of pandemic.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Medical Council of India. Module on Pandemic Management; 2020. p. 1-75.  Back to cited text no. 1
    
2.
Torales J, O'Higgins M, Castaldelli-Maia JM, Ventriglio A. The outbreak of COVID-19 coronavirus and its impact on global mental health. Int J Soc Psychiatry 2020;66:317-20.  Back to cited text no. 2
    
3.
Talevi D, Socci V, Carai M, Carnaghi G, Faleri S, Trebbi E, et al. Mental health outcomes of the COVID-19 pandemic. Riv Psichiatr 2020;55:137-44.  Back to cited text no. 3
    
4.
Grover S, Sahoo S, Mehra A, Avasthi A, Tripathi A, Subramanyan A, et al. Psychological impact of COVID-19 lockdown: An online survey from India. Indian J Psychiatry 2020;62:354-62.  Back to cited text no. 4
  [Full text]  
5.
Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun 2020;88:901-7.  Back to cited text no. 5
    
6.
WHO. Clinical Management of COVID-19, Interim Guidance; 27 May, 2020. Available from: https://www.who.int/publications/i/item/clinical-management-of-covid-19. [Last accessed on 2020 Aug 24].  Back to cited text no. 6
    
7.
Government of India, Ministry of Health & Family Welfare, Directorate General of Health Services (EMR Division). Revised Guidelines on Clinical Management of COVID-19; 31 March, 2020. Available from: https://www.mohfw.gov.in/pdf/RevisedNationalClinicalManagementGuidelineforCOVID1931032020.pdf. [Last accessed on 2020 Aug 24].  Back to cited text no. 7
    
8.
Kishor M, Gupta R, Ashok MV, Isaac M, Chaddha RK, Singh OP, et al. Competency-based medical curriculum: Psychiatry, training of faculty, and Indian Psychiatric Society. Indian J Psychiatry 2020;62:207-8.  Back to cited text no. 8
  [Full text]  
9.
Kishor M, Menon V, Vinay HR, Bhise MC, Isaac M, Chandran S, et al. COVID-19 pandemic highlights the need to reconsider psychiatry training of Indian medical graduate. Int JHealth Allied Sci 2020;9:S104-6.  Back to cited text no. 9
    

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Correspondence Address:
M Kishor
Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education, Mysore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/psychiatry.IndianJPsychiatry_1019_20

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