Telepsychiatry in the Arabian Gulf region - Implications beyond the Covid-19 pandemic

Abstract

Coronavirus Disease 2019 (Covid-19) was declared as a public health emergency by the World Health Organization in March 2020 (WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020, n.d.). The State of Qatar confirmed its first positive case on 29thFebruary 2020, and by June we had the highest infection rate per million population (COVID19 Home, n.d.). This public health emergency prompted large-scale lockdown and home confinement to limit the spread of infection. The Ministry of Public Health in Qatar advised minimizing direct contact with patients for non-urgent care. These restrictions had a huge impact on provision of psychiatric services. As the pandemic was evolving, it became clear that mitigation strategies need to be put in place, and in March 2020, telepsychiatry services were introduced. These services used telephone or videoconferencing to limit face-to-face interaction in the delivery of outpatient psychiatric services. We analyzed the data on the number of new and follow-up cases and the rate of non-engagement (no-show rate) in the mental health outpatient setting in the four months following the introduction of telepsychiatry, and found that the total number of individuals accessing mental health services between March and June of 2020 increased by approximately 36.5 % compared to the same period in 2019, with a similar pattern following differential analysis of new and follow-up cases. In addition, a trend towards higher rate of engagement (less percentage of no-shows) was also observed when comparing the corresponding time periods. No discernible differences were found following gender stratification (Table1). Of note, the total population of Qatar is about2.79 million as of June 2020, compared to 2.63 million in June 2019, indicating that the significant rise in demand on mental health services was most likely due to COVID-related distress than would be expected from population growth alone (Monthly Figures on Total Population, n.d.).