Community Psychiatry’s Regional Medical Director, Dr. Ramanujam, was featured in The BroglieBlog discussing how he is providing care to his child and adolescent patients during the pandemic.
By: Rahul Kumar | The BroglieBlog | September 25, 2020
Right now, amid the seemingly never-ending pandemic, many are understandably anxious, worried, and stressed. At BroglieBox, we are speaking to different mental health professionals that are providing support for individuals during this time, and understanding how care has adapted as a result of the pandemic.
Generation Z was already experiencing a mental health crisis during this pandemic, as seen by the rising rates of anxiety and depression among this demographic cohort. A recent survey administered by the Center for Disease Control and Prevention (CDC) youth reported the highest levels of symptoms of anxiety and depression, showing that adolescents may be struggling particularly arduously during this coronavirus pandemic. We took a look into how a child and adolescent psychiatrist is providing care to young people in the middle of this mental health crisis.
BroglieBox Peer Writer, Rahul Kumar, speaks to Dr. Abhijit Ramanujam, MD, a board-certified child and adolescent psychiatrist and one of the Regional Medical Directors at Community Psychiatry, a mental healthcare company with a focus on medication management, with over 40 locations across California. Here, Dr. Ramanujan talks about the role of telemedicine in fostering accessible treatments, the implications of telepsychiatry for youth, and recommendations for cultivating an optimistic outlook at this time.
Rahul Kumar: What does providing care to children and adolescents look like at this time?
Dr. Abhijit Ramanujam: There is certainly a big change in the way youth get access to mental health services. For starters, most appointments are conducted online via Zoom, so many youth are actually more willing to seek help from a mental health professional. There is a certain anonymity that being online provides. While establishing care, Many patients report being less intimidated making online appointments as compared to face-to-face visits.
RK: What kinds of implications are you seeing with telepsychiatry? What are some advantages and challenges about telehealth?
AR: There are surprising advantages that we are seeing. The initial discomfort of telemedicine has faded away amongst youth and they have embraced these online sessions. Many are more comfortable and are able to open up. Some even prefer this given their busy schedule, and many are thankful that they can continue to have sessions despite the pandemic precautions.
Some of the challenges I have noticed are that children communicate nonverbally much more than adults, so it is sometimes hard to read body language as easily on Zoom. It requires careful attention on both sides. There is a chance that the child might have completely misunderstood what one intended to say. After an important discussion, I always ask for clarification.
Many children with social anxiety who do not make any eye contact struggle the most. Online sessions require you to constantly stare at the screen, which can be fatiguing and intimidating. It takes a while to get used to. Many children also report that they do not have complete privacy during the appointment since there are other siblings at home.
RK: In your opinion, how are healthtech initiatives making big strides in the youth mental health space? Do you believe this is fostering greater access to mental health services?
AR: Absolutely. During the Covid crisis, our entire organization of outpatient offices was able to transition smoothly to online services. Most patients embraced this and were thankful for the services. Although initially apprehensive, their comfort level is continuing to increase with time. Recent studies indicate that many patients rate on line telemedicine roughly similar to face-to-face appointments. Many youth who are in different cities with previously limited access to healthcare are better able to connect with a clinician, thanks to telemedicine. Although not a complete substitute to face-to-face appointments, telemedicine is here to stay and brings about its own advantages.
RK: How has the pandemic driven greater conversation around mental health, especially among young people?
AR: More recently, anxiety and depression has been so pervasive that many more people are aware of its presence and the challenges these issues present. Due to telepsychiatry, many people have access to healthcare which they did not before. I do believe we are moving in a positive direction, although we must be cautious. Although access to health care has increased, so is the access to disinformation online.
RK: What kinds of general mental health and wellness resources are you recommending to young people at this time?
AR: I strongly recommend visiting CDC.gov and other official resources to obtain their facts, and especially limiting exposure to ‘sources’ via social media.
RK: What are some recommendations you have for youth to foster an optimistic outlook?
AR: Some of my recommendations include limiting media exposure, making sure to engage in regular physical activity, having a routine and practicing mindfulness. Having a routine immediately reduces some anxiety, as it helps keep a sense of control over one’s day, and physical activity has been shown to improve mood. Whenever there is a sense of panic after watching a traumatic event on the news, it is important to remind ourselves that the majority of us will survive and not all of our loved ones will die. We also need to focus on things that are under our control such as wearing a mask, regular sanitizing, practicing social distancing and feeling proud that we are doing our part in following safe health care recommendations.
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