Anandhi Narasimhan, MD
Program: Psychiatry Residency (2005 alumna)
Staff Psychiatrist, Masada Homes
Psychiatrist, TelaDoc Behavioral Health
Asylum Evaluator, Physician for Human Rights
Location: Los Angeles, CA
I have witnessed a variety of reactions with respect to mental health and COVID-19. For some of my patients, their symptoms have decreased, and for some of them, symptoms have exacerbated. Some patients have relied on learned coping strategies to deal with being in quarantine and for those who experience stress with social interactions, the isolation is welcome. For some of the families I treat, not having the stress of making sure students get to school on time, running around to different extra-curricular activities, and staying at home more has improved bonding. For others, it has increased conflict and stress.
Regarding telehealth, it has been beneficial in terms of maintaining continuity while minimizing possible exposure to coronavirus. For patients with higher acuity and those recovering from substance dependence, it has been difficult as they often benefit from the structure of groups and activities that are supportive. Many patients that receive multidisciplinary services such as wraparound and full- service partnership have struggled not having face to face interaction with the team. Behavioral interventions such as therapeutic behavioral services have been challenging to do virtually. However, despite the challenges and the need for more support of mental health care, it is beneficial to administering care that we can use technology to serve patients virtually. As a psychiatrist, I am continuously weighing in my mind getting my patients appropriate care they need, while also trying to mitigate risk of contracting the virus if higher level of care is required.
Personally, I have welcomed some aspects of life in quarantine, such as not having to commute to work, and reflecting on personal as well as professional goals. However, I am concerned about my family and friends contracting the virus having symptoms of higher severity. Those living alone face the very real challenge of isolation, having to put on hold normal social activities that would help decrease feelings of loneliness and provide hope for the possibility of a relationship. I think about my patients and how to keep them in good mental and physical health. Also, my colleagues are stressed with increased volumes in ICUs, in addition they also have concerns of job security with decreased outpatient visits in certain specialties. The lack of protective equipment has contributed to health care workers and other essential workers contracting the virus. This has caused a monumental loss of life, traumatizing families and loved ones. As an asylum evaluator for Physicians for Human Rights, I know that the pandemic is of particularly concerning in high-risk populations such as those in detention and seeking asylum.
This is an unprecedented time in history for this country as well as the world. There will be so many questions to be answered, starting with the inquiry of how the spread could have been contained and transmission mitigated. How do we manage the mental health ramifications that have historically manifested after a pandemic, epidemic or natural disaster? What will our new normal look like for years to come? How will businesses recover from the economic loss and how will individuals attain financial stability? Will the idea of adopting a more plant-based diet become more appealing partially to reduce illness that originate from animal ingestion? How will race relations in this country be further affected by this pandemic? What will this mean for humanity in a spiritual sense and how will we collectively heal?
Read other alumni reflections on their work and life in COVID-19 times.