Collaborative Tele-Neuropsychiatry Consultation Services for Patients in Central Prisons

Background: Tele-medicine helps to provide clinical care comparable to in-person treatment in various clinical settings. It is a novel system of healthcare delivery in both low-resource settings and sites where adequate medical care continues to pose greatest challenge like in prison's in India and worldwide. Aim: To study the sociodemographic and clinical profile of patients from Central Prisons, having received collaborative Tele-Neuropsychiatric Care. Methodology: Psychiatry, neurology, and neurosurgery specialists provided tele-neuropsychiatry consultation through Specialist-Doctor-Patient model as part of the state-run program for the two central prisons from July 1, 2014, to June 30, 2016. A retrospective file review was done of the tele-neuropsychiatry case records at Tele-Medicine Centre, Located at Tertiary Neuro Psychiatric centre of South India. Results: A total of 53 patients were provided tele-neuropsychiatric consultation over 2-year period. Of these, 48 (90.6%) were male and 34 (64.1%) were aged more than 30 years. In total, 20.7% of them had severe mental illness, i.e., schizophrenia and mood disorders, 20.7% with substance use disorder (alcohol and cannabis), 17% had anxiety disorders while 17% with seizure disorder. Nearly 81.1% of patients (inmates) were advised pharmacotherapy while 18.9% were suggested further evaluation of illness and inpatient care at the higher center. Conclusion: The collaborative care was successful in delivering psychiatry, neurology, and neurosurgery consultation with a Specialist-Doctor-Patient model to prison inmates.