Redefining Access to Mental Health Care Through Sustained Tele-mentoring: A Report of the Instant Collaborative Video Consultations with Primary Care Doctors.

BACKGROUND

Mentoring primary care doctors (PCDs) improves their competency and aids in integrating psychiatric care into primary care, especially in resource-constrained settings. This study evaluates the socio-demographic, diagnostic, and treatment profiling of instant collaborative video consultations (i-CVCs) and the diagnostic (domain-wise and disorder-wise) and treatment concordance of PCDs with tele-psychiatrists.

METHODS

This was a cross-sectional study that was a part of a digitally driven capacity-building program that provided tele-mentoring to PCDs via i-CVCs with tele-psychiatrists. A total of 382 i-CVCs conducted between November 2022 and July 2024 were analyzed for diagnostic and treatment profiling. Concordance between PCDs and tele-psychiatrists was assessed using Cohen's kappa (n = 358).

RESULTS

Among the domain-wise diagnostic distribution by the tele-psychiatrist, the majority were classified as common mental disorders (CMDs) (47.7%), and among the disorder-wise distribution, the majority was depressive disorder (22.5%). The analysis revealed very good to good diagnostic agreement between PCDs and tele-psychiatrists across major domains: SUD (κ = 0.96), SMD (κ = 0.81), and CMD (κ = 0.75), all with p < .001. Disorder-wise concordance was highest for alcohol disorders (κ = 0.96). Treatment concordance also showed moderate agreement for all the major classes of psychotropic medications (κ = 0.5 to 0.6; p < .001), including antidepressants, antipsychotics, benzodiazepines, and nicotine replacement therapy. i-CVC support was primarily sought for diagnostic/treatment confirmation and clarification on dosage strategies.

CONCLUSIONS

i-CVCs facilitate real-time learning and improve confidence in managing psychiatric disorders within live primary care clinics, demonstrating a scalable approach to address the treatment gap.