Ritu Jha-
The 41st Annual Convention and Scientific Assembly of the American Association of Physicians of Indian origin (AAPI) will be held from July 6 to 9, 2023 in Philadelphia, a platform to interact with leading physicians, health professionals, academicians, and scientists of Indian origin.
AAPI members have a significant influence on the American healthcare system. It has over 120,000 medical professionals in 130 chapters. They make up for 10% of all physicians in the US and over 50% of international medical graduates.
AAPI president and noted psychiatrist Dr Ravi Kolli, spoke to indica about mental health concerns faced by both Americans and Indians, and the challenges ahead. He also shared his views on the Global Healthcare Summit held in the Indian city of Visakhapatnam in January this year.
Dr Kolli said the demand for mental healthcare has zoomed after the pandemic. “It impacted all aspects of human life,” he said. “Physicians and other health professionals on the frontlines of Covid-19 care have experienced so many unknown challenges during the pandemic. They’ve also put their own health and the well-being of their families on the line to provide care.”
He said Covid is not the only reason, as “the pandemic magnified pre-existing mental health disorders.”
Obesity and substance abuse, for example. “We are encouraged to eat fast food and consume sugary drinks. These give rise to obesity. The lack of emphasis on healthy food and allowing fast food to be available everywhere, are roles played by society in physical and mental health disorders. Psychological stress levels peaked on account of a lack of family structure and values. Everything plays a role,” he said.
In India, mental health awareness and interventions have long way to go, he feels. “The president of the Indian Psychiatric Society presented a status report on the state of affairs of psychiatry and the need and issues. There’s a significant need for awareness, need for access to rural
settlements.”
Kolli said the Indian government has laid some emphasis on mental health but resources are needed to complete the circle of care for mental health patients. “It’s a limited network of qualified people. The intent is there and the concept is there, but the resources are not yet in place,” he said.
It is not so different in the US, too. “There are not enough mental health professionals to take care of all the patients,” he said. “People have to wait for two to three months before they can get an appointment with a psychiatrist.”
In that context, he said, the Global Health Care Summit in Visakhapatnam was a successful event, “beyond everybody’s expectations.” He said, “This year, we had robust attendance, and it was extremely rewarding to make our points and speak on topics in front of a huge audience”
The audience comprised top political leadership, including the health minister of Telangana, along with other of ministers, secretaries, and principal secretaries.
“We talked about the stigma, avoidance of treatment, and awareness of treatments,” he said. “We organized a march on the last day on the beach to generate awareness about mental health stigma, how to address this, and to tell people what to do. Everybody – medical staff, legislators, lawmakers, and healthcare systems – has a role to play in dealing with this growing problem.”
He added: “We have to address this issue in a holistic matter. In the US, too, there is stigma. Even doctors don’t seek treatment. When you apply for a job or a license, the authorities ask you about your mental health and substance abuse treatment. So people hide it and do not seek care. We need to normalize health-seeking behavior for people to take help.”
“Mental health is a mystery to a lot of people. We take pride in taking care of the physical health, but we don’t emphasize mental health. Having emotional challenges is normal and that’s why the care of mental health also has to start from a young age. Society needs to promote awareness, and encourage others to seek help whenever they need it.”
Dr. Kolli spoke about identifying mental health problems: “If you’re not functioning at your best, at your optimum and there are changes in your patterns of behavior, your relationships, your social connections and you are isolating yourself or increasing substance abuse and resorting to reckless behavior – these are some signs that we can be aware of.”
He also spoke about growing instances in the US of young kids leaving their homes. “These are challenging years for teenagers. If you don’t allow them to seek help or show their vulnerability, that forces them to do things they’re not comfortable with. Kids need to realize that their brains are still growing, they need to be careful about the company they keep, the treatment they need, and what substances they put in their bodies. They need to have some healthy coping skills like exercise, socializing, not using drugs and alcohol, and connecting with parents and friends.”
Dr. Kolli said AAPI is reaching out to organizations, including AAPI’s local chapters and other cultural, ethnic, and professional organizations, to speak about these issues. “The idea is to help people to understand how they can help themselves and how they can help each other.”
He said he welcomes the increased emphasis of the US government on mental health. “The government supports wellness with programs such as the 988 suicide hotline. We want to promote programs like that and make them more accessible. We want to help networked people bring more people into the system.”
In India, Dr Kolli said, AAPI has worked with governments to design a program to deal with school students’ mental health concerns. “It requires a lot of support from the government, in funding, and enrolling teachers and counsellors. We don’t have the resources, but we know the method and help the government to implement it, provided adequate support is provided.”
AAPI is also extending financial help and expertise to doctors in India to screen for diseases such as diabetes and kidney disease. “Once we have relevant data, we want to provide that to local doctors and local champions. While AAPI is working on several projects to give back to India, there are many challenges that prevent Indian American doctors from giving medical help to India as there are restrictions for foreign doctors practicing in India.”
He said AAPI has spoken to the National Medical Council chair to facilitate some level of licensing flexibility. They are working on it. Though medical licensing is a state issue, the National Medical Council can formulate some guidelines on how the states can allow doctors from other countries especially the ones who graduated from India, or those who had a license in India at one time, to provide some telecare or teleconsultation. That is being discussed and hopefully, it will be recommended,” Dr Kolli said.
Interview: AAPI chief Dr Ravi Kolli on mental healthcare in the US and India
