Mental health issues and service delivery in COVID-19 quarantine facilities: A qualitative study

Objectives: The rapid global spread of coronavirus disease 2019 (COVID-19) pandemic has necessitated quarantine as a public health measure but without planning for mental health support therein. The experience of mental health providers working in quarantine facilities can help plan provision of mental health support in similar settings. Methods: The experience of providing mental health care in six quarantine facilities in Delhi shared by three psychiatrists, six clinical psychologists, two psychiatric social workers through written communication, and in-depth interviews was subjected to thematic analysis. Results: The main psychosocial themes among quarantined persons were loneliness, missing home and family, worry regarding COVID-19-related issues (education, livelihood, career, finances due to accompanying lockdown, and anticipated economic recession), irritability, denial for the need to quarantine, depression, anxiety, and insomnia. Cognitive distortions (minimization and magnification), apprehension about getting infected, and health-related anxiety were also noted. Non-pharmacological interventions included psychoeducation, supportive psychotherapy, sleep hygiene, cognitive behavior therapy, mindfulness, motivation enhancement therapy, recreational activities, relaxation training, and stress management techniques in individual and group settings. Pharmacological interventions were limited to the continuation of psychotropic medications for stable patients, medications for migraine/headache, insomnia, and nicotine replacement therapy. The mental health providers were themselves concerned about getting infected, availability of personal protective equipment and transport (due to lockdown). Conclusion: COVID-19 pandemic has provided mental health professionals a unique opportunity to provide mental health support to quarantined persons but without any defined template. The paper fills the gap and can help in planning the provision of mental health support care in quarantine facilities.