key: cord-0764863-ch20beaw authors: S Gowda, Guru; Chithra, Nellai K; Moirangthem, Sydney; Kumar, Channaveerachari Naveen; Math, Suresh Bada title: Homeless Persons with Mental Illness and COVID Pandemic: Collective efforts from India date: 2020-06-24 journal: Asian J Psychiatr DOI: 10.1016/j.ajp.2020.102268 sha: 19bd6e63b63e9a82eec2f403572eff2f3d5559f7 doc_id: 764863 cord_uid: ch20beaw COVID-19 pandemic had made an unprecedented impact on worldwide public psychiatry and society. India has entered into a total lockdown by invoking the special provision of Epidemic Diseases Act of 1897 and Disaster Management Act, 2015. The complete lockdown policy has a direct and indirect impact on Homeless Persons with Mental Illness (HPMI) concerning shelter, basic needs and access to health care and spreads and acquire COVID infection. In this manuscript, we highlight the collective efforts undertaken by both the Government and Civil Society in providing care and prevention COVID to HPMI during the lockdown in India. The unprecedented impact of COVID-19 on public health and the society worldwide, Initially Bhilwara in Rajasthan, officially started lockdown on March 21, 2020 , and subsequently, on March 22, 2020, on the call of the Indian Prime Minister, India underwent a self-imposed -Janata curfew, as a test of resolve & preparedness and later on, the official countrywide lockdown was imposed upon from March 25, 2020, and continuing till date ("India Lockdown news: India to be under complete lockdown for 21 days starting midnight: Narendra Modi," n.d.). Several legal and policy measures were invoked through the special provisions of Epidemic Disease Act of 1897 and Disaster Management Act, 2015 (Awasthi, n.d.) . Under this, all the non-essential services like shopping malls, social gatherings are closed to ensure adequate social/physical distancing. Also, the Ministry of Health and Family Welfare, Government of India (Uday Foundation, 2020) implemented and promoted the strategic measures like promoting personal hygiene, social distancing and isolation of confirmed cases and quarantine of suspected cases or those who are suspected to be exposed to infected people as advocated by the World Health Organization ("Advice for public," n.d.)The total lockdown has both a direct and indirect impact on every citizen of India and more so with double marginalized Homeless Persons and HPMI. Tandon, 2020 has rightly pointed out the relevance of psychiatry and COVID-19, differing mental health J o u r n a l P r e -p r o o f challenges faced in different parts of Asia; in the context of homeless people, refugees, economic and political crisis (Tandon, 2020) . With relevance to the above, this article focusses on the collective efforts from India towards HPMI during COVID-19 and lockdown period. Outreach staffs who provide services for HPMI must take precautionary measures like a) ensuring adequate social distancing with the client, b) ensuring adequate hand hygiene by using hand sanitizers or soap with water, c) use masks to ensure respiratory hygiene, d) to follow the Centre for Disease Control standards while providing care and thereby facilitating the health care to suspected COVID-19 cases (CDC, 2020b). It is better to screen for COVID and admit after COVID results turn negative, as there is a high risk of spread to co-inmates and health care workers. So, soon after the admission, it is better to keep them in a designated possible risk zone for the next 14 days. Later on, patients can be shifted to a regular ward, where there no risk for COVID. In COVID positive cases, HPMI can be isolated and admitted in COVID designated General Hospital, where he can be provided with both mental health and supportive care for COVID infection. The COVID pandemic created negative mental health consequences to everybody (Grover, 2020) which will be more with a vulnerable population like HPMI. In this context, there is a need for simple community based psychosocial management and preparedness (Banerjee & Nair, 2020) . The role of a mental health professional (MHP) /psychiatrist is essential in the pandemic crucial period for the identification, J o u r n a l P r e -p r o o f diagnosis, treatment and rehabilitation of HPMI (Tandon, 2020) . He / She may act as medical experts, a true mental health professional, a scholar, a researcher, a good communicator, collaborator, a manager and a supervisor, a leader ad a health advocate (Grover, 2011) based on the need of settings to provide care to HPMI. As scarcity of MHP / psychiatrist (Math et al., 2019) , tele psychiatric service can be an option to provide care to HPMI, through which reduce the contact with COVID and reach the HPMI community in large. India: COVID-19 Lockdown Puts Poor at Risk Centre invokes 'Epidemic Act' and 'Disaster Management Act' to prevent spread of coronavirus Handling the COVID-19 pandemic: Proposing a community based toolkit for psycho-social management and preparedness. Asian reliefservices?gclid=CjwKCAjwnIr1BRAWEiwA6GpwNYGycF0uQ8U03OvFV4RkEbQd COVID-19 Guidance Note, Protection for those living in Homelessness Special Rapporteur on the right to adequate housing Clinical outcome and rehabilitation of homeless mentally ill patients admitted in mental health institute of South India Sociodemographic and clinical profiles of homeless mentally ill admitted in mental health institute of South India State of consultation-liaison psychiatry in India: current status and vision for future Why all COVID-19 hospitals should have mental health professionals: The importance of mental health in a worldwide crisis! The Coronavirus Pandemic and State Response India Lockdown news: India to be under complete lockdown for 21 days starting midnight: Narendra Modi During the Covid-19 pandemic, nowhere is safe for homeless people Lockdown | 200 choultries, marriage halls to house homeless in Bengaluru Homeless mentally ill people and COVID-19 pandemic: The two-way sword for LMICs. Asian journal of J Locked down India struggles as workers flee cities Cost estimation for the implementation of the Mental Healthcare Act MoHFW (Ministry of Health and Family Welfare), Government of India Ministry of Health and Family Welfare), Government of India, Novel Corona Virus (COVID 19), Basic Protective measures Mumbai's homeless at high risk of contracting Covid-19 infection despite BMC's initiative Ministry of Health and Family Welfare, Govt of India COVID-19 pandemic: New challenge to securing mental well-being in conflict settings The Clinical Presentation and Outcome of the Institutionalized Wandering Mentally Ill in India Surviving COVID-19: Struggles of Homeless India Mental Healthcare Act, 2017 and homeless persons with mental illness in India The COVID-19 pandemic, personal reflections on editorial responsibility Uday Foundation, 2020. Coronavirus disease (COVID-19) Donate Care kit for Homeless Nil.