Mental Health In The Time Of Pandemic

Mental health is not just about presence or absence of a mental illness but is a crossroad between emotional, psychological, and physical well-being. The issue of mental health has become crucial due to COVID-19 pandemic.

• Along with the health impacts of the disease, COVID-19 has led to, self and social isolation, disconnection from family and friends, quarantine and lockdowns on movement resulting in more people experiencing feelings of helplessness, isolation, grief, anxiety and depression.
• According to World Health Organization survey, over 60 per cent reported disruptions to mental health services for vulnerable people, including children and adolescents (72 per cent), older adults (70 per cent), and women requiring antenatal or postnatal services (61 per cent).”

Reasons for Mental Health Issues during Pandemic

• Fear of Death: Since anyone of any gender and socio demographic status can be infected, individuals experienced mental health issues such as fear, anxiety or depression of falling sick or dying.
• Economic Insecurity:Many people have lost their jobs or are working reduced hours. The collapse of industries resulted in widespread unemployment and financial losses. Many people are earning their livings on a daily basis, often in the informal sector, so lockdowns resulted in loss of livelihood and income leading to mental health issues.
• Stigma: Persons who are sick or quarantined may experience shame, guilt, or stigma. Longer duration of quarantine was associated with an increased prevalence of post-traumatic stress disorder symptoms correlating with symptoms of depression.
• Lack of Social Support: People under quarantine or in isolation in hospitals are at increased risk of psychiatric issues, as they are deprived of their social supports and risk uncertainty for repatriation, thereby necessitating practical and emotional support for them.
• Government Inability to Provide Necessary Infrastructure: At the community level, there could be distrust towards other individuals in terms of disease spread and the government and healthcare services in terms of their capability to manage the outbreak.
• Loss of Loved Ones: The traumatic and sudden loss of loved ones from the outbreak has led to depression, anxiety and panic attacks.
• Other Factors: Disruption to education, intimate partner and family violence, issues of working from home, increasing uncertainty , restricted movements, etc. are risk factors for mental health conditions and behavioural problems such as depression and substance use disorders

Efforts by WHO

In 2020, a wide range of resources were developed in many languages by WHO in collaboration with partners, including: a stress management guide for the general public; a guide for COVID-19 responders on basic psychosocial skills; and a toolkit to help older adults maintain mental well-being.

• During the World Health Assembly, delegates endorsed the Comprehensive Mental Health Action Plan 2013-2030.
• The Assembly urged Member States to develop and strengthen comprehensive mental health services and psychosocial support as part of universal health coverage, with a focus on improving understanding and acceptance of mental health conditions.

Efforts by Government to Tackle Mental Health Crisis during Pandemic

Realizing the impact that COVID-19 may have on the mental health of the people, the Government has taken a number of initiatives to provide psychosocial support during COVID-19. These initiatives include:

• Setting up of a 24/7 helpline to provide psychosocial support, by mental health professionals, to the entire affected population, divided into different target groups viz children, adult, elderly, women and healthcare workers.
• Advocacy through various media platforms in the form of creative and audio-visual materials on managing stress and anxiety, and promoting an environment of support and care for all.
• Issuance of detailed guidelines by the National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru- "Mental Health in the times of COVID-19 Pandemic - Guidance for General Medical and Specialized Mental Health Care Settings".
• All the guidelines, advisories and advocacy material can be accessed on Ministry of Health and Family Welfare website under “Behavioural Health – Psychosocial helpline”.
• Online capacity building of health workers by NIMHANS in providing psychosocial support and training through (iGOT)-Diksha platform.
• Funding 25 Centres of Excellence in Mental Health and 47 PG training Departments in Mental Health specialties to increase the PG training capacity in mental health as well as improving the tertiary care facility
• The District Mental Health Programme (DMHP) has been extended to 692 districts of the country, under which, enhanced financial assistance of upto Rs. 83.20 lakhs per district per year is being provided to the districts for detection, management and treatment of mental health issues.
• As mandated by the Mental Healthcare Act, 2017, mental healthcare services have been integrated into general healthcare services like National Health Mission, PMSSY, Rashtriya Kishore Swasthya Karyakram, AYUSHMAN Bharat, PMJAY, etc.
• The Ministry of Education has undertaken a proactive initiative, named, ‘Manodarpan’, covering a wide range of activities to provide psychosocial support to students, teachers and families for Mental Health and Emotional Wellbeing during the COVID outbreak and beyond.

Possibilities and Prospects

To address the mental health issuesand increase the capacity and availability of support, governments, local communities and civic organizations need to increase the resources directed towards addressing psychological suffering, now and after the pandemic has passed.