Mental health crisis: An unintended consequence of Covid pandemic

As parks, sports complexes, community centres, markets, malls, places of worship etc., are either closed or have restricted entry, the people who badly need to avoid social isolation are forced to stay at home. Among them, the worst off are those who were earlier dependent on social care and other voluntary services.

Mental health crisis
Mental health crisis

We are living in an unprecedented time. The world as we know it, is getting transformed owing to global pandemic. We are witnessing a shift in the ways we live, work and interact socially with others. The changes owing to pandemic are impacting not only our socio-economic and political life but also our psychological and mental wellbeing. In the absence of any effective anti-viral drug or a vaccine/acquired immunity against coronavirus, the only available option to handle this pandemic of coronavirus diseases of 2019 (COVID-19) is to keep ourselves in safe distance from others to avoid getting infected.

 To maintain a safe physical distance from each other is what we call ‘social distancing’. As recommended by the Centre of Disease Control and Prevention (CDC), Atlanta, USA, to practice social distancing, we should not only stay at least 6 feet (2 arms’ length) apart from others but also not to gather in groups or participate in any gathering. World Health Organization (WHO) has also outlines their advice to countries in a statement, stressing that ‘a mix of social distancing, testing and contact tracing and isolation will be crucial to curb the spread of corona virus already devastating much of the globe’

As a result, social distancing is now pivotal to the preventive measures recommended by the government and other institutions including experts. However, there is a huge impact of social distancing, as being enforced by the government in the country. Though primarily the intention is to prevent Covid infection through ‘physical distancing’ i.e. to keep a safe distance from each other but in practice, we are unintentionally isolating many people belonging to vulnerable section of society like elders.

 Already the country is facing tremendous pressure on economic front due to prolong lockdown in various parts of the country. As a result, the people are deeply impacted by way of loss of jobs and livelihood, deep uncertainty (as to how long pandemic will last), fear of infection, dying and losing their family members. Losing a job is one of life’s most stressful events. Huge workforce has either lost or is at the risk of losing livelihoods due to complete or partial shutdown of economic and commercial activities. We can well imagine the severity of suffering and emotional distress of their families on the loss of regular income.

Even people are fearful to visit hospitals, nursing homes and health centers due to fear of getting infected with COVID-19. The lockdown has brought pain and suffering for other patients who aren’t infected with corona, especially those who need treatment and medication for serious ailments. There is a fear psychosis driven by fake news, psychological anxiety, uncertainty and insecurity. Incidents of domestic violence have increased sharply as relationships become bitter and strained when people are forced to sit at home with no work. This has led to increased psychological distress and suffering among vast population.

The healthcare workers who are fighting on the forefront of pandemic are among the worst affected. They work not only with the fear of getting themselves infected with Covid-19 but also to infect their family members. Besides, they work under very challenging and stressed environment with long working hours. They are required to spend their duty hours, with masks, gowns and PPEs, mostly places without air condition. The healthcare professionals are seeing patients, who are mostly alone and away from their close family members, dying from Covid-19. In many hospitals where corona infected patients are being treated, frontline workers are closely encountering dead bodies dailies in large numbers. Under the circumstances, there is a real risk of sharp increase in mental health problems in those workers.

Even before the pandemic of Covid-19 stuck the world, the problem of loneliness and other mental illnesses like depression and anxiety were taking the shape of an epidemic in various parts of the globe. In India, according to Lancet report titled: “The Global Burden of Disease Study 1990- 2017” released in February, 2020, nearly 197 million people were suffering from mental disorders in India including 45·7 million with depressive disorders and 44·9 million with anxiety disorders.

One in seven Indians were affected by mental disorders of varying severity in 2017. The cases are almost doubled since 1990. Loneliness is also a kind of mental health problem, spreading fast in various parts of the world. Increasing number of people are becoming lonelier. Even in India, senior citizens living alone have increased multi-fold in recent years. They rarely speak to their families or close relatives on phone. Hardly anyone close to them visit their homes.

 Now with social distancing being in force, the problem of their isolation or loneliness has sharply deteriorated. As parks, sport’s complexes, community centres, markets, malls, places of worship etc are either closed or have restricted entry (people above 65 are generally not allowed), the people who badly need to avoid social isolation are forced to stay at home. Among them, the worst are those who were earlier dependent on social care and other voluntary services.

Many experts and institutions including WHO and United Nation have warned that high levels of emotional and mental distress from COVID-19 pandemic may lead to a mental health crisis. Social distancing has deeply impacted the migrant labourers and urban homeless people due to increased impoverishment. Those who need the support most from the government machinery are collectively in a state of trauma. Currently, they are not in a position to get any care and support for consultation, therapy and medication to overcome severe distressed conditions. Even during period before COVID-19, most of these people either they don’t know they have a mental health problem or afraid of seeking professional help owning to social stigma. That’s the reason, hardly one-tenth people suffering from mental illnesses seek medication or therapy.

The debate between lives and livelihood is becoming sharper day by day. It’s obviously a subject matter where both the sides seem equally strong. However, when we weigh the arguments of either side, we tend to ignore the huge impact of shutdown on psychological and mental wellbeing of vulnerable class of people. We simply overlook the people who are getting isolated or lonelier by way of social distancing, the way it’s being enforced. We wilfully become blind to hidden cost of increasing number of mental health problems including serious mental disorders like depression and anxiety. Various studies across many nations have confirmed the trend.

This is the right time that the Central Government should come out with national framework/policy guidelines for elderly and other psychologically vulnerable people for ensuring adequate safeguards against social isolation, loneliness and mental illnesses as a consequence of corona pandemic. Social care and psychological support including counselling and therapy through government institutions and NGOs should be extended through right mix of technological intervention and personal contact. Otherwise, the very obvious fallout of COVID-19 pandemic will be the mental health crisis, which is already showing signs of emergence and being warned by global agencies like UN and WHO.

Balvinder Kumar is Member-Uttar Pradesh – Real Estate Regulatory Authority (UPRERA). As an IAS officer, he served as Secretary, Ministry of Mines; Vice-Chairman of Delhi Development Authority (DDA) and Vice Chairman, Lucknow Development Authority (LDA). He is the author of two books – ‘Redesign Your Life in Modern Age’ and ‘Explore Your Life Journey’.