Mental health in the time of COVID-19 outbreak

In January 2020, while some of the top opinion leaders discussed the roadmap of improving mental health globally, what no one saw coming was the damages that the spread of a flu-like virus will inflict on these efforts and the humankind.

Mental ill health remains an epidemic

The novel coronavirus has stirred some very strong emotions in us: fear, trauma, grief and anxiety. The COVID-19 outbreak in several countries and with the news related to the disease, there is a strong likelihood of a dip in the mental health of the people at large. There are plenty of reasons for this mass panic — loss of lives and livelihoods; economic slowdown, rising health care costs; uncertainty; misinformation, over-information and also lack of appropriate information; isolation and separation from loved ones, and so forth.

The World Health Organisation taking note of this situation has listed certain health considerations developed by its Mental Health Department as support for mental and psychological well-being during COVID-19 outbreak. It rightly advises people to not attach the disease to any ethnicity or nationality and advocates empathy towards those who are affected, in and from any country.

According to a WEF report, mental ill health remains an epidemic: more than one in ten people worldwide suffer from some kind of mental disorder at some point in their lives, with depression and anxiety alone costing the economy $1 trillion a year as well as taking a terrible human toll. In low-income countries, there are only two mental health workers for every 100,000 people.

The COVID-19 outbreak has been the nature’s way of forcing us to slow down. Let us take heed, reflect and respond responsibly.

- Alisha Moopen, deputy managing director, Aster DM Healthcare

Mental health has huge bearings on the socio-economic fabric of the country; health impacts productivity, productivity drives consumption and corresponding economic growth propels societies forward.

There is a constant state of conflict (in various forms) across the world, arising primarily from the overwhelming fear of rapid change which makes people adopt a bunker approach which is very inward looking and self-focused. What we need is a win-win approach that will enable people to create constructive solutions to problems.

People are often extremely guarded when speaking about mental health issues vis-a-vis talking about physical ailments. The biggest deterrent is the stigma people attach to mental health problems. Stigma not only restrains people from seeking help (and treatment) but also pushes them farther away from normality with a lowered self-esteem, increased probabilities of self-harm, depression and other behavioural challenges. When I reflect back on our own experiences with extending this care, both to our staff with a 24/7 helpline and to our new moms post-delivery, I was shocked to see next to no use of such a service because of lack of acceptance and fear of being exposed.

Challenges around mental health cannot be addressed in a piecemeal manner but requires concerted efforts from the civil society, policymakers and health care practitioners. The good trend we are seeing is that the millennials and young generation are not afraid to talk about it. What we need is the government to include these in policies and to allow our population to not suffer in despair but with hope for recovery. India took a giant leap in this direction by decriminalising suicide attempt by someone with the notification of the Mental Healthcare Act 2017. It states that any person who attempts to commit suicide “shall be presumed, unless proved otherwise, to have severe stress” and that the government will be duty bound to provide care, treatment and rehabilitation to the person who attempts suicide, so that he or she doesn’t make such an attempt in future. Similarly, in January 2020 Singapore also amended its Penal Code to decriminalise attempted suicide.

How we ignore the signals of the body and mind

Mental health is included in UN’s Sustainable Development Agenda as a part of “universal, integrated and transformative vision for a better world.” Mental health is also identified as one of the key performance indicators of world class health care in UAE’s National Agenda with directions to integrate this into primary health care services. Changes such as these lays the foundation of an ambient atmosphere where more people may choose to reach out for help over suffering in silence.

However, given the magnitude of this problem it requires a sea-change in attitudes, policies and health care infrastructure to truly create a dignified and inclusive environment for those affected by it. This can be achieved with a three-pronged approach: public education; quality health care infrastructure; and increased public health expenditure. This will need to be supported by an action plan necessitating proactive efforts to encourage people to come forward and seek help.

My greatest take away from Davos is that whether it comes to the economy or personal health, it requires a conscious effort by individuals to engage and be in the mindset to find a solution and be active in its execution.

We often tend to ignore the signals that the body and mind are giving us. We need to be more attentive towards small broken messages from our body: from increasing body weight, increased stress, increased burnout to the increasing incidence of non-communicable diseases. The need of the hour is a more engaged patient and consumer who gets up and takes control of their own health as the new age diseases are mostly triggered by sedentary lifestyles and behaviours.

There are many divergences from all sides that take centre stage but at the end of the day, we have to take care of the self and this needs to be prioritised. Be conscious of self, be mindful, be kind and ensure you follow your purpose with passion. The role we have in this world is to do good and do well. This starts internally to then be extrapolated to those around us and enhance the impact we have demonstrated. Sometimes, it may just help to keep it simple and stick to the basics: that is using one’s mind and brain for a cognitive revolution to not be in a rat race but in a mindset to collectively and collaboratively drive positive change. This results in business growth, self-growth and better societies which are sustainable.

Let us calm our minds and let this stillness make us more aware and let the healing process happen naturally. Our body and mind is capable of incredible recoveries and we just need to seek it and help it with our smallest to biggest choices of living our life and respond to it.

Meditation is a great tool to help us relax and relieve stress. So is slow breathing to help calm our nerves and pace ourselves better while we get worked up. We need to physically slow down activity externally and internally of all our organs. This simple slowing down helps tremendously to manage any stressful situation better. There is a lot of research around walking on grass and seeing nature specially the trees that helps to relieve stress. Maybe those with gardens or windows looking out could look at such options. Listening to sounds of the rain or ocean also has a calming effect on people. At the end, nature heals and we have to find a way to immerse ourselves back in the sounds and sights of nature to get our balance. The world inside is the world outside.

While we practise physical ‘social distancing’ and ‘self-isolation’ to contain the spread of COVID-19, let us ensure to use technology to connect with those who need us or even to express our own anxieties. It is extremely important to communicate in times when the world looks so grim.

Let us create a peaceful mind inside and appreciate the world outside. The COVID-19 outbreak has been the nature’s way of forcing us to slow down. Let us take heed, reflect and respond responsibly. We owe ourselves and the world that.

— Alisha Moopen is deputy managing director of Aster DM Healthcare