Global Mental Health: The Shadow Pandemic

The Coronavirus pandemic outbreak has led the world to a standstill for the better part of the year. But COVID-19 may not be the only health complication that affects people in this extraordinary situation.  Cases of various other health disorders may rise in the near future as a consequence, as suggested by various experts. The most significant and apparent of these pseudo endemics that might ensue in the near future is not a physical disorder, but, mental. The World Health Organisation (WHO) and its parent body, the United Nations, have pointed out the urgency that is required to check the surge in mental disorders due to isolation. “After decades of neglect and under-investment in mental health services, the Covid-19 pandemic is now hitting families and communities with additional mental stress. Even when the pandemic is brought under control, grief, anxiety, and depression will continue to affect people and communities,” Antonio Guterres, Secretary-General, UN, said. Studies in countries like the United States have shown that mental health issues were prevalent in approximately 45 per cent of the country’s population. Similarly, for Australia, a country that has comparatively kept the outbreak under control, top resident mental health experts predict that the social impact of the lockdown may result in an increment of 50 per cent in the suicide rates of the country.

As governments across the world redirect their healthcare facilities towards dealing with the crisis at hand, psychosocial support and emergency mental care have taken the back seat. Also, the problems faced by the people with pre-existing mental disorders due to this have been generally underreported. India, not unlike the rest of the world, has seen a surge in the number of reported mental health issues since the lockdown has been imposed.  A survey conducted by The Mavericks India titled ‘e-Rebooting 2020: A Story of COVID-19, and Shifting Perceptions’ has found that 61 per cent of Indians are currently dealing with mental health related issues due to the looming financial crisis and rise in unemployment due to the lockdown.

“Depression has increased 20 per cent in the people who are living in their house. This is coupled with the anxiety around the risk of catching the virus. This is causing people to reach the peak of general anxiety that we call Generalised Anxiety Disorder (GAD). This leads an affected person to become absolutely worrisome about small thingswhich has further aggravated due to the pandemic,” AanchalTusid, an independent practicing psychologist based in Gurugram, told Urban Update.

To understand the issue better, Urban Update reached out to Sanjivini Society for Mental Health and AASRA, two prominent mental health and suicide prevention helpline NGOs based in Delhi. Responding to the surge in the number of mental health related calls, KalpanaBapna of Sanjivini told us that the cases have increased so significantly that the with limited numbers of counselors tending to the people in distress they have to keep people in waiting lists. “Separation from family, unemployment, and financial issues have been the most common reported issues to Sanjivini,”Bapna told us.

“People who didn’t deal with issues beforehand are also facing issues like anxiety and panic attacks. But for them it is much easier to deal with the problem at hand than for people who are already facing mental problems. Panic or fear over the virus and death goes to pathological levels for them. Those who already have preexisting anxiety issues don’t have the skills to deal with the aggravated problem by themselves. Hence, it is imperative for people who have pre existing mental conditions to seek help immediately. Counseling and reaching out to a psychiatrist is a must,” she said.

There is a perceived stigma associated with reaching out to a psychiatrist, something that has become stereotypical in Indian society. Bapna, however, clarified that, in her experience, in the past 20 years that stigma has gone down significantly. “Especially for younger people when they realise that something is wrong, they are open to see a psychiatrist. It is more the parents that have problems and we generally have to convince them that help is required,” she said.

Johnson Thomas, Director, AASRA, in conversation with Urban Update, told us that the pandemic would have a lasting mental effect on the population. “It is almost like being in a traumatic event for an extended period of time. Hence, most people would end up suffering from post-traumatic syndromes even after this is over.  It is bound to happen as we’re basically trapped within four walls and there is no clarity when you can escape from this situation. And when you get outside for getting basic commodities, the fear of contracting the virus is always there”, he said.

Bapna suggested medication isvery efficient in taking the edge off the anxiety and dealing with the issue at an individual level.  Thomas said that it is best that one develops ways to get physical exercise, deep breathing amongst other ways, within their confines if the problem is not severe. “With this, you can feel calm and tackle the rest of the day smoothly”, he added. 

Domestic Violence: A direct consequence of mental health complications

When asked about the most common cases that have come up to them post the lockdown, Thomas told us that most of the cases reported to them have been centered around domestic issues. “Domestic violence is one issue [that is frequently reported to us], lack of communication and aggression and cases of children not paying attention to their parents and vice-versa are some common problems. In a domestic violence case, there is a strong need for intervention. NGOs are doing their bit to provide emotional support as physical intervention is not possible at this point,” he said.

Rekha Sharma, Chairperson of the National Commission for Women, in the initial part of the lockdown, said that there had been a reported increase in violence against women in India. She further noted that there has been an increase in the number of cases of domestic violence day by day during the quarantine in a later interview and the commission’s lines of communications like email, online portal and social media outlets are functional for women facing issues in any part of the country.

Further, in India, 52 helplines have come up across the country, where victims of domestic violence/abuse can call for help. These helplines are being run by police departments, NGOs and women welfare departments, a Health Ministry official confirmed. 

The rise in the number of domestic violence cases, especially against womenis a direct consequence of growing mental illness. A study conducted by Jacqui True, an Australia based researcher, titled “Gendered violence in natural disasters” observed, “If Gender-based violence and women’s particular needs are not addressed in disaster preparedness, disaster recovery plans, and humanitarian assistance, then women and girls’ vulnerability will increase.” “It is not going to stop. Women need to reach out for help,” Kalpana Bapna said.