Author:
Revathi Rajagopal, Psycho-oncology team, Cytecare Hospitals, Bangalore
Human civilization probably is passing through one of the most crucial phases when its existence is being challenged by the emergence of a novel severe acute respiratory syndrome coronavirus (SARS-Cov-2) that has invaded several territories all over the world rapidly. There are no two opinions about it. COVID-19 has brought mankind to its knees, and nature seems to be having the last laugh. The pandemic has truly turned the world topsy turvy and has affected all aspects of our daily life without a doubt. New rules and norms have been set and are here to stay.
There is still extensive uncertainty around COVID-19 that is ultimately impacting our habits, routines and overall- our lives. We are living in a time of endless unknowns. Our lives are full of movement and change, and very little of it can be controlled. The pandemic has brought in adaptive cycles to human existence that has made this possible by allowing continuous evolution of the larger living system. This means it’s more capable of meeting the challenges and disruptions that it faces. But humans are also living systems and can use nature’s ease and pattern of adaptation to guide them through these disturbances.
In today’s day and age of social distancing, masks and hand wash remains the new norm. When it comes to evaluating our habits, it can be helpful to reflect on specific aspects of our “old” normal lives. Certain questions pertaining to the best and important ways to utilise our time, beginning to see what is essential, what is more meaningful in life, identifying thoughts, feelings or behaviors that are futile that won’t help us in adapting to a new normal are beginning to be viewed through a magnifying glass.
What has been brought to the forefront by this pandemic is the need for man to understand man itself and the need to be more human. A recent survey in Bangalore revealed that more people have hitherto never thought of contributing to any social cause, but are now voluntarily reaching out and helping others in whatever way possible, contributing by way of donations or other direct means.
While basic needs such as food, clothing, and shelter requirements are being addressed to an extent by the government and the NGOs, there is another dimension that the pandemic has created which is far from being addressed. This is the issue of mental health.
Although the COVID-19 crisis is, in the first instance, a physical health crisis, it has the seeds of a major mental health crisis as well, if the necessary action is not taken. Good mental health is vital in the functioning of society at the best of times. It must be the center of every country’s response to and recovery from the COVID-19 pandemic. This crisis has severely impacted the mental health and wellbeing of many societies and as a priority should be addressed urgently.
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The trauma and stress of various kinds owing to the lockdown has affected all age groups from all walks of life; from school going kids to adolescents, to working-class people to senior citizens. In fact, no other world event has ever had as much an impact on mankind as the COVID-19 crisis since the Second World War, UN chief Antonio Guterres stated at the virtual launch of a report on responding to the socio-economic impact of the COVID-19.
Many people are distressed due to the immediate health impacts of the virus and the consequences of physical isolation. Many are afraid of infection, dying, and losing family members. Individuals have been physically distanced from loved ones and peers. Millions of people are facing economic turmoil having lost or being at risk of losing their income and livelihoods. As a result of this, people are being prone to various kinds of psychological anomalies such as increased levels of anxiety, fear, sadness, frustration, irritability, loneliness, depression, anger, increased alcohol and drug use, self-harm or suicidal behavior and the demanding stress-coping-adjustment process which is ongoing.
Frontline healthcare workers and first responders have been exposed to numerous stressors and ensuring the mental health of healthcare workers is a critical factor in sustaining COVID-19 preparedness, response and recovery. A recent Lancet study in December 2019 estimated that one in seven Indians was affected by mental disorders of varying severity that included 45.7 million having depressive disorders and 44.9 million with anxiety disorders.
People who already have mental health issues find it hardest to deal with the uncertainty of the pandemic. Adverse psychosomatic outcomes among common people are nevertheless expected to increase significantly due to the pandemic itself and due to the constant flow of readily available information and reinforced messages that are being circulated online via social networking platforms.
Luckily with the availability of technology, e-mental health is an area open to reach out for help to Psycho-oncologists. Tele-psychotherapy is one such approach. It refers to the provision of psychotherapy services using telecommunication technology including email, text messaging, video conferencing, online chat, messaging, or internet phone by trained mental health professionals. It helps give access to both counselling and even follow-up through online aids. The practice of tele-psychotherapy presents both opportunities and challenges to traditional psychotherapy practice.
It is no doubt a challenge to use communication technology to access and to care and also be effective. Although given the current scenario tele-psychotherapy has proved to be particularly salient in times such as the Covid-19 pandemic when access to in-person psychotherapy sessions is limited, stress levels may be high. These are based on national and international guidelines formulated in response to the emergent needs of access and continuity of mental health services. The immediate need for such e-mental health services to function effectively is to have scientific and ethical validation using user experience and of course maintain confidentiality, data privacy and security.
During the past few months, there have been efforts initiated to support people in distress and to ensure care for people with mental health conditions. Innovative ways of providing mental health services have been implemented, and initiatives to strengthen psychosocial support have sprung up. Because of the size of the problem, the vast majority of mental health needs still remain unaddressed. Therefore it is the need of the hour to access help despite poor investment in mental health promotion, prevention and care by economies. It seems imperative to choose a rather more individual approach to recognise and get the help one needs.