The Coronavirus pandemic has now completely changed the face of the world, on the one hand people are dealing with this spreading virus and on the other hand the ensued lockdown has its own negative impact on people. The lockdown leads to many socio-economic and health problems in India, one such issue is of mental health of people in India. Every individual is now living under the fear of getting contracted with COVID-19.
This COVID-19 Pandemic is more challenging for people suffering from any mental disorders, for example, a lady was found on the roads of Bengaluru, dishevelled, talking to her own self with garbled speech was brought into an emergency room by the police. Lady was homeless, she did not know where she belonged to, and evidently she was mentally ill. She needed urgent treatment, but first, she had to be screened for COVID-19. She lived on the streets uncared for and did not know where she had been. She could have been to railway station; bus stands, shelters or some other crowded places, and might came into contact with many people. She needed to be admitted for serious in-patient care in a hospital ward. But as per the guidelines issued by the Ministry of Family, Health and Welfare she was not under the category to be tested; the people to be tested had to have travelled internationally, or come into contact with confirmed cases, or work in health care. The doctors had to decide what to do in the moment, especially to protect dozens of others who would be affected if she was admitted for care. Finally, she tested negative for COVID-19, but sadly, she was diagnosed with a tumour. If she was to be treated, she would need to wait until other hospitals reopened after lockdown and outpatient departments began to function. With uncertain future of lockdown this mentally ill homeless woman was left to roam alone on deserted roads, at the mercy of whoever could give her food, entirely forgotten by the state in its attempts to contain the spread of the virus.
WHO anticipated the challenges which people are facing, so WHO released a document on mental health considering COVID-19 impact which has several points for general mass
1. COVID-19 had and is likely to affect people from many countries, in many geographical locations. When referring to people with COVID-19, do not attach the disease to any particular ethnicity or nationality. Be empathetic to all those who are affected, in and from any country. People who are affected by COVID-19 have not done anything wrong, and they deserve our support, compassion and kindness.
2. Do not refer to people with the disease as “COVID-19 cases”, “victims” “COVID-19 families” or “the diseased”. They are “people who have COVID-19”, “people who are being treated for COVID-19”, or “people who are recovering from COVID-19”, and after recovering from COVID-19 their life will go on with their jobs, families and loved ones. It is important to separate a person from having an identity defined by COVID-19, in order to reduce stigma.
3. Minimize watching, reading or listening to news about COVID-19 that causes you to feel anxious or distressed; seek information only from trusted sources and mainly so that you can take practical steps to prepare your plans and protect yourself and loved ones. Seek information updates at specific times during the day, once or twice. The sudden and near-constant stream of news reports about an outbreak can cause anyone to feel worried. Get the facts; not rumours and misinformation. Gather information at regular intervals from the WHO website and local health authority platforms in order to help you distinguish facts from rumours. Facts can help to minimize fears.
4. Protect yourself and be supportive to others. Assisting others in their time of need can benefit both the person receiving support and the helper. For example, check by telephone on neighbours or people in your community who may need some extra assistance. Working together as one community can help to create solidarity in addressing COVID-19 together.
5. Find opportunities to amplify positive and hopeful stories and positive images of local people who have experienced COVID-19. For example, stories of people who have recovered or who have supported a loved one and are willing to share their experience.
6. Honour carers and healthcare workers supporting people affected with COVID-19 in your community. Acknowledge the role they play in saving lives and keeping your loved ones safe.
WHO also referred some advices for different categories like health workers, child carers, isolated people.
These are the instructions which can be followed by normal person to stabilise mental health but those who are going through Severe Mental Disorders (SMDs) are more vulnerable now because of lockdown. By late March, outpatient departments, including psychiatric outpatient departments of large institutions like the National Institute of Mental Health and Neuro-Sciences (NIMHANS) had to close. There is also difficultly in providing medicines to last mile patients. For patients living with psychosis, a variation in lifestyle in the home and changes in routine can be threatening . With crowded households and all family members at home, the stress of managing emotionally is demanding for the persons with SMDs. A critical comment from a family member can be very hard to cope with. Family members of people with SMDs will be further strained due to lack of access to the hospital and time outside their role as caregivers, and sometimes even because some patients can tend to wander away from home, which puts them at high risk of contracting COVID-19. This situation gives a valid reason to include mental health in Public health infrastructure. Not only psychiatric patients are at threat but also many psychological problems are arising due to this Pandemic, among which the biggest is fear of contracting COVID-19.
To deal with such situation many private and public institutes are now offering tele-medicine and tele-counselling services, they are now providing prescriptions online. Also now there is a bigger need of providing economic stimulus because increasing economic distress leads to many psychological issues. This is the time when Public and Private health sector must converge their efforts and help India in coping up with this stressful situation.
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