India and Mental Health: The relationship between Pandemic and Mental Health

Overview

The COVID-19 pandemic is not the first and surely won’t be the last disaster that has affected mankind in one way or another. The impact of the pandemic has been exorbitant. Thousands of people have died and many have lost their jobs due to restrictions imposed to mitigate the spread of the disease. There is also an increase in domestic violence and a negative environment brewing behind closed doors. These incidents are not only a problem of these few months, but it embeds in the minds of victims, leaving in disturbed individuals for society. The restrictions imposed and constant exposure to negative news regarding oxygen shortage and the increasing spread of the virus and its deadly variants have impacted mental well-being to a great extent.

Pandemic and Mental Health

People locked up in their homes have increased cases of anxiety, stress and insomnia, and some other mental ailments. People who have suffered the loss of a loved one’s life and could not even perform their last rituals are prone to PTSD (Post Traumatic Stress Disorder) as well. The Current Situation regarding mental health has surely exposed a suboptimal response to the psychological impact of disasters and once again reminded us all of the importance of preparing well for the mental consequences of disasters as well.

The second wave of coronavirus in India has led to a massive shortage of resources in the country due to unpreparedness and inadequate infrastructure. This has made the situation of mental health issues more complex in India considering the socially & economically vulnerable population like children, migrant labourers, daily age labourers etc, lack of mental health infrastructure, the burden of pre-existing mental health conditions, lack of digital initiatives, and above all the misinformation and lack of certainty amongst people.

Affect on Mental Heath due to Disasters

We can take examples of many global disasters which had grave mental consequences as well. The studies of mental health consequences of people affected by disasters like the Chernobyl Disaster and the Katrina hurricane have suggested that women, children, and vulnerable elderly populations have a higher risk of developing psychological disorders. The resilience of working individuals is generally high and the people who are displaced from their homes also have a greater tendency to develop PTSD, Substance Use Disorder, Major Depressive Disorder, etc.

What studies show:

• One study showed that the prevalence of PTSD can be around 30-40 % among direct victims.
• A study of the Texas population impacted by the Ike Hurricane showed that around 5% of them met the criteria for Major Depressive Disorder.
• The Victims of the 26/11 terror attack in Mumbai have also developed Mental Disorders.
• The symptoms include hallucinations, too much skepticism, and insomnia.
• The studies have also shown that man-made disasters impart greater psychological stress than natural disasters.

What the government has done till now for mental health and pandemic:

In the last year, the government has introduced the Aarogya Setu, made use of media to dispense fear vis a vis vaccination, deployed Aanganwadi Workers to support women and children in rural areas and the supreme court has successfully issued an advisory to all health insurance companies to organize a mental health camp for their customers.

Some recommendations by NIMHANS

NIMHANS suggests that a ‘Psychological intervention medical team’ can be formed as a standalone team or be part of the general medical team attending to people affected by the pandemic. The staff should consist of psychiatrists, with clinical psychologists and psychiatric nurses participating and the teams should formulate interventions plans separately for different groups for example,

• Confirmed cases who are hospitalized with severe symptoms
• Suspected cases and close contacts of confirmed cases
• People with mild symptoms who are in-home quarantine
• Health care personnel working with people with COVID-19

As it is, mental health alone is a global challenge in itself and the COVID-19 pandemic greatly escalated the mental health burden as well.

Possible solutions

• Emphasis on patient’s mental health as anxiety and stress can cause the BP and other vitals to fluctuate which affects physical health too.
• Transparency in the healthcare infrastructure of the country so that people don’t live in shade and uncertainty.
• Setting up of mental health booths in covid vaccination centers where people can voluntarily come and survey about their mental health and they can be approached for tele-counseling based on their answers.
• Training of nurses to ask a check on patients and their family’s mental health by asking basic questions.

Conclusion

Although the psychological consequences have a grave impact on overall health. The attention it receives from the government has been very low. A Banglore-based psychiatrist revealed that the number of calls he receives during the second wave of the pandemic has been around 5 times greater than the first wave but still the government is not doing enough for mental health. India’s mental health system is carried by just a few altruistic NGOs which are doing everything they can but still a state-sponsored and state-managed mental health system can benefit large masses especially the underprivileged ones who do not even know about mental health.