By Arlinda Cerga-Pashoja
Physical health is at the forefront of our minds in the context of the COVID-19 pandemic. But our psychosocial health is also critical. WHO and Public Health England have released short guidance on improving mental health during the COVID-19 pandemic and the main messages are: Limit watching or reading news about COVID-19 to one or twice a day; Stay connected and maintain social networks; Try as much as possible to keep personal daily routines; Try to be physically active within your abilities. You can find full guidances here and here. Many others are offering support, including the International Federation of Red cross and Red Crescent Societies, who have a psychosocial centre (See here).
Whilst everyone’s wellbeing is important, there are some important groups of people to consider who are likely to be high risk. The pandemic is particularly difficult for older people, who are at higher risk of serious disease, and in many contexts cannot now be physically close to their families. Psychological issues and burnout depersonalisation are also established as serious concerns for those who respond in a humanitarian crisis. Frontline staff who are responding to COVID-19 in very difficult circumstances, are likely to face similar challenges. In addition, we know that health workers in quarantine during the SARS epidemic had more severe symptoms of post-traumatic stress than members of the general public, felt greater stigmatisation, exhibited more avoidance behaviours after quarantine, reported greater lost income, and overall were consistently more affected psychologically. Early evidence around this for COVID-19 is from China, where front line workers, especially women and nurses directly caring for patients with COVID-19, are reported to be at an increased risk of suffering from psychological problems such as depression and anxiety. There is a recent report on this here.
For those who are experiencing concerning mental health difficulties we would strongly advise to contact your GP or mental health team (if you already have one). Mental health services have not paused their support, and many therapists are offering ongoing support through different means such as telephone, skype sessions and digital interventions. Digital interventions are being used widely in the NHS, in UK, with platforms such as Silver Cloud being utilised to support therapists’ work remotely or as standalone treatments for a wide range of mental health issues. Digital interventions for mental health, have evidence base and have been rolled out in most European countries, USA, Australia, South America, Middle East etc including several low and middle income countries. In a recent initiative The I Fight Depression tool ( https://ifightdepression.com/en) for example has recently launched free access to everyone experiencing low mood in Germany, Estonia, Turkey, Albania and Kosovo etc. Another great initiative comes from Inuka, a social enterprise that works to make evidence-based support accessible to everyone by offering certified coaches via chat, anytime, anywhere and have been supporting people in Romania, Kenya and Zimbabwe. For Covid-19 they have made all coaches available on a pay what you can basis, via inuka.io/covid19, covering among other languages services in Hindi, Kiswahili and Shona.
Thanks for the interesting blog, Arlinda. The importance of mental health in outbreak response has really been highlighted in COVID-19.
I've also seen that there is new guidance from Africa CDC on mental health and psychosocial support, which is here https://africacdc.org/download/guidance-for-mental-health-and-psychosocial-support-for-covid-19/