The Uncertainty Stressor: Response to Mental Health Implications of COVID-19

By Zulnash Shaukat

COVID-19 has increased the workload on the health sector as the cases continue to increase while the curve has still not flattened out. As the world heads towards an uncertain and unchartered territory, people are going into a survivalist mode. Amidst these circumstances, where burden on healthcare has increased, a wide segment of society that faces mental health concerns is being overlooked. The ignorance of the differential impact of the epidemic on people facing mental health challenges may augment the already existing health inequalities.

Pakistan and the State of Mental Health

There is already a lack of mental health awareness in Pakistan at a mass level, including the prevalence of taboos surrounding psychotherapy. The state of COVID-19 lockdown may serve as an additional stressor. One explanation is that due to conditions of confinement, the mental health of not only those who are already suffering from a spectrum of issues, but also the healthy minds can be affected. While many see the lockdown as a way to reconnect with loved ones and spend time with family, people living in abusive households are more vulnerable now with almost no avenues to escape. The lack of focus on mental health and absence of support platforms worsen the wave of fear, anxiety and depression caused by the epidemic. Amongst this vulnerable population, medical staff, security forces such as police, daily-wage earners, people living alone, and the graduating Class of 2020 are few of the worst hit groups.

Our Understanding

The policy response to COVID-19 in Pakistan should also focus on support mechanisms and guidelines to protect the mental health of individuals. An independent e-panel discussion was conducted by Learners’ Republic, attended by mental health practitioners and public policy professionals. The discussion was organized to call for a proactive approach instead of a reactive one.

Dr. Faryal Razzaq, CEO of The FEEL and an Assistant Professor at Shaheed Zulfiqar Ali Bhutto Institute of Science and Technology, highlighted that the uncertain times of today calls for a training of teachers and relevant personnel from academics to provide support mechanisms to students and also provide relief to them. Dr Razzaq opined to pursue both digital resources and on ground outreach to support vulnerable members of the population. She said, “The term social distancing has a wrong connotation associated with it and implies severance of connection. The term she uses is “physical distance with social responsibility”.

Ms. Hira Jamil, a clinical psychologist mentioned that mental health issues among the youth are growing and many of them remain unable to find emotional support from families as depression and anxiety are considered a taboo in our society. She highlighted to enhance awareness that visiting a mental health practitioner should be considered as visiting a physician for any disease.

As pointed out by the World Health Organization (WHO) in its directive on COVID-19 and mental health, a former Federal Secretary endorsed the responsible reporting in order to avoid sensationalization of information which creates further panic amongst the already stressed people. Furthermore, the public policy arena also needs to identify the possible implications of mental health deterioration on socio-economic progress and provide relief to the affected accordingly.

Way Forward

People with mental health concerns can be exposed to barriers in accessing timely health services because of the underlying systemic discrimination against them in health-care settings in Pakistan. While the long-term goal is to strengthen mental health advocacy programs, the need of the hour is to control the exacerbation of mental health problems right now.

1. There is a need for a collaborative approach amongst all stakeholders to devise an effective communication strategy. A mental health directive needs to be circulated at federal and provincial level to endorse flexibility and relief at workplaces and educational institutes.
2. Mauna Gohar, a Clinical Psychologist shared that mental health care routines and practices that can help in sailing through this time are missing. She further said that the professional community in the area of mental health should come up with one vice on practical steps people should adopt to take care of their mental health.
3. A special initiative should be launched by the government to take care of mental health of doctors, nurses and their families.
4. While telemedicine initiatives are providing consultation for not only prevention from corona but also to other regular patients, the same platform should be utilized for psychotherapy.
5. The initiative launched under King Edward Medical University Lahore has psychiatrists available round the clock for people who need help regarding mental health issues, either related to COVID-19 or on pre-existing issues which have been aggravated under the lockdown. Other hospitals should also come forward with such initiatives.
6. A public functionary suggested the use of FM radio stations with talk-back shows as a medium to reach out to the masses and help them recover during these times of despair.
7. Ministry of Information, PEMRA and TV Channels will be approached to request them to organize more TV programs with mental health practitioners. These experts should advise people how to take care of their mental health in this difficult time.
8. Students should come up with a learning routine in order to keep themselves busy and connect with people they trust. Universities need to establish their support systems for students and the Higher Education Commission (HEC) should guide universities in this area.
9. Pakistan as a state needs to exercise compassion to take care of people with mental health challenges.
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   Zulnash Shaukat is a graduating senior at Lahore University of Management Sciences (LUMS) with a major in Economics and minor in Public Management. Her current research domain broadly focuses on public policy of developing urban economies.