Covid-19 has achieved pandemic status worldwide. But countries battling this crisis have not yet fully explored its psychological impact. People are in a state of constant fear and deep anxiety as there is no final word on how long this pandemic will linger on.
People are now told to make up their minds to live with this virus for a long time without any clarity. However, the psychological impact on our migrant workers is clearly visible from what they are saying and doing in the wake of the pandemic and lockdown. Mental trauma and the threat infection are now firmly entrenched in the minds of the people and it is most likely to have an adverse impact on the mental health of the sufferers and their well-being. Researchers and psychologists should try to analyse the nature and gravity of the mental impact on all sections of society including children.
No doubt Covid-19 is killing people daily worldwide and its effects on the body are known to one and all. But people will also die because of its psychological impact, slowly and silently, and that will not make any headlines. Today, everyone is busy ascertaining the effects of the disease on people's physical health, the economy and the nation at large.
At an early stage, the World Health Organization had issued guidelines for managing the problem from both biomedical and psychological points of view. As per its guidelines, while preventive and medical action is the most important aspect, emergency psychological crisis interventions for people affected by Covid-19 are also very significant which cannot be ignored. In addition, it is also important to monitor adverse psychological impacts and psychopathological symptoms during the pandemic and thereafter as well.
According Dr Krystal M Lewis, who is an evidence-based clinical psychologist at the National Institute of Mental Health NIMH (USA), which is the largest research organisation in the world specialising in mental illness, “Covid-19 has caused increased anxiety and panic given the health risks. Those with anxiety around health and wellness, contamination and germs, safety, and separation from family members and loved ones may experience increases in mental health difficulties. Given the extended stay-at-home order, we are seeing increased anxiety and depression in some young people as a result of the change in their routines, having less access to their social networks, experiencing increased family conflict, grieving lost opportunities, and increased worry about the future. Generally, most people will move through this pandemic and experience moments of anxiety and sadness, but ultimately will return to baseline when the stressors are minimised. However, for some, this pandemic will lead to continued mental health difficulties. Research does demonstrate that long periods of isolation and lack of access to resources can have a negative impact on mental health and psychological functioning. There are studies now being conducted to explore the long-term impact of Covid-19 on mental health."
On what other countries should do to minimise the psychological impact, Dr Lewis said, “Physicians and mental health providers should have open conversations about the importance of mental health and encourage people to seek help when feeling stressed. There needs to be a push to reduce stigma that surrounds mental health. In order to minimise the impact, providers should promote positive stress management strategies and normalise the experience of anxiety and fear during this time.”
“Research evidence gathered after the onset of Covid-19 suggests that the pandemic has adverse consequences at psycho-social levels universally, said Dr DS Faruquie, executive director, Oxford Evidence and Interventions and director of Centre for Evidence-based Policy, Practice and Interventions (CEPPI). "Since the World Health Organization has expressed that Covid-19 is going to stay longer and has declared it as a likely endemic, the world will see a new order of mental health practice. Evidence-based approach to policy and research provides a pragmatic standpoint in establishing interventions and guidelines for mental health areas. Therefore, new guidelines and methodologies to practice in the post Covid-19 era will be established accurately and appropriately with the help of evidence-based approach. Covid-19 has cast its effect on the hazard of multitude of psycho-social outcomes such as anxiety, depression, social isolation, loneliness, and self-inflicted injuries whether physical or emotional and amounting (in some cases) to suicide. The evidence-based approach to extenuating the effects of these problems is to deliver carefully developed psycho-social interventions that operate on the feedback of standardised outcome measures. The interventions will be manoeuvred as primary (directed to all Covid-19 patients or lockdown affected), secondary (intended to eliminating or reducing existing risk), or tertiary (aimed at improving outcomes for affected with mental issues in Covid-19 context) all in the form of online clinics and community support system,” Dr Faruquie said.
The Covid-19 period provides opportunities to explore new ways and methods for mental health professionals such as establishment of wider public e-mental health approaches, a shift towards digital, novel interventions that are mainly powered by theories of behaviour change and prosocial behaviour. The quest of achieving most-effective and cost-effective interventions will be informed by identification of their barriers and facilitators, adaptive new M & E methods and their implementation in the form of large social experiments designed across population clusters. As part of this drive, CEPPI is developing an evidence-based digital intervention meant for those who are facing Covid-19 related psycho-social challenges. A beta version of this intervention will be delivered to the affected people in an experimental setting.
Dr Tracy Wharton, associate professor of social work and medicine at University of Central Florida, USA, said, “Separated from the physical rituals of moving from place to place- such as going to work, or returning home after work, it is much more difficult to keep routines and maintain work standards. For those able to work from home, the boundary between work space and personal life gets diffused, and this can break down carefully delineated boundaries. For those who do not have access to stable internet connection and video capability, they have not only lost connections to others, but are subject to knowing they are being excluded from the growing list of online activities and group meet-ups that are happening. This exclusion highlights a class divide that will have impacts far into the future, as youth are unable to link up to educational resources, strategic planning for communities happens in online spaces, families are unable to connect across miles, and friends are isolated for extended periods of time. Family milestones continue to happen, as in any disaster, and those who are fortunate to be able to 'link in' via technology still experience the emotional impact of seeing small images of each other and missing physical contact, while those without such access miss out on these milestones entirely.”
On its impact on migrant workers, Roomana N Siddiqui, professor and chairperson,department of psychology, Aligarh Muslim University, said, “The once starry-eyed people moving to the cities in search of a better livelihood are braving the heat and storm on the roads of metropolitan cities on their own. The visuals of mass exodus of migrant labourers from the cities is a saga of dejection, betrayal and abandonment. They worked tirelessly day and night so that others can sleep comfortably, but when they needed a helping hand it was missing. To add to their misery, arrangements were made to bring back those stranded abroad but none for them. This lack of sensitivity to their needs and desperation to reach their homes has added to the stress level and feeling of helplessness and hopelessness. This trauma of uprootedness is going to haunt their psyche for a long time."