The COVID-19 pandemic has forced many people, who have either tested positive for the disease or are suspected of carrying the virus, to live alone cut-off from their family members and the society. Experts fear that this distressing experience could trigger serious mental disorders like anxiety and depression.
Acknowledging this risk, the Ministry of Health and Family Welfare recently released detailed guidelines on mental health care during the Covid-19 pandemic. The guidelines prepared by the National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bengaluru, listed fear of contracting the illness, loneliness, social distancing, job losses, the stigma of Covid-19, as some of the factors that can aggravate mental health issues during the lockdown.
Union Health Secretary Preeti Sudan has also written to states and union territories, asking them to spread awareness about mental health issues and create an environment to enable open discussions about depression and anxiety.
In her letter, addressed to chief secretaries dated 6 July, Sudan highlighted that there is a need to bring mental health issues to the fore and make them accepted as common ailments. She noted that the lack of knowledge and ignorance can aggravate the problem and suggested that common signs and symptoms of depression and anxiety should be discussed openly so that people facing the problem can seek help.
In fact, she said that mental health services including advocacy and awareness campaigns should be part of the government's response to COVID-19.
Released on 4 July, the ministry's guidelines predicted that India's existing mental health burden can see both aggravations and additions during the pandemic. It stated that persons with pre-existing mental illnesses are most likely to be affected during the lockdowns due to reduced access to medication, which can cause a relapse of symptoms. Among persons with substance use disorders, sudden withdrawal could lead to seizures, delirium, agitation, and even suicide, the document said.
Further quarantine and isolation can increase stress and trigger mental health concerns like anxiety and depression among people. Fear of contracting the illness, isolation from the family, helplessness and guilt associated with behaviours which led to infection may even lead to some people in quarantine to harbour suicidal thoughts, the NIMHANS report said.
The Health Ministry also noted that the drugs currently used to treat Covid-19 may cause psychiatric symptoms. The use of chloroquine, steroids, and anti-retrovirals are associated with psychiatric symptoms like psychosis, delirium, mood disorders, and cognitive disturbances.
In her letter, Sudan also made mention of the steps taken by the Health Ministry to deal with mental health issues during the COVID-19 pandemic. She pointed out that the launch of 24 7 helpline (080-4611 0007) to provide psychosocial support by mental health professionals, a separate helpline for healthcare workers, advocacy on mental health issues, and the guidance document.
Sudan also wrote that the incidence and prevalence of mental health issues are higher in urban areas, especially in metropolitan cities. She noted declining social support in the nuclear families and restricted social networking due to Covid-19 as the major causative factors to this reality.
She stressed the need to focus on preventive aspects of mental healthcare and early detection, but also noted that identification and acceptance of mental health issues are relatively low due to the stigma attached to it.
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