COVID-19 and its Mental Health Consequences: Detailed Notes

The global community is concerned about the long-term consequences of COVID-19 on various spheres of life, including the economy, industries, global market, agriculture, human health, and health care.
The WHO is focused on controlling and mitigating the impact of the pandemic through identifying, testing, and treating infected people, as well as developing drugs, vaccines, and treatment protocols.
However, the future direction of the pandemic remains uncertain.

The WHO has expressed concern over the pandemic’s mental health and psycho-social consequences.
New measures like self-isolation and quarantine have disrupted daily activities, routines, and livelihoods, potentially leading to:
- Increased loneliness.
- Anxiety.
- Depression.
- Insomnia.
- Harmful alcohol and drug use.
- Self-harm or suicidal behavior.

Lockdowns have led to an increase in domestic violence cases, leaving women and children with no escape from their abusers during quarantine.

A recent survey by the Indian Psychiatric Society indicates a 20% increase in mental illnesses since the coronavirus outbreak in India.
Psychologists and mental health professionals anticipate a global impact on mental health, with rising cases of depression, suicide, and self-harm.

Closing of alcohol outlets has resulted in withdrawal symptoms and suicides among alcohol addicts, as reported in states like Kerala, India.
There are concerns about the development of neurotic disorders such as generalized anxiety disorder and obsessive-compulsive disorders (OCD) in large population groups.
Overemphasis on consistent handwashing (for 20 seconds) may affect a significant portion of the population, potentially leading to OCD and related maladaptive behaviors.

Anxieties have led to hoarding of essential items, causing shortages in many states.
Millions of people have lost their jobs, particularly those in informal and unorganized sectors, struggling for food, shelter, and livelihoods, leading to uncertainty, depression, suicide, and self-harm.

Lockdowns, while important for breaking the chain of transmission, have also caused boredom and monotony among office workers and children.
Children staying indoors may become restless and, in some cases, violent.
Some households have closed windows and doors due to misconceptions about the infection.

The pandemic has been accompanied by a constant stream of rumors and misinformation via social media, creating fear, anxiety, and stress.

Many people exposed to positive cases or those who traveled abroad are reluctant to get tested due to social stigma and isolation.
They fear blame, isolation, and separation from family members.
Counseling from psychologists and mental health professionals is crucial to clarify doubts and provide social and psychological support, compassion, and kindness.
Lessons from the negative impact of stigma on HIV prevention should be applied.

With over one hundred thousand deaths worldwide, providing psychosocial support to bereaved family members is essential.
Children may respond to stress in various ways, such as:
- Being more clingy.
- Anxious.
- Withdrawing.
- Angry or agitated.
- Bedwetting.
Children need love, attention, extra time with parents/family, and reassurance. Separation should be avoided, but if it occurs (e.g., hospitalization), regular contact and reassurance are necessary.
Young children who have lost parents are particularly vulnerable and need a safe, supportive environment, guidance, and help to express their feelings.

The mental and psychological well-being of healthcare providers is a concern.
They work in fearful, stressful, resource-constrained settings under continuous threat of exposure and infection.
Their mental health and psychosocial well-being are as important as managing the health of the infected population.

The WHO has issued a 31-point guidance for mitigating these problems, including guidelines to safeguard mental health for different age groups, with a focus on children, women, and service providers.
These guidelines suggest measures to mitigate anxiety, depression, and stigma.
Various online resources are available to help manage and cope with pandemic-related stress.
Taking care of oneself, family members, and friends, and helping others cope with stress, strengthens the community.

The biggest challenge in mitigating mental health consequences is the lack of mental health professionals, practitioners, counselors, and health facilities.
In India, there are only $0.29$ Psychiatrists, $0.07$ Psychologists, and $0.36$ other paid mental health workers per 100,000 people.
Simple counseling packages that can be delivered at home or in hospitals are needed, emphasizing empathy, support, compassion, and kindness.
Establishing online mental health and counseling services at hospitals, community health care centers, and university psychology departments could address the crisis.
China has implemented emergency psychological crisis interventions to reduce the negative psychosocial impact on public mental health.

States should recognize public mental health as a priority area and formally integrate it into public health preparedness and emergency response plans.