Dr Brainerd Prince
The Covid pandemic has wreaked havoc on many aspects of our lives. With the mutations and the new wave, most if not all of us have lost people in our networks and we have regularly faced death at close quarters like never before. Covid lockdowns have also had a huge impact on the economy as a whole as well as on the livelihoods of millions of people.While technology companies and Edu-techs have made hay, most traditional jobs have simply vanished. The effect of the Covid pandemic has been on our social lives as well. The mantra of the new trinity is ‘masks on, sanitize hands and maintain social distancing’. And all these three actions that are said to reduce the spread of the deadly virus also directly impede social contact and relationships. Finally, while pandemics like any other catastrophe would have expected to draw people nigh to God, but because of the shutdown of all community activities, some have counter argued that religion and spirituality too have lost ground. People’s faith has equally suffered a severe blow with many unanswered questions about the sufferings and pain that Covid has brought in their lives.
While all these various domains of our human life have been analysed with regard to the rampage caused by Covid, an area that has been neglected or least examined is the area of mental health. Without a doubt it is easier to check body temperature or identify a cough or the other symptoms of Covid on our physical self, than check how Covid has affected our mental health. There are a few more reasons as to why mental health is kept at an arm’s distance and why it is not easily broached.
Just as changes in environment affects our physical health, similarly, it also affects our mental health. However, while it is always easier to identify and know when and where our body suffers or is in pain, in contrast, we are hardly aware when our mental health fails. Also, normally, we do not pause to reflect on the status of our mental health. Perhaps this is because, our mind is not explicitly visible like our body, so mental hurts and sufferings unlike our physical hurts and wounds are not on display to be directly observed. Furthermore, our minds have an enormous capacity to recover and recuperate at a fast pace and thus it is nearly impossible without professional help to even identify any form of sustained mental ills. We have also developed a language in common parlance that downplays mental illness. For example, we assign any mental ill-behaviour to mood swings or stress or even plain tiredness and irritability. This language makes invisible the actual status of the person’s mental health. Another important reason why this area goes unexamined is because of the social stigma attached with anything that is connected to mental health. No one wants to be identified as being unsound, but that is precisely what the popular perception is about a person being identified with any form of failing mental health. Finally, and probably most importantly, since our mind needs to reflect on itself in order to assess our mental health, it is something that does not come intuitively for anyone of us. Often, it is only those around us who in response to our behaviour are able to point us to problems in our mental health. Perhaps it is a combination of these reasons that has kept the theme of mental health away from the conversation on the Covid pandemic.
Perhaps, then, a good question to begin with is – what exactly is ‘mental health’ and how should we understand ‘health’? According to the traditional medical model, health is defined as the absence of illness or disease and emphasises the role of clinical diagnosis and intervention. However, the World Health Organisation (WHO) in 1948 defined health as ‘a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity’. This is consistent with the biopsychosocial model of health, which considers physiological, psychological and social factors in health and illness, and interactions between these factors. This definition was developed in the wake of World War II, when the United Nations created the WHO to spark global health initiatives for individuals all over the world.The WHO definition links health explicitly with wellbeing, and conceptualises health as a human right requiring physical and social resources to achieve and maintain. ‘Wellbeing’ refers to a positive rather than neutral state, framing health as a positive aspiration. From this perspective health is a means to living well, which highlights the link between health and participation in society.A major criticism of this view of health is that it is unrealistic, because it ‘leaves most of us unhealthy most of the time’ (Smith, 2008). However, broadening definitions of health has contributed to improving understanding of the mental dimension of health and wellbeing, and increasing recognition of public mental health as integral to public health. Since the publication of the UK government’s strategy No Health Without Mental Health in 2011, the NHS has been working towards parity of esteem between physical and mental health – in other words, ensuring that mental health is recognised as equally important as physical health in the development, delivery and provision of health and social care services. Perhaps, this is something we can learn from the NHS for our populations.
With regard to the Covid pandemic and the biopsychosocial model of health, while the impact of Covid on the physiological and social factors can be clearly seen, the psychological damage has been hidden most of the time. But how could a virus affect the psychological health of a person? This is a legitimate question but the logic of the answer goes somewhat like this – more than the virus it is the response to the virus that has affected the mental health of the population. On the one hand, the virus itself, in those who have caught it and in others the fear of catching it, has caused great stress that has had a negative impact on mental health. On the other hand, what has seriously contributed to the mental health damage, has been our response to the pandemic. Once it was found out that the Corona virus spread from one person to another via the air, the State has enforced lockdowns and curfews and curtailed social participation. However, if health as wellbeing requires participation in society, then this is precisely what has suffered during the Covid pandemic even if it is enforced by the State to deter the spread of the virus. In other words, the pandemic with its lockdowns and curfews has had and will continue to have an impact on our mental health. Unfortunately, this has neither been acknowledged nor addressed adequately.
The first steps would then be to determine as to what extent the environment of the pandemic has affected our mental health and wellbeing. A quick internet search using the phrase ‘mental health self assessment’ or ‘mental health test’ will give you a few free mental health tests that you can take to assess by yourself the status of your mental health. I used this test which even has a few questions on the Covid pandemic:www.sapienlabs.org/mhq/
Even if one’s overall assessment falls within the wellbeing limits but has certain areas of concern, one should begin to address it by talking this out with friends, confidantes and even family. Let there be no fear or shame. And, of course, if the test results reveal a critical or severe condition then one should reach out to mental health practitioners or even a hospital without and get help.
Finally, I want to say that each of us can also be a mental health caregiver and do basic mental health first aid when we become aware of someone with a need. The skills required to offer immediate first-aid are not specialized and you would already possess these skills at different levels of proficiency. Hone these skills, practice them, and use them to give immediate care to those around you who are struggling with mental health issues. I want to share my top five skills required by mental health caregivers: (1) Compassion and Empathy, (2) Observation and Listening Skills, (3) Communication and Inter-personal Skills, (4) Patience and Humility, and (5) Self Care. These skills are self-explanatory and do not need any further elaboration, except perhaps the last one, which focuses on the responsibility we all have for our own self-care especially if you find yourself helping others. Just one thing to keep in mind – let us not forget that as first-aiders we are not professional mental health practitioners, so let us not play doctor but simply be the first point of contact when we notice mental health breakdowns and then connect the person to professionals who can take it forward.
I would strongly urge each one of us to take these first few steps of self-assessment and the seeking of help. In short, I am suggesting four simple steps for all of us: First – Take a Mental Health Self-Assessment Test; Secondly – Talk with Friends and Family; Thirdly – Seek Professional Help; Fourthly – Be a Mental Health First Aider.All of us have a right to know the status of our mental health and a right to mental wellbeing.
