MENTAL HEALTH DURING COVID-19 OUTBREAK

Sir,

The novel coronavirus was declared a pandemic in March 2020 by the World Health Organisation (WHO). Public health authorities around the world and WHO have been working tirelessly to try and contain the virus. However, it is essential to communicate and support mental and psychosocial wellbeing in different target groups during the outbreak.

Message for the general population
Fear, stress and anxiety are normal reactions during abnormal times such as these. However, it is more important to support each other. We must also be empathetic to all those who are infected and affected by COVID-19. Therefore, it is important that we do not label them as ‘COVID1-19 cases’, ‘victims’ or ‘COVID-19 families’ or ‘the diseased’. They have not done anything wrong and they deserve our support, compassion and kindness.

Advised

People are also advised to minimise watching, reading or listening to news about COVID-19 that cause distress, but instead seek information only from trusted sources like WHO and local health authorities. This will help people to take practical steps to prepare their plans and protect themselves and their loved ones. The sudden and near constant stream of news reports about an outbreak can cause anyone to feel worried. Protect yourself and assisting each other in times of need can benefit both the person receiving support and the helper. This can be done by telephone, social media and physical visits whilst observing social distance and wearing face masks to avoid transmitting the disease.

Avoid

If you must stay at home, it is advisable that you maintain a healthy lifestyle (a proper diet, sleep, and exercise and minimise contact even with loved ones at home).  Avoid using tobacco, alcohol or other drugs to cope with your emotions. If you are feeling overwhelmed, talk to a health worker, social worker or another trusted person in your community (religious leader or community leader). It is advised that one must have a plan in place to go seek help for physical and mental health needs, if required.
Older adults may become more anxious, stressed, angry, withdrawn and over suspicious during the outbreak particularly because they may be vulnerable due to limited information sources, weaker immune systems and higher COVID-19 mortality rates in older population.

Share simple facts about what is going on and give clear information about how to reduce the risk of infection in words older people with/without cognitive impairment can understand and repeat information whenever necessary. Instructions need to be communicated in a clear, concise, respectful and patient manner. Engage family members and other support networks in providing information and helping people to practice preventive measures like hand washing.

Chronic

For adults with underlying chronic health conditions (e.g. diabetes, kidney disease and HIV), ensure that they have uninterrupted access to essential medication and ensure adequate stock for at least four weeks. Also, ensure that they maintain a healthy lifestyle like physical exercise which may be as little as going around the yard, eating well and getting enough rest. Routine change should be minimal.

People living with mental illness, learning difficulties, and neurodevelopment disorders.
There is a need to also consider vulnerable groups including those with severe mental illness, learning difficulties and under developmental disorders as they may be neglected and forgotten yet they are also part of our society and need to be attended to just like anyone else.

Explain

Explain to a language and level that they can understand so that they are able to have a picture of what is going on and also try to follow safe precautions. Teach them on how to wear a mask, properly washing of hands and maintain a social distance so that they are also safe from contracting and passing on the virus. There must be little alterations to the routines as they may not be cognitively fit to assimilate a lot of information at the same time and a drastic change of routine may result in regressing in their development.Older people with mild cognitive impairment or early stages of dementia need to be informed of what is happening within their capacity and provided support to erase their anxiety and stress.

National Referral Psychiatric Hospital

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