When President Cyril Ramaphosa announced a lockdown in March last year, interventions were immediately put in place to hamper the spread of the virus. Education about the virus was also pushed up a gear and was well communicated. We were all soon aware of the physical signs and symptoms to look out for. Very little, however, was said about the toll this pandemic would take on our mental health.
And yet, according to Dr Tedros Adhanom Ghebreyesus, the director-general of the World Health Organisation (WHO): “Good mental health is absolutely fundamental to overall health and well-being.”
It is a conversation seldom had, but it is time for it to be magnified.
This lack of emphasis on the importance of mental health is nothing new. Health has always been attached to the physical body and not to the mind. The effects of the lockdown on our mental health, however, is a pressing matter. This is because according to a survey conducted by the South African Depression and Anxiety Group (Sadag), nearly two thirds of participants said that their mental health had worsened during the lockdown. This is significant in our context where statistics show that 230 people seriously attempt committing suicide daily and 23 people die by suicide every day.
The lockdown has added factors which further strain our mental health. These are factors such as job losses, bereavement, isolation and loneliness or fear about the virus. Other factors are best described by an article published in the Journal of Affective Disorders involving 976 participants titled, Psychological distress related to Covid-19 – the contribution of continuous traumatic stress which states: “The severity of an individual’s psychological distress in response to Covid-19 may be related to specific Covid-19-related stressors. Being diagnosed with Covid-19, belonging to a risk group for Covid-19 complications, and perceiving one’s physical health in a negative fashion may all raise substantial concerns during the pandemic and might intensify one’s emotional plight. Having family members or close others who belong to a risk group for Covid-19 might also increase worries and generate or exacerbate psychological distress. Lastly, being quarantined or living alone during the pandemic might also have detrimental effects. Reduced social interactions and loneliness are well-known risk factors for psychopathology and might increase individuals’ vulnerability, particularly under conditions of exposure to stressors. Indeed, a recent review which included 24 studies, found posttraumatic stress symptoms, confusion, and anger among quarantined children and adults.”
All of these reasons have increased the demand for psychology sessions or therapy (let’s term these “mental health services”). South African psychology/psychiatry resources, however, are already limited. This point is confirmed by the WHO statistics which highlight the chronic underfunding of mental health services. According to WHO, prior to the pandemic, countries were spending less than 2% of their national health budgets on mental health, and struggling to meet their populations’ needs. A WHO survey found that the Covid-19 pandemic has disrupted or halted critical mental health services in 93% of countries worldwide.
This already limited supply was further strained by the lockdown regulations and social distancing protocol. Face to face therapy sessions were limited and became teletherapy (telephonic). Teletherapy resulted in its own challenges, firstly because of the disparities in its uptake by different communities. Statistics show that more than 80% of high-income countries reported deploying telemedicine and teletherapy to bridge gaps in mental health, compared with less than 50% of low-income countries. Also, for those who do manage to get these sessions, medication dispersion may be difficult to do and the usual advice of “go out for a walk, find a hobby, enjoy time with friends” to ease mental tension may be difficult under lockdown regulations.
Therefore, now more than ever, it’s important to be kind to one another and treat each other with empathy. Always being aware of those around us and having regular conversations about our feelings is vital. It’s also important to identify things that have been noted as stressors in our lives and in the lives of those around us.
Solutions may be helping out financially when it comes to those who have lost their jobs and assisting them to find employment where possible — reaching out for help if we are the ones who have lost the employment. It’s important to comfort those who have lost loved ones and allow ourselves to be comforted by those around us if we are the ones grieving. We should not allow ourselves and those around us to be alone for too long. It is also important to stick to the lockdown regulations in order to be physically safe and well (even though that does not guarantee that one won’t contract the virus, it does reduce the chances). Lastly, it helps to trust and connect to a higher spiritual power that is greater than us all for strength and hope during this time.
The remaining question is: have the full effects of the lockdown on mental health been reached or will there be an after-effect resulting in the emergence of more diagnoses? According to the research about traumatic stress mentioned above, people could develop a mental illness related to the pandemic, particularly those who have previously been exposed to a traumatic event or have experienced continuous traumatic stress. And suicide is always a risk. With this in mind, however, Suntosh Pillay, a clinical psychologist working in the public sector in Kwazulu-Natal stresses the importance of not pathologising people’s feelings because sadness, anger and anxiety are acceptable emotions and sometimes do not lead to serious mental illness.
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