COVID-19 pandemic has raised awareness on the need to pay attention to mental health among governments and policy makers. Whether this will lead to an appropriate response in terms of development of policy, services, more funding and better research should be seen, said Oye Gureje, professor of Psychiatry and Director, World Health Organisaton Collaborating Centre for Research in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, University of Ibadan, Nigeria.
Mental health issues are usually relegated to the background, and now the authorities see how important it was, he said.
“Clearly, the pandemic has raised awareness on mental health and importance of mental wellbeing… This was an unexpected, good outcome of the pandemic. Whether this will lead to the kind of response that we think mental health should receive is another issue, response in terms of development of policy, development of service, more funding and better research. That would be the appropriate response. We have to build on the awareness and keep emphasising it,” he told The Hindu during his recent visit to the city to take part in a conference organised by Schizophrenia Research Foundation.
New challenges were emerging throughout the world because of the pandemic.
“People could not pursue normal economic activities due to restrictions such as lockdowns. It has created tension in homes. There is an increase in domestic violence, something that has happened in many parts of the world. Of course, there are issues in children — restricting them, not being able to go to school and play with their peers. This has had immediate implications in children such as behavioural issues and could have long-term effects as well,” he said.
There is clear evidence of an increase in the need for mental health services, he said. “When we have widespread dislocation and turmoil, the most common problems that occur are anxiety, depression and substance use,” he said.
The first step towards prevention of suicides is creating awareness on mental health. “When people are not aware that what they have is a mental health condition, they do not seek treatment. That awareness creation among the population is important,” Prof. Gureje said.
There is a need to improve the first line of care — frontline providers and family care providers. “They need to be trained and be aware of mental health conditions that could lead to increase in suicidal behaviour. Some of the conditions are better tackled at very early stages but it is easy to miss them if people are not trained. Improvement in the organisation of services is vital,” he added.
This does not have to be only in the health centres but also at the school-level through creation of mental health literacy, he pointed out. “Creation of mental health awareness in schools and among teachers can be a very important step to identify vulnerable children and make services available to them.”
He said that teachers could be trained to identify mental health challenges in children, how they manifest and how they can be picked up. “A teacher might be able to see that a child’s behaviour is changing in the classroom, a child is becoming withdrawn, a child is not paying attention, a child seems to be drifting away when the class is on. A teacher can notice that even though a child seems to be looking at me, the mind is somewhere else. They can certainly help in identifying,” he said.
A big challenge
“In every part of the world, stigma is a big challenge. It is a handicap both for the patients as well as their families. It is problematic for developing services because policymakers have stigmatised attitudes sometimes. That has an impact on the help seeking in many parts of the world, including high income and middle income countries,” he said.
In many parts of the world, there were resource constraints — both material and human resources. In addition to these challenges, in India, services should be improved in some remote parts of the country.
“For example, we are doing a study in Nigeria, India and Trinidad. There are some remote parts of the countries where our colleagues are assessing patients with psychotic disorders. We find a large number of them are not receiving any care at all… So, I think there is an issue of how do you extend care to the hard-to-reach population in India,” he said. “If services are better organised, there will be creation of awareness. People in remote villages will seek care,” he added.
Prof. Gureje stressed on the need to keep building a population of specialists. He called for revising mental health policies to meet the current needs.