A Deep Dive into India’s Mental Health Problem after the COVID-19 Pandemic
Infections and diseases are commonly and incorrectly associated only with physical physical problems. The fact is that each episode of physical problems has mental health components. During the covid-19 pandemic, with every rise in infection and fresh wave, mental health problems have increased. Before the pandemic, the national mental health survey 2018-19 had found that 12% of India’s population has some form of mental health issues. Most of these conditions are mild but 2% of the population have mental health conditions that need regular treatment.
The mental health impact of the pandemic has arguably been higher than the episodes of physical physical problems. In addition to those who tested positive for covid-19, the fear of virus, uncertainties and apprehensions among everyone, the physical problems and death of near and dear ones, reduced sources of income, cost of treatment and many other factors have impacted the mental health of everyone. A study published in the journal The Lancet reported that in 2021, depression and anxiety disorders increased about 25% globally, and by 35% in India.
In 2021, the hospitals and healthcare providers across India have reported an increased number of people seeking consultation and requiring admission-based treatment for mental health conditions. We have personally observed this increase in our medical practice. Cases included old problems re-emerging and new complaints, ranging from very mild to severe conditions. With the emergence of Omicron, there is fresh stress, apprehension and anxiety among people.
How do we respond to the challenge of mental health? The short answer: At an individual level, increase awareness about various aspects of mental health and take a pledge for self-care. At the societal level, introduce concrete policy interventions to increase access to mental health services.
A pledge for self-care
The first thing to remember is that self-care for mental health is not selfish but the right approach. One needs to remember that if you have good mental health and are calm and composed, then you are likely to be more productive in your personal life and can be an effective care provider for others. Then, each of us needs to be aware about mental health red-flag signs. As an example, anxiety and depression are common mental health issues. In both, the changes in sleep and eating patterns provide important early clues. Sleeping excessively or failing to sleep; waking up at odd hours of night and then being unable to sleep; overeating or not feeling like eating, all of these should raise concern.
The other common mental health red-flags are loss of interest in a previously enjoyable activity, difficulty in concentrating, repeated negative thoughts, persistent and pervasive sadness lasting through the day, and persistent low energy levels. If any or more of these symptoms last 10 days or longer, consulting a healthcare professional is advisable.
The feelings and thoughts of helplessness and hopelessness could be a precursor to suicidal thoughts and attempts, and should be taken seriously and professional help should be sought immediately.
Prevention is better than cure is an adage applicable to both physical and mental health. Therefore, everything which is good for physical health is good for mental health and vice versa.
Regular exercise or physical activity, eating healthy, adopting a sleep schedule and allocating sufficient hours to sleep, all help in fighting and reducing stress. Limiting screen time; doing pranayama, yoga and any form of meditation, and staying connected with families and friends are other proven preventive health approaches. We need to make proactive efforts to deal with stressful situations.
One of the sub-groups that has been impacted disproportionately in the pandemic are parents and children. Parents, women especially, had additional responsibility as caregivers to children who were at home as schools were closed. It was stressful for both.
Children often take emotional cues from adults—largely from parents and teachers—therefore, it is vital for adults to manage their emotions well. Parents need to be calm and proactive in conversation with children. Children and adolescents need to be encouraged to talk about their feelings and reach out to trusted family members and friends.
Amid all the challenges associated with the pandemic, there are a few silver linings. One, people are more open to discussing mental health issues. Second, the stigma traditionally associated with mental health problems and care seeking has reduced.
It is time to debunk the myths that mental health issues are an urban or a big-city phenomenon. The pandemic has shown that mental health issues affect people across the country, including small towns and rural areas. In the absence of discussions about mental health, the burden has not been fully recognized.