State's response to Mental Health Crisis due to COVID-19 By: Kaustubh Srivastava

The Author, Kaustubh Srivastava is a 3rd Year student of Dr Ram Manohar Lohiya National Law University, Lucknow.

The plight of Covid 19 has become more and more threatening to the world with the number of people infected with the virus soaring every day with no sign of any potential slowing down or vaccination in sight. Countries and their Governments are trying to fight the pandemic in one or the other ways as and well suited for their citizenry.

Many countries have imposed lockdown and have mandatorily blanketed the isolation, like India, Italy and other European Countries, whereas, others are trying to save their faces in denial like Brazil. The most effective method of prevention at present available for the Government’s disposal is lockdown and forced isolation. It is hence understandable why the Government of India would impose a 21 day lockdown, to prevent the virus from further spreading faster.

But with few days left to the end of initial set lockdown, unless the Government is forced to extend it, a lot of ancillary issues have surfaced which has tested the foresight of the governments imposing the lockdown and one of these many issues if the problem of mental health. As observed across the world, many countries have seen an exponential increase in the mental health issues and cases, during the imposed lockdown. This especially affects the poor, the lower and average middle class.

Even in India, the presumption that living at one’s home with the family should be very convenient for one’s safety and dwelling. But trends have suggested that a generation conditioned and cultured by the forces of capitalism is not used to finding time for concomitance and cogent dwelling and is often exposed to the worst existential truths, themselves. This is even further intensified when the living conditions of poor and the daily wage worker is considered. For a very convenient example, our daily maids have now found themselves being locked inside their homes, with no guaranteed source of income. On a surprising scale, these domestic helpers face the issues of domestic violence and problems related to poverty. This impact has become more and more threatening to the every class of people who have tried to accommodate themselves in this new secluded schedule. Mark Townsend has reported on Guardian on 4^th April, 2020 that one of the most pertinent impacts of Lockdown on the population living in UK has been soaring numbers of domestic violence. This is just one example of distorted family dynamics that the situations are highlighting today. The investment of states in the conditioning of family welfare and development has mostly been economic in nature for far too long, and now, since people are forced to live with their families, locked in houses, it is becoming a glaring need of the hour.

Some researchers from the Harvard University[1] have evaluated the collective impact of the lockdown on the country worst hit by the disease in terms of the scale of impact and numbers of deaths, Italy. They suggest, “The quarantine is beginning to have serious negative effects on the population’s mental health… Communications should move from explaining to citizens that they should stay at home to what they can do there.”

Their survey on the population clearly show that there is a struggle amongst the people with the limitations on freedom to venture out of their houses, enjoy the pleasures of fresh air, exercises and social interactions, which has surfaced loneliness and boredom amongst people. It is also observed that groups of different classes are facing the situations in different capacity. The middle class or the class which can afford staying at home is facing problems of family conflicts and space issues in their lives. One could ignore this problem owing to the privilege of the class, but the intensity and the impact of the problem is too real to be set aside. The governments, like the Government of India, are now adopting the suggestion of the authors and researcher’s suggestion of “morale-boosting” activities, as apparent with the Hon’ble Prime Minister’s continuous efforts like 9 pm 9 minute, in solidarity with the professionals working on the front. The attempts are being dramatized in media to an altogether different extent, and is dismissing the sociological value of such impacts and reducing the value of such efforts to mere gimmicks. The researchers also suggest, “If we look for activities and interventions that make the quarantine easier for those affected by it, the population may be able to better tolerate the treatment for as long as it takes to overcome this public health crisis”. The dissatisfaction with the Governments and their actions is another vital ground affecting the mental health. The same has been observed by the researchers in the report as, “Though 78% of respondents believe social distancing is an effective health measure, only 62% think the government’s reaction to the crisis is appropriate (rather than extreme or insufficient) and 36% think the (rest of) public’s reaction is appropriate. Additionally, a slim majority of 58% believe the government has been truthful regarding information about the crisis, and only 51% of the public say they trust the Italian Government to take care of them in the crisis.”

UK’s Liberal Democrat spokesperson Munira Wilson said, “Social distancing means millions are now home alone, facing the prospect of only the most minimal contact with another soul for months. This isolation is likely to have a grave impact on their mental health. Millions more, without being completely isolated, will still be struggling with the rapid changes the coronavirus has wrought upon our way of life.” The measures are now being adopted universally, in all the countries observing the impact of the pandemic on the lives of the people.

Even the director of European Branch of the WHO, Hans Kluge, has said, “Isolation, physical distancing, the closure of schools and workplaces are challenges that affect us, and it is natural to feel stress, anxiety, fear and loneliness at this time… It is essential to address the public mental health of people during the following weeks”. As we witness more and more people forced to stay in home quarantine or lockdown, it is important for the states to provide for psychological support for the general population. Even the health workers in India are reported to have been facing the issues here mentioned, with them being forced to vacate their rented homes and having no place of accommodation. ‘The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus’ reported that the medical workers were facing overwork, frustration, discrimination, isolation etc.

The Kerala Model

One state in India has transformed the trend of dealing with the pandemic. The Government of Kerala has learnt from the Nipah outbreak and has transformed the healthcare system to a robust force of action to manage Covid-19 pandemic, especially in the field of mental health care. Th Wire has reported on 27^th March, 2020 that, “Various projects like District Mental Health Programme (DMHP), DISHA under Department of Health and Family welfare are brought together to strategize and implement mental health initiatives. The multi-disciplinary team under DMHP provides counseling and psychosocial support for people in isolation and quarantine.  This facilitates people to share their emotions, concerns, and clarify queries openly without fear of stigmatization. The experts are trained to address these situations in a positive way with empathy, deep listening and confidentiality.

DMHP coordinates with the local panchayat authorities for community level interventions, primarily with regard to stigma. Regular follow-up is also done.”[2] The Government of India has now taken a leaf out of Kerala’s book in order to deal with the crisis and its impact on mental health by launching a mental health helpline number, "National Institute of Mental Health and Neuro-Sciences (NIMHANS) has also launched a toll free number 08046110007. I request everyone to fight unitedly against this disease so if we see any mental health issues then all the institutes are equipped to provide you with necessary support," said Lav Agarwal, Joint Secretary, the Ministry of Health at the press briefing. [3]

These steps have become a highlight in the recent times with respect to addressing the issues which have now surfaced in the context that set by the pandemic that is turning every tide around and is testing the best of population. It is only hoped that these services do deliver the benefits it intend on delivering and reach out to the people worst hit by the pandemic.

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