Millions of people face grief over lost family members and friends. Many more are anxious over unemployment and fearful of the future. Older people may experience isolation and loneliness, while children and adolescents may feel alienated and distressed.
Karachi
On the occasion of World Mental Health Day, being observed today The October 10, the United Nations have called for taking action to redress the glaring inequalities exposed by the pandemic – including the inequality in access to mental health services.
“In high-income countries, over 75 percent of people with depression report that they do not receive adequate care. And in low- and middle-income countries, over 75 percent of people with mental health conditions receive no treatment at all,” a UN communique said.
“This is the direct consequence of chronic under-investment, as governments spend an average of just over 2 percent of their health budgets on mental health,” it said.
“This is unacceptable. At long last, we are beginning to see recognition that there can be no health without mental health,” UN said further stating that the member States have endorsed the World Health Organization’s updated Comprehensive Mental Health Action Plan.
“The United Nations family, together with partners across the global mental health community, are introducing new guidelines and developing new tools to improve mental health. These are positive steps – but we have a long way to go,” UN said.
“On World Mental Health Day and every day, let us commit to work together with urgency and purpose to ensure quality mental health care for all people, everywhere,” UN urged.
It is pertinent to mention that the pandemic has left highly adverse social, psychological and financial effects on people of Sindh.
A research report on ‘Impact of Covid19 on Mental Health’, first ever survey of its kind conducted by Sindh Mental Health Authority in collaboration with other stakeholders, released a few months back suggests that “Almost 62 percent people reported major loss of income or earning which was more pronounced in rural (81 percent) then urban (43 percent) setting.”
The estimated prevalence of depression as assessed on self-reporting questionnaire was 42%. Among the participants 10% reported to have received any psychiatric diagnosis. The overall prevalence of self-reported anxiety was 85%. When assessed on perceived risk of COVID-19, around 87% participants reported that it posed low risk. This perception was more prevalent in rural (91%) then urban setting.
The general findings suggest poor understanding of risks associated with transmission and infection with COVID-19. Around 69% participants reported adequate social support through family, friends and informal support networks.
Report revealed that when inquired about the financial constraints, 36% reported borrowing money while 21% reported selling property, possessions or livestock to make ends meet. Around 32% individuals reported that they are able to respond resiliently when change occurs; in terms of having one close relationship to confide in times of stress, 40% individuals reported it to be true, nearly all the time.
When we asked about the economic impact of COVID-19, almost 62% reported being affected one way or another, which was more pronounced in rural (81%) then urban (43%) setting. The participants were asked to rate the loss in terms of ‘major loss of income or earning’ and ‘some loss of income and earning’. When inquired about receiving financial support through EHSAS Program, or some other government agency, about 76% individuals reported no financial assistance. Only 24% responded in affirmation to receiving funds through Government support programs. The amount received was average of Rs.12037.
Food source or security was also threatened with 72% reporting that they don’t have enough money to buy food. In terms of changes in the quality of diet or food intake, 38% reported change in the items of routine food intake during the COVID-19 pandemic. This was roughly double in rural (50%) in rural then urban setting (25%).
Impact of COVID-19 on Mental Health
In order to assess the morbidity related to depression and anxiety, the Self Reporting Questionnaire was administered.
The estimated prevalence of depression as assessed on self-reporting questionnaire was 42%. Noteworthy was higher prevalence of depression in rural setting (55%) compared to urban (29%). This finding is congruent to international figures. The previous epidemiological surveys in the Country have pointed to higher prevalence rates of depression in women especially in the rural settings.
About 25% reported positive to the “THOUGHTS OF ENDING ONE’S LIFE” i.e. suicidal ideations, which is a point of health concern. Among all the participants only 10% were detected to have any psychiatric disorder given the mental health care services. This has implication on treatment delay and worsening of clinical condition.
The symptoms of Anxiety were assessed as self-report items. The overall prevalence of anxiety was 85%. It was higher in urban setting (88%) compared to rural (83%).
When inquired about the financial constraints and borrowing of money during the COVID-19 pandemic, about 36% reported borrowing money from others to make ends meet. About 21% reported selling possessions, livestock or property, to make payments when due. About 33% reported difficulties, like being evicted due to not able to pay the rent. In 18% cases spouse or family member started working outside the home to support the household income.
Pakistan is an agriculture society with people living in extended family network and community support. Informal support is given by family and friends in times of stress. The teams explored the details of this process through direct inquiry. Around 60% reported that they can count of anyone to provide emotional support by listening, either directly or through telephone, which they found meaningful. The extent of this support was assessed over the course of twelve months.
Post-Traumatic Disorder
In the final section of survey the teams employed Impact of Event Scale (IES), one of the most widely used measures of posttraumatic stress reactions. The IES assesses the frequency with which respondents experience intrusive thoughts and avoidant behaviors over the past week. During the survey 18% individual were found to have definite post-traumatic stress disorder (PTSD) while 4.35 had probable diagnosis; some symptoms were present 60% individuals. The percentage of case positive was slightly higher in rural then urban setting (21% VS 15%).
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Sindh Courier
