People with mental health disorders at risk of infections during outbreaks, experts say
In epidemic situations such as the raging coronavirus disease (Covid-19) outbreak, people with mental health disorders are susceptible to infection that can be attributed to cognitive impairment, low-risk awareness and decreased personal protection efforts among patients, along with constraints in accessing regular healthcare, experts say.
According to the Global Burden of Disease study, one in seven Indians, or 197 million, are affected by mental disorders, and their contribution to the overall disease burden has doubled from 2.5% to 4.7% over the last two decades.
High susceptibility to stress worsens the existing mental health condition.
“As a result of prolonged lockdown restrictions, in the latter half of this year, we can see several outbreaks of secondary epidemics such as stress-related disorder. In the current situation, the world is desperately trying to build enough beds to treat Covid-19 patients. Sadly, not much is being done in creating any sort of protection tents of psychological and social welfare to avert the crisis,” said Prafulla Shriyan, research fellow, Indian Institute of Public Health, Bengaluru.
In General population
Despite knowledge of human coronaviruses, the new Covid-19 strain has created panic among the general public because of its widespread transmission across the globe. Various alarming video clippings of Covid-19 are accessible to all individuals in developing countries via their smartphones and computers.
The use of physical control measures such as physical distancing, home quarantine, closure of schools, and workplaces are leading to disruption of social support networks. Sudden change in social circumstances and increased stress induce recurrence of already cured mental health problems in patients.
Phobia related to isolation/quarantine
People in quarantine are likely to develop psychological symptoms, emotional disturbance, depression, stress, irritability, and insomnia. These impacts will be higher when parents are quarantined along with their children.
There are several reasons for stress, including fear of becoming sick, separation from the loved ones, loss of the loved ones, and financial hardship. Healthcare workers, children, and older people are at higher risk for long-term mental health problems.
The deaths that occurred due to the pandemic are associated with severe psychological implications. Covid-19 is characterised by fear, anxiety, and grief. The reported suicidal cases show the number of suicidal deaths is high among older adults, as they are sensitive to isolation and are more dependent on social support.
“In India, over 90 people fled from Covid-19 isolation wards, and more than 10 suicidal deaths were reported across states because of the social stigma attached to the disease and the fear of isolation. This creates panic about the disease and helps to spread it even further. People don’t want them to be labelled as infected and are fleeing from healthcare facilities wherever they are isolated or quarantined. Panic may also paralyse them with fear and these internal emotions progress to hopelessness and desperation,” said Dr. Giridhara R Babu, professor, Indian Institute of Public Health.
Infected people experience high levels of stress, due to fear, uncertainty, financial anxiety, and limited interactions. “Symptomatic patients are more likely to experience anger, confusion, hopelessness, anxiety, depression, and post-traumatic stress disorder. Isolating independent persons in a single room with limited movement and contact precautions can induce severe stress,” said Dr. Babu.
An asymptomatic individual can also report distress, frustration, and fear due to long quarantine, perception of risk, and inadequate information.
Closed schools due to prevailing lockdown restrictions have resulted in different kinds of mental health issues in children.
“Disruption of daily routine causes children with special needs to feel frustrated and short-tempered. Nationwide school closures also increase the risk of exploitation, violence, and abuse due to interrupted social services and movement restrictions,” said Shriyan.
Caregivers in most of countries subject children to homicidal practices. What if those kids couldn’t leave home, stay away from teachers, friends, or supportive services? Who will protect them? Millions of children have been addicted to digital technology. Now, how do we keep them safe from the risks and hazardous consequences of the internet?
Healthcare workers’ safety and psychological resilience are essential components of sustaining critical healthcare services throughout the epidemic. They are facing a greater risk of exposure, extreme workload, and a rapidly changing working environment due to the pandemic. It forces healthcare professionals in a challenging situation, attempting them to make tough decisions and work under immense pressure.
Most people, especially the vulnerable are susceptible to mental healthcare issues due to the pandemic. “Along with Covid-19, there might be a surge in mental health issues due to the economic crisis, unemployment, poverty, and homelessness. Mental health services need to be prioritised by strengthening the existing healthcare system. Screening of people at high risk such as those with an earlier history of mental health and senior citizens along with an effective intervention to minimise adversities should be the top priority,” Shriyan added.