World Mental Health Day was observed in October. The number of people with mental illnesses had been increasing across the world even before the pandemic. Despite mental health issues constituting a significant percentage of the health burden in India, the country does not have enough mental health professionals, especially psychiatrists and clinical psychologists. Though the pandemic has a deep psychological impact on people of all age groups, children are especially vulnerable to adverse mental health conditions during such times. According to a recent review in the Journal of the American Academy of Child and Adolescent Psychiatry, children whose movements have been severely restricted are at a higher risk of experiencing feelings of loneliness, depression and anxiety during the pandemic.
Most governments around the world took the drastic step of closing educational institutions. When schools are closed, children lose their moorings and are likely to get disoriented. If not appropriately addressed at the right moment, the mental health consequences of the pandemic for a generation of children and young people could outstrip the immediate health and economic impacts of the pandemic.
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In the early stages of the pandemic, UNICEF had conducted a survey of children, parents, teachers and caregivers in 104 countries on how the event was affecting their lives, particularly their mental health and psychosocial well-being. It pointed out that there is an urgency to work for the mental health and psychosocial well-being of the world’s children and lend support to parents and caregivers as well. As the pandemic rages on, it is important to monitor young people’s mental health status and provide psychosocial support whenever and wherever necessary.
Psychosocial support in Odisha
Odisha had some experience of psychosocial support in the aftermath of the super cyclone in 1999 and a severe cyclonic storm in 2019. On both occasions, UNICEF, NIMHANS of Bengaluru, and the NGO, Bharat Gyan Vigyan Samiti, made psychosocial support interventions for children traumatised by the unsettling events. In a few hundred coastal villages of Odisha, volunteers were trained in providing psychosocial support. Children were encouraged to participate in various activities like painting, music, storytelling, dance, quizzing, toy-making. They were also encouraged to share their emotions. It was possible, through structured counselling, to improve the coping capacity of disoriented children. These experiments were found to be useful in bolstering their confidence and getting them back to school.
However, all these were not used in mainstreaming psychosocial support in the overall public health system of the State. This can be said to be true for the country as well. In India, where basic health infrastructure is weak, access to mental health services is a far cry. Now that the pandemic has once again exposed this weakness, it is time for greater attention to be paid to the availability of adequate mental health services both in urban and rural areas.
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Community volunteers
Since it is unlikely that the availability of professionals will ever match the requirements of a growing number of people suffering from mental illness, creating a cadre of community volunteers to reduce the burden on health workers can be considered. Sometime back, The Economist highlighted the inadequacy of mental health professionals in Western countries as a result of which two-third of people with a mental health problem do not receive any treatment. In such a scenario, ‘talk therapy’, recommended by the World Health Organization, could be the first line of treatment. This can be delegated to community volunteers. The experiences of countries such as Zimbabwe, Canada and New Zealand show that community volunteers with some basic training can supplement regular mental health services. When an adequate number of such volunteers work as frontline workers, the mental health needs of a society can be met not as a one-off event and in sporadic manner but on a sustained basis.
Ananya Behera is an independent researcher based in Bhubaneswar
