Despite the fact that quality of psychiatric treatments has become more effective over the course of five decades, most people still do not seek medical help for treatment for their mental illnesses because of the stigmas attached with being “mentally ill”. The fear of being tagged a mental patient and further isolation from job opportunities and daily social activities force people to remain quiet and hide their mental illness, regardless of how chronic it might become. This is called “Label Avoidance” – people belonging to this group keep their illnesses to themselves in fear of being stereotyped by society.
A lot of factors play role in triggering mental ailments; different people have different reactions to traumatic situations depending upon their mental capability to withstand shock and trauma. The fundamental cause of not going to therapists is the culturally dominant alternative such as witchcraft, evil eye, sorcery, etc.
Amidst the pandemic, psychological setbacks are not paid as much attention as needed. Secondly, fewer or no resources are allocated to cater to mental health needs and wellbeing. This lack of emphasis on mental healthcare may be understood during the critical level of the disease outbreak where the priority is emergency treatment, testing, containing the disease and its impact, but in the long run, psychological impact needs equal attention.
A study conducted in China between the first two months of 2020 showed appalling results. Out of 1210 respondents, 54% of people were moderate to severely affected by COVID-19, while 29% of the people showed anxiety symptoms and 17% showed moderate to severe symptoms of "depression". These are extremely troubling figures. During the swine flu outbreak in 2009 a study conducted had showed that people with neurotic disorders showing moderate to severe symptoms were in significant numbers.
There are many valid reasons for not overlooking the mental health impact of the pandemic. One of the most important reasons is that psychological health controls the basic mechanism of adherence in human beings. It determines the course of action that people take to cope with significant physical, economic and social losses. The present situation shows the importance of psychological healthcare during COVID-19. Some of the prominent psychological reactions to the current pandemic include depression, anxiety, panic attacks, fear of the unknown, defensive attitude, etc.
Pakistan falls under the category of a developing country. It is host to many issues that are affecting the lives of citizens. There are serious internal and external factors like political upheavals, social boycotting, economic vulnerability, job saturation, cultural and ethnic influences and gender inequality. These issues have stimulated more health glitches during the crucial time of the pandemic, when more people are vulnerable to joblessness, poor healthcare facilities and increased psychological distress.
There is no data available in Pakistan related to the psychological impact of COVID-19. The increasing financial constraints have been resulting in mental illnesses - an issue given very little attention. Not to mention the meagre resources allocated to health sector and lack of a separate budget for mental health. According to World Health Organization’s Assessment Instrument for Mental Health Systems (WHO_AIMS), in 2009 only 0.4% of the health spending was allocated to mental health. There are 3,729 mental health facilities and only 5 mental hospitals which have 5,056 beds with a total of 342 psychiatrists. There have been no specific policy amendments made since 2009 and the mental illness burden has continued to rise in all age groups.
For a young intellectual humbly trying to document the mental health conditions of Pakistan amid the pandemic, it has been an eye-opening journey. There are only a handful of mental hospitals facilitating thousands of individuals. With an over saturation in public hospitals, patients are forced to seek treatment from private psychiatrists, who charge a whopping amount per session. It is indeed an intriguing question: why is no one discussing the vicious psychological impacts of COVID-19?
For further study
Cullen, W., Gulati, G., & Kelly, B. (2020). Mental health in the COVID-19 pandemic. QJM: An International Journal of Medicine, 311-312.