In the year since the World Health Organization (WHO) declared the coronavirus a pandemic, billions of lives around the world have been turned upside down. Experts have warned of adverse mental health consequences amid increased reports of anxiety, depression and distress.
“From the onset of the pandemic, those of us working in the field knew there was going to be a mental health crisis,” Dr. Steven Taylor, professor and clinical psychologist at the University of British Columbia and author of The Psychology of Pandemics, told Al Jazeera.
According to the WHO, before the pandemic hit, one billion people were living with a mental health problem. Over 264 million people worldwide were affected by depression, and suicide was the second leading cause of death among young people.
During the pandemic, essential mental health services were interrupted in 93% of the world’s countries, according to the WHO, while the demand for mental health support continued to increase.
WHO Director-General Tedros Adhanom Ghebreyesus said the effect would last “for many years to come” as “every individual on the face of the world … has been affected”.
Ministry of Loneliness
Before the outbreak, the WHO said social disconnection was already a serious public health crisis. With governments imposing severe restrictions on work and social life, often ordering people to stay home and not mix with others, loneliness has been a defining feature of the COVID-19 pandemic for many.
In Japan, the government created a ministry of loneliness, an initiative that came after the country saw suicide rates spike last year. Prime Minister Yoshihide Suga last month said women, in particular, are struggling with loneliness and urged the new loneliness minister to find solutions.
According to preliminary figures released by the National Police Agency, a total of 20,919 people committed suicide in 2020, an increase of 750 from the previous year. Local media reported that this was the first year-over-year increase in 11 years.
In the UK, amid the pandemic, charities have also reported an increase in case of loneliness among the elderly.
According to a study conducted in the UK by PLOS ONE in September 2020, 36% of respondents said they sometimes or often feel lonely during the pandemic.
“People who don’t have a strong social support network to start with, and who may end up being isolated by the nature of the disease, are a vulnerable group,” Dr. Joshua Klapow, a clinical psychologist, told Al Jazeera.
“They live alone and their family cannot visit them, they are at high risk because they cannot be supported by their family, friends, or religious organizations. And this isolation can lead to loneliness.
“When loneliness kicks in, we feel a sense of hopelessness. We have feelings of helplessness which can usually lead to depression or substance use. “
Feelings of depression, stress and anxiety
From the onset of the pandemic, healthcare professionals stressed the importance of monitoring rates of depression, stress and anxiety among vulnerable populations, including health workers.
According to a study conducted by the Columbia University Mailman School of Public Health, published in March, the global prevalence of depression and anxiety during COVID-19 was 24% and 21.3% respectively.
The same report showed that before the pandemic in Asian countries, the estimated prevalence of depression ranged from 1.3 to 3.4 percent. Anxiety rates in Asia before COVID-19 ranged from 2.1% to 4.1%, while in Europe, pre-COVID anxiety prevalence estimates ranged from 3% to 7, 4%.
In China, a recent study showed that 34.1% of people subjected to quarantine during the epidemic in early 2020 reported experiencing at least one psychological symptom.
In the United States, about four in 10 adults reported symptoms of anxiety or depressive disorder during the pandemic, compared with as many as one in 10 adults who reported the same symptoms from January through June 2019.
In the UK, in mid-2020, nearly one in five adults suffered from some form of depression, this figure almost doubling from around one in 10 before the pandemic, according to the most recent data released by the ‘Office for National Statistics.
“[During this health crisis] you cannot separate the measurements from the [symptoms] we have seen, ”Dr Jose Ayuso-Mateos, director of the WHO Collaborative Center for Research in Mental Health Services and President of Universidad Autonoma de Madrid, told Al Jazeera.
“And in this regard, the most affected were young people, people who lived alone, those who had a previous health problem, those who had a medical history and frontline health workers,” he added. .
Dr Ayuso-Mateos said youth mental health emergencies have increased in Madrid.
“We had to open new beds and space for young people, that was something we didn’t expect,” he said. “We have seen an increase in suicide attempts among the teenage population.”
Dr Klapow pointed out that experiences of the “new normal” have been very different.
“We tend to think that the impact on people is a bit the same, but there are big variations,” he said.
“For some people, they were doing relatively well, because their life was not badly disrupted… but we [also] I’ve seen people who have isolated themselves… or people whose lives have been turned upside down because a loved one is sick, or their social circles have disappeared. “
“The more disturbance there is, the more potential psychological damage there is,” he added.
Frontline health workers
Frontline healthcare workers were a very vulnerable group as they were at a higher risk of not only becoming infected with the virus, but also facing a high workload during the pandemic and, during the early stages. weeks, lacked protective equipment.
According to a recent study published in PLOS One, more than one in five frontline health workers suffered from anxiety, depression and post-traumatic stress disorder during the pandemic.
In 65 studies involving 97,333 health workers, researchers found a high prevalence of depression, anxiety and PTSD. Regionally, estimates of depression and anxiety were highest in studies conducted in the Middle East.
“When we talk about healthcare professionals, we see that they are pushing their psychological resources to the absolute limit,” said Dr Klapow.
“They are very often in desperate situations where they cannot do what they were trained to do. They can’t help people, or they watch people die. “
“We can see anxiety disorders, depression and alcoholism or substance use,” he added.
China, where mental illnesses have long been stigmatized, has been praised for its efforts to tackle the pandemic’s consequences on mental health.
In January 2020, the National Health Commission of China shared principles for dealing with the emergency psychological crisis, and mental health helplines were allowed across the country to offer counseling and psychological services.
Dr Taylor cited an example in Chengdu, the capital of Sichuan Province, where mental health workers set up a nightly program on mental health issues.
“There was a self-help line where people could phone in and get advice … and if they couldn’t resolve issues during the self-help consultation, they were referred to Zoom meetings with mental health practitioners, ”he said.
Despite the rapid reaction of the Chinese authorities, according to national surveys, anxiety and depression were prevalent in the general population of the country. But according to the Columbia study, China had the lowest prevalence of the two disorders compared to other countries.
Can the world bounce back?
The WHO has warned that the pandemic could generate mass trauma on a larger scale than World War II.
“After WWII, the world suffered mass trauma because WWII affected so many lives. And now, even with this larger COVID pandemic, more lives have been affected, ”WHO Director-General Tedros Adhanom Ghebreyesus said in March.
“And that means mass trauma, which is out of proportion,” he added.
However, some experts believe that many people will be able to “bounce back”.
“If you go back to 1919, during the Spanish flu, there was the pandemic, there was also the lethargic encephalitis pandemic at the same time, the so-called sleeping sickness, there were childhood illnesses, there was World War I, people died when they were 60… it was dark, and a year after all of that in 1920, people bounced back, ”explained Dr. Taylor.
“In 1919, everyone wears masks and in 1920 no one wears masks. In Wuhan in August 2020, when they were released from lockdown [people] I indulged in parties.
However, Dr Taylor noted that there will always be a checkup for mental health, with many people in need of mental health resources.
“[This will happen] for people who, for example, developed COVID-19, developed PTSD, developed long COVID-19, these are the people who will experience the deep trauma, ”he said.
“There could also be lingering economic hardship for people… the economic consequences, and it will take longer for them to recover.
“But for a lot of other people, they’re just going to bounce back and they’ll want to forget about COVID-19.”