Protecting Mental Health As We Fight COVID-19
“Science shows that anxiety and isolation have a rigorous physical toll on the brain’s circuitry. They increase the vulnerability to disease — by triggering higher blood pressure and heart rates, stress hormones and inflammation — among people who might otherwise not get sick. Prolonged loneliness can even increase mortality rates.” Robin Wright, The New Yorker
When I first heard of coronavirus and the disease it causes, COVID-19, back in December, I did not expect it to reach Africa and my own country of Rwanda. Turns out, the entire world is more connected than we thought which is making it easy for COVID-19 to travel across borders. So, here it is, suddenly. Infected cases are increasing by the day in Rwanda and all residents are advised to stay home to prevent the spread. This pragmatic public health recommendation as well as the myriad health, economic, and social impacts of the pandemic have caused and will continue to cause many stresses. Indeed this COVID-19 pandemic has significant impacts on the mental health of the global population — reactions to COVID-19 have the potential to do more harm than the virus itself.
Anxious feelings and worries are not only unique to those infected with COVID-19. Within my own network, friends and family are reporting helplessness, loneliness, and depression due to isolation. Speaking from personal experience, I barely slept when the total lockdown began. I experienced extreme panic and fear of getting infected or dying. I washed my hands constantly and sometimes would wake up in the middle of the night to wash my hands and face. During this time period, my friend and I shared experiences of chest pains and fear about wanting a test for COVID-19.
Beyond the health implications, the pandemic is likely to take a hit to GDP growth across the world. In Rwanda, economic fear about the outbreak has stemmed from airlines cutting flights, travelers canceling their trips, closure of non-essential businesses, cancellation of important events and conferences, and more. These actions have wide-reaching implications for tourism, impacting local merchants, markets, moto taxi drivers that rely on visitors, as well as others in informal jobs that have been suspended. With schools closed, many health workers may also be experiencing anxieties and worries about their children being at home alone without appropriate support. Worry about loss and financial struggles make it challenging to imagine how people’s lives will look in a couple of months.
Considering and acknowledging human capital as a fundamental source of economic growth, we need interventions to protect and maintain population mental health during and after COVID-19. In Rwanda, mental health has been prioritized by First Lady Jeanette Kagame and remains a unique opportunity to explore.
Rwanda encountered a significant burden of mental health disorders with a majority emerging from the 1994 Genocide against the Tutsi which caused a magnitude of destruction and losses. The crisis left more than a million orphans and approximately 30,000 widows in its wake and destroyed social, economic, and health systems. In response, the government of Rwanda established a National Mental Health Policy and guidelines to support decentralization and integration of mental health care in the existing health care systems. Additionally, with development partners, the country has continuously supported organizations and local initiatives to invest in capacity building to strengthen the mental health care system.
As COVID-19 is causing disconnection and evoking fear, anxiety, and worry about livelihoods and well-being, it may have a chilling impact on our immune systems, depriving us of our joy, peace, and hope. We need to collectively stand strong, together, amidst the crisis to lift each other up and comfort those who are struggling. We must consider proactive measures to address the whole range of mental health challenges that the pandemic is causing. Some suggestions to complement existing measures to maintain social distancing and sustain good mental health include:
- Build a network of mental health specialists. This is a public appeal to psychiatrists, psychologists, and therapists willing to volunteer to contact the Ministry of Health to set up a mental-health assistance network for people experiencing isolation or anxiety.. Post-pandemic, we can also prepare a mental health task force to identify critical cases that may call for serious attention and action.
- Create a mental health support toll-free number that people can call/text in case of need.
- Promote virtual connections through apps like Zoom, Skype, FaceTime, Facebook Messenger, Whatsapp, and other mediums.
- Organize programs on radio/television channels for mental health awareness and provide tips on how to manage some of the challenges.
- Provide clinical supervision and psychological support to front line health workers.
Holly Louise Irasubiza was a 2017–2018 fellow at Partners in Health in Rwanda.
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