We must prioritise mental health in Covid-19 response

The current global situation around Coronavirus and the rising number of positive cases in Kenya are causing a lot of turmoil in the minds of people.

Going by the statistics, the pandemic is spreading to regions where there was no prevalence initially. In a country, like Kenya, there are worries around how long it will disrupt everyday lives and activities and whether the health systems can cope with the increase in positive cases, those suspected or in contact with index cases.

A Johns Hopkins Covid-19 interactive map shows how much the pandemic has spread to Africa. All research evidence and advisory from the World Health Organization says that the faster there is a lockdown and emergency planning, the better the outcomes.

Most people have panicked and are anxious not knowing what to do next mostly because the origin of the virus is surrounded in mystery. There are so many myths and misconceptions all over social media day in day out causing lots of confusion.

Fear and the need to educate the masses

Despite the Government of Kenya, WHO and world leaders giving guidance a lot still need to be done to psycho-educate the masses. Most people have no idea what the virus is all about especially now that the virus was first reported to have originated from Wuhan –China, so people labeled it a Chinese problem, leading to the stereotyping of some Chinese nationals.

The majority of the people are worried as they don’t know what steps to take next, suddenly you have to wash hands more frequently, self-quarantine, stay, work from home, and children have to think of homeschooling because all learning institutions are closed. People’s normal lives have suddenly changed; this is taking a toll on people psychologically.

To the majority of people living on less than a dollar per day with limited living conditions and spaces, they have to suddenly think about how they will keep the social distance guidelines, avoid congestion, but still keep their children in the city as no one is allowed to travel upcountry.

The biggest question in this situation is where do I get my next meal when there are so many restrictions around on one's right to freedom, work, and association?

Fear of the unknown is growing and spreading like a bushfire, not knowing what tomorrow brings; this for sure is spiking stress and related mental health issues, which if not handled well might lead to depression in the long run.

Another fear is triggering obsessive-compulsive disorder episodes among the populace –there is so much emphasis on people to hand wash and sanitize, many will take it too far or maybe a trigger to some people.

Economically, the viral lockdown has already started leading to job losses, which will ultimately affect the country’s economy as all sectors of the economy are slowly grinding to a halt.

We also expect to see an increase in insecurity, and robberies targeted to those perceived to be rich as people try to survive for as long as the conditions prevail.

There is already a strain on the already existing health care system, with coronavirus cases projected to rise it will only get worse, for the system and more so the health care workers mentally and physically.

Daily living and social engagements

We cannot stop living life and meeting our everyday activities and goals completely. There are a few things we need to do regularly and need to do these well. Self-quarantining for two weeks has been recommended for those who recently traveled from level 3 countries and self-isolation and identification by relevant health authorities has been recommended for those who might have come in contact with someone with Covid-19.

These are well-recommended guidance that most countries impacted by the virus are following. Ensuring that the ‘real-time’ social engagements are limited and that our social activities are curtailed is also important at this hour.

Practising good hand hygiene with frequent handwashing for 20 seconds with soap and water at least or with a sanitizer is recommended. What is also equally critical is to ensure that we are not obsessing over news around Covid-19. We do want to update ourselves but watching the news, reading multiple channels, doing multiple social media conversations around the virus and numbers will only mentally wear us out.

Maintaining a sense of humanity

Upon announcement of the virus in the country, panic shopping which sets in, Freudian ego defense mechanisms get activated to protect the ego from overwhelming anxiety from outside. Rationalization of panic buying and displacement of anxiety around germs towards purchasing excess supplies of cleaning products and sanitary items are examples of defenses that help justify the hoarding behavior. This has led to basic supplies running out in some countries, toilet papers and sanitizers.

Let’s support each other buy only what you need, think about the other shopper too, we can only win this if we work as a team. Let’s avoid attaching the Covid-19 to any ethnicity or nationality. Let’s practice empathy of the infected and affected. Avoid stigmatizing and discriminating against those testing positive for Covid-19. Accurate, timely communication and updates should be provided to all.

Ensure health care workers involved in the management of the patients are accessing mental health and psychosocial support services. Prioritize urgent mental health and neurological complaints (e.g. delirium, psychosis, severe anxiety or depression) within emergency or general health care facilities.

This pandemic is also testing our sense of humanity. It is critical for a tolerant and diverse society like Kenya to rise up to the occasion and support the community, the country and those in need. In that sense, social responsibility in helping those in need, ensuring that we start by being responsive to those who work for us, who work with us in allowing them time off and in understanding their stresses.

It is also pertinent to be tolerant and not think that viruses are about them versus us! Viruses especially of the type this is – do not discriminate and latches on to the next person without concern for race, creed or wealth. Respect for others, empathy for others, respect for individual freedom is critical for a good socially responsive stance. These values also strengthen our mental health.

The authors are all based in Nairobi. Shillah Mwaniga is clinical psychologist and HIV Program manager; Isaiah Gitonga a public health specialist and mental health researcher; Nduku Wambua and Dorcas Khasowa are clinical psychologists;  Manasi Kumar is a clinical psychologist and senior lecturer, department of psychiatry, University of Nairobi.