Lesson 1: MENTAL HEALTH SUPPORT TRAINING

DAY 1: MENTAL HEALTH SUPPORT TRAINING; Introduction to Covid-19 and its impact on Mental Health

Welcome to today’s training, How to offer Mental Health Psychosocial Support in the face of COVID-19 and stay without depression. Trainer: Mr. Ogoenyi Isaac Agbo, a Clinical Psychologist.

In any epidemic, it is common for individuals to feel stressed and worried.

Common responses of people affected (both directly and indirectly) might include:

  • Fear of falling ill and dying.
  • Avoiding approaching health facilities due to fear of becoming infected while in care.
  • Fear of losing livelihoods, not being able to work during isolation, and of being dismissed from work.
  • Fear of being socially excluded/placed in quarantine because of being associated with the disease (e.g. stimatization against persons who are from, or perceived to be from, affected areas)
  • Feeling powerless in protecting loved ones and fear of losing loved ones because of the virus
  • Fear of being separated from loved ones and caregivers due to quarantine regime.
  • Refusal to care for unaccompanied or separated minors, people with disabilities or the elderly due to fear of infection, because parents or caregivers have been taken into quarantine.
  • Feelings of helplessness, boredom, loneliness and depression due to being isolated
  • Fear of reliving the experience of a previous epidemic.

Emergencies are always stressful, but specific stressors particular to COVID-19 outbreak affect the population. Stressors include:

  • Risk of being infected and infecting others, especially if the transmission mode of COVID-19 is not 100% clear
  • Common symptoms of other health problems (e.g. a fever) can be mistaken for COVID-19 and lead to fear of being infected.
  • Caregivers may feel increasingly worried for their children being at home alone (due to school closures) without appropriate care and support.
  • Risk deterioration of physical and mental health of vulnerable individuals, for example older adults (Intervention 1) and people with disabilities (Intervention 2), if caregivers are placed in quarantine if other care and support is not in place. Furthermore, frontline workers (including nurses, doctors, ambulance drivers, case identifiers, and others) may experience additional stressors during the COVID-19 outbreak:

Stigmatization towards those working with COVID-19 patients and their remains Strict bio-security measures:

– Physical strain of protective equipment

– Physical isolation making it difficult to provide comfort to someone who is sick or in distress

– Constant awareness and vigilance

– Strict procedures to follow preventing spontaneity and autonomy

– Higher demands in the work setting, including long work hours, increased patient numbers and keeping up-to-date with best practices as information about COVID-19 develops

– Reduced capacity to use social support due to intense work schedules and stigma within the community towards frontline workers

– Insufficient personal or energy capacity to implement basic self-care. Insufficient information about the long-term exposure to individuals infected by COVID-19

– Fear that frontline workers will pass COVID-19 onto their friends and family as a result of their work. The constant fear, worry and stressors in the population during the COVID-19 outbreak can lead to long-term consequences within communities and families:

– Deterioration of social networks, local dynamics and economies

– Stigma towards surviving patients resulting in rejection by communities

– Possible anger and aggression against government and frontline workers.

– Possible mistrust of information provided by government and other authorities.

– People with developing or existing mental health and substance use disorders experiencing relapses and other negative outcomes because they are avoiding health facilities or unable to access their care providers. Some of these fears and reactions spring from realistic dangers, but many reactions and behaviors are also borne out of lack of knowledge, rumors and misinformation.

Common rumors regarding COVID-19 include:

  • The virus only attacks old people and spares young people and children.
  • The virus can be transmitted through pets and people should abandon their pets.
  • The use of mouthwash, antibiotics, cigarettes, and liquor with high alcohol can kill COVID-19.
  • The disease is premeditated and COVID-19 is a bioweapon designed to target a specific population.
  • Food items are contaminated and will spread the virus.
  • Only members of specific cultural or ethnic groups can spread the virus.

Social stigma and discrimination can be associated with COVID-19, including towards persons who have been infected, their family members and health care and other frontline workers. Steps must be taken to address stigma and discrimination at all phases of the COVID-19 emergency response. Care should be taken to promote the integration of people who have been affected by COVID-19 without over-targeting. On a more positive note, some people may have positive experiences, such as pride about finding ways of coping and resilience. Faced with disaster, community members often show great altruism and cooperation, and people may experience great satisfaction from helping others.

 Examples of MHPSS community activities during a COVID-19 outbreak might include:

  • Maintaining social contact with people who might be isolated using phone calls or text messages.
  • Sharing key factual messages within the community, especially with individuals who don’t use social media.
  • Providing care and support to people who have been separated from their families and caregiver. Some of these fears and reactions spring from realistic dangers, but many reactions and behaviors are also borne out of lack of knowledge, rumors and misinformation.

 ACTIVITIES THAT WILL SUPPORT ADULTS’ WELLBEING DURING HOME ISOLATION/QUARANTINE

  • Physical exercise (e.g. yoga, tai chi, stretching)
  • Cognitive exercises
  • Relaxation exercises (e.g. breathing, meditation, mindfulness)
  • Reading books and magazines.
  • Reduce the time spent looking at fearful images on TV.
  • Reduce time listening to rumours.
  • Search information from reliable sources.
  • Reduce time looking for information (1-2 times per day, rather than every hour).

The messages below focus on promoting mental health and wellbeing in communities affected by COVID-19. MESSAGES FOR THE GENERAL PUBLIC FOR DEALING WITH STRESS DURING THE COVID-19 OUTBREAK:

  • It is normal to feel sad, distressed, worried, confused, scared or angry during a crisis.
  • Talk to people you trust. Contact your friends and family.
  • If you must stay at home, maintain a healthy lifestyle (including a proper diet, sleep, exercise and social contact with loved ones at home). Keep in touch with family and friends through email, phone calls and making use of social media platforms.
  • Don’t use tobacco, alcohol or other drugs to cope with your emotions.
  • If you feel overwhelmed, talk to a health worker, social worker, similar professional, or another trusted person in your community (e.g., religious leader or community elder).
  • Have a plan where to go and seek help for physical and mental health and psychosocial needs, if required.
  • Get the facts about your risk and how to take precautions. Use credible sources to get information, such as WHO website or, a local or NCDC.
  • Decrease the time you and your family spend watching or listening to upsetting media coverage.
  • Draw on skills that you have used in the past during difficult times to manage your emotions during this outbreak.
  • Be optimistic and hopeful.
  • Spiritual connection to feel supernaturally protected.

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