by Seema Gupta
World Health Organization estimates that India will suffer economic losses amounting to a staggering 1.03 trillion dollars from mental health conditions between 2012 and 2030. The raging COVID-19 pandemic has hedged people inside their homes for the last two years, nurturing within it a long-standing silent pandemic – of mental health.
COVID -19, pressed the panic button.
Communities, families, and individuals have been plagued with loneliness, violence, panic, fear of infection, ill-health, co-morbidities, death, bereavement, migration stress, job insecurities, and financial crises. This prolonged uncertainty with disruption in the social fabric has led to chronic anxiety and stress, resulting in a spectrum of mental health concerns. The impact was heightened in the already vulnerable sub-sections. Age-based differences in a study revealed that younger age groups were more susceptible to stress, depression and anxiety symptoms. The impact was also felt amongst the health workers, the front line warriors in our fight against the pandemic.
The sudden lockdown worsened the already skewed and unequal access to coping mechanisms and services for mental health. A survey of 130 countries conducted by the World Health Organisation (WHO) concluded that 93 per cent of the countries faced severe disruptions in their critical mental, neurological, and substance use services delivery and a heightened need for such services.
While society must start normalizing mental illnesses at par with other physical diseases, it is even more critical for those in the health care field to do so.
Maharashtra’s BMC-Mpower 1 on 1 mental health helpline received about 45,000 calls within the first two months of the pandemic. Of these, 82 per cent of the callers complained of anxiety, isolation, uneasiness, and depression, while others stemmed from sleep irregularities and exacerbation of pre-existing mental health issues. 
These consequences were noticeably higher amongst the vulnerable sub-groups like women, young children, people in conflict, and caste-class minorities.
An ORF survey reported that 65 per cent of nearly 6,000 youth aged 18-32 years felt lonely during the lockdown, and 37 per cent felt that their mental health had been ‘strongly impacted’. “The pandemic saw an exponential increase in cases of depression, anxiety and stress amongst the adolescents, who led abnormal, isolated lives and in many cases, there was a rise in substance abuse”, says Dr Rohit Garg, a leading psychiatrist of India. Poor sleep, lower levels of resilience, loneliness, and absence of social interactions with peers, impacted youngsters. The prolonged shutdown of schools regressed progress in accelerating education and building agency for girls. Over 240 million Indian students have readjusted their everyday routine multiple times in lieu of schools closing and reopening due to COVID-19. The absence of routine, peer interactions and classroom settings pivotal to a child’s overall development also affected their mental health.  
Most important, yet often neglected, was the mental health of the health workers themselves. Faced with unprecedented emergencies, they responded with agility and long working hours, often with distancing or isolation from their families. They had lingering exposure to trauma, grief and demanding circumstances during this period. Anecdotal evidence indicates that to appear infallible and competent, they would dismiss and hide their symptoms such as anger, anxiety, PTSD, and suicidal behaviour. 
Now that we seem to have crossed the acute phase of the pandemic, health workers continue to face anxiety and chronic stress as they nervously tread back into the new normal, guiding communities and patients for the same.
Mental Health May 
The Mental Health May (Awareness Month) organized by WHO prioritizes going #backtobasics,wherein multiple stakeholders inculcate proactive and preventive mental health interventions across all levels. Centre for Knowledge and Development (CKD) recognizes this need and has undertaken initiatives within all ongoing projects to mainstream mental health amongst the stakeholders engaged with and the communities served.
The last year brought the public health system to its knees during the peak of COVID-19 and presented an abundantly evident insight into the growing need for holistic mental health services. The asymmetry between the supply and demand of mental health services in India continues to be a challenge; the estimated number of psychiatrists per 100,000 population in India is a dismal 0.75 compared to 3 in developed countries.
Collective action – need of the hour  
Mental health is a profoundly intersectional and inter-sectoral issue. To address the chronic underfunding, continued neglect, unawareness and stigma around mental health, collective action from different stakeholders is needed —including medical professionals, activists, non-profits, and government systems. Synergistic conversations on mental health amongst all stakeholders, engagement of technical experts, training of health workers strengthening early identification and management and leveraging government initiatives like State Mental Health Authority are imperative to avoid a mental health epidemic. 
The COVID-19 pandemic has changed the world as we know it. We were caught off guard and grappled with our response, suffering as we coped. In the wake of this learning, it is our moral responsibility now to impede the mental health epidemic looming on the horizon. There is a dire need for establishing focused synergies, inter-sectoral efforts, and investments to strengthen our ill-equipped mental health infrastructure.
(The author is Seema Gupta, Advisor, Centre for Knowledge and development. Views expressed are personal and do not reflect the official position or policy of FinancialExpress.com.)
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