As the coronavirus (COVID-19) pandemic sweeps across the world, it is causing widespread concern, fear and stress, all of which are natural and normal reactions to the changing and uncertain situation that everyone finds themselves in.
“The issue facing each and every one of us is how we manage and react to the stressful situation unfolding so rapidly in our lives and communities. Here we can draw on the remarkable powers of strength and cooperation that we also fortunately possess as humans. And that is what we must try to focus on to respond most effectively to this crisis as individuals, family and community members, friends and colleagues,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe.
WHO takes the impact of the crisis on people’s mental health very seriously and is monitoring the situation together with national authorities, while providing information and guidance to governments and the public.
At a press briefing held on 26 March, Dr Kluge, together with Dr Aiysha Malik, Technical Officer, Department of Mental Health and Substance Abuse, WHO Headquarters and Dr Dorit Nitzan, Acting Director of Emergencies, WHO/Europe, answered questions on mental health issues in the context of COVID-19 and offered insights on tools, techniques and interventions to address them.
“With the disruptive effects of COVID-19 – including social distancing – currently dominating our daily lives, it is important that we check on each other, call and video-chat, and are mindful of and sensitive to the unique mental health needs of those we care for. Our anxiety and fears should be acknowledged and not be ignored, but better understood and addressed by individuals, communities and governments,” Dr Hans Kluge noted.
Many of the questions focused on specific population groups, including children and older people.
This is indeed an unprecedented time for all of us, especially for children who face an enormous disruption to their lives. Children are likely to be experiencing worry, anxiety and fear, and this can include the types of fears that are very similar to those experienced by adults, such as a fear of dying, a fear of their relatives dying, or a fear of what it means to receive medical treatment. If schools have closed as part of necessary measures, then children may no longer have that sense of structure and stimulation that is provided by that environment, and now they have less opportunity to be with their friends and get that social support that is essential for good mental well-being.
Being at home can place some children at increased risk of, or increased exposure to, child protection incidents or make them witness to interpersonal violence if their home is not a safe place. This is something that is very concerning.
Although all children are perceptive to change, young children may find the changes that have taken place difficult to understand, and both young and older children may express irritability and anger. Children may find that they want to be closer to their parents, make more demands on them, and, in turn, some parents or caregivers may be under undue pressure themselves.
Simple strategies that can address this can include giving young people the love and attention that they need to resolve their fears, and being honest with children, explaining what is happening in a way that they can understand, even if they are young. Children are very perceptive and will model how to respond from their carers. Parents also need to be supported in managing their own stressors so that they can be models for their children. Helping children to find ways to express themselves through creative activities, and providing structure in the day – if that is possible – through establishing routines, particularly if they are not going to school anymore, can be beneficial.
Mental health and psychosocial support services should be in place, and child protection services need to adapt to ensure that the care is still available for the children of families who need it.
Regarding older people and also those with underlying health conditions, having been identified as more vulnerable to COVID-19, and to be told that you are very vulnerable, can be extremely frightening and very fear-inducing. The psychological impacts for these populations can include anxiety and feeling stressed or angry. Its impacts can be particularly difficult for older people who may be experiencing cognitive decline or dementia. And some older people may already be socially isolated and experiencing loneliness which can worsen mental health.
On a positive note, there are many things that older people can initiate themselves or with the support of a carer, if needed, to protect their mental health at this time. These include many of the strategies that we are advocating across the entire population, such as undertaking physical activity, keeping to routines or creating new ones, and engaging in activities which give a sense of achievement. Maintaining social connections is also important. Some older people may be familiar with digital methods and others may need guidance in how to use them. Once again, the mental health and psychosocial support services and other services that are relevant to this population must remain available at this time.