In January 2020 the World Health Organization
(WHO) declared the outbreak of a new coronavirus disease to be a Public
Health Emergency of International Concern. WHO stated there is a high risk of
the 2019 coronavirus disease (COVID-19) spreading to other countries around
the world. In March 2020, WHO made the assessment that COVID-19 can be
characterized as a pandemic.
WHO and public health authorities around the
world are acting to contain the COVID-19 outbreak. However, this time of
crisis is generating stress in the population. These mental health
considerations were developed by the WHO’s Department of Mental Health and
Substance Use as messages targeting different groups to support for mental
and psychosocial well-being during COVID-19 outbreak.
General population
1. COVID-19 has and is likely to affect people
from many countries, in many geographical locations. Do not attach it to any
ethnicity or nationality. Be empathetic to all those who are affected, in and
from any country. People who are affected by Covid-19 have not done anything
wrong, and they deserve our support, compassion and kindness.
2. Do not refer to people with the disease as
“COVID-19 cases”, “victims” “COVID-19 families” or the “diseased”. They are
“people who have COVID-19”, “people who are being treated for COVID- 19”,
“people who are recovering from COVID-19” and after recovering from COVID-19
their life will go on with their jobs, families and loved ones. It is
important to separate a person from having an identity defined by COVID-19,
to reduce stigma.
3. Minimize watching, reading or listening to
news that causes you to feel anxious or distressed; seek information only
from trusted sources and mainly to take practical steps to prepare your plans
and protect yourself and loved ones. Seek information updates at specific
times during the day, once or twice. The sudden and near-constant stream of
news reports about an outbreak can cause anyone to feel worried. Get the
facts; not the rumors and misinformation. Gather information at regular
intervals, from WHO website and local
health authorities platforms, in order to help you distinguish facts from
rumors. Facts can help to minimize fears.
4. Protect yourself and be supportive to others.
Assisting others in their time of need can benefit the person receiving
support as well as the helper. For example, check-in by phone on neighbors or
people in your community who may need some extra assistance. Working together
as one community can help to create solidarity in addressing Covid-19
together.
5. Find
opportunities to amplify positive and hopeful stories and positive images of
local people who have experienced COVID-19. For example, stories of people
who have recovered or who have supported a loved one and are willing to share
their experience.
6. Honor caretakers and healthcare workers
supporting people affected with COVID-19 in your community. Acknowledge the
role they play to save lives and keep your loved ones safe.
Healthcare workers
7. For health workers, feeling under pressure is
a likely experience for you and many of your health worker colleagues. It is
quite normal to be feeling this way in the current situation. Stress and the
feelings associated with it are by no means a reflection that you cannot do
your job or that you are weak. Managing your mental health and psychosocial
wellbeing during this time is as important as managing your physical health.
8. Take care of yourself at this time. Try and
use helpful coping strategies such as ensuring sufficient rest and respite
during work or between shifts, eat sufficient and healthy food, engage in
physical activity, and stay in contact with family and friends. Avoid using
unhelpful coping strategies such as tobacco, alcohol or other drugs. In the
long term, these can worsen your mental and physical wellbeing. This is a
unique and unprecedent scenario for many workers, particularly if they have
not been involved in similar responses. Even so, using strategies that have
worked for you in the past to manage times of stress can benefit you now. You
are most likely to know how to de-stress and you should not be hesitant in
keeping yourself psychologically well. This is not a sprint; it’s a marathon.
9. Some healthcare workers may unfortunately experience
avoidance by their family or community due to stigma or fear. This can make
an already challenging situation far more difficult. If possible, staying
connected with your loved ones including through digital methods is one way
to maintain contact. Turn to your colleagues, your manager or other trusted
persons for social support- your colleagues may be having similar experiences
to you.
10. Use understandable ways to share messages
with people with intellectual, cognitive and psychosocial disabilities. Forms
of communication that do not rely solely on written information should be
utilized If you are a team leader or manager in a health facility.
11. Know how to provide support to, for people
who are affected with COVID-19 and know how to link them with available
resources. This is especially important for those who require mental health
and psychosocial support. The stigma associated with mental health problems
may cause reluctance to seek support for both COVID-19 and mental health conditions.
The mhGAP Humanitarian Intervention Guide includes
clinical guidance for addressing priority mental health conditions and is
designed for use by general health workers.
Team leaders or managers in health facility
12. Keeping all
staff protected from chronic stress and poor mental health during this
response means that they will have a better capacity to fulfil their roles. Be sure to keep in mind that the current
situation will not go away overnight and you should focus on longer term
occupational capacity rather than repeated short-term crisis responses.
13. Ensure good quality communication and
accurate information updates are provided to all staff. Rotate workers from
higher-stress to lower-stress functions. Partner inexperienced workers with
their more experienced colleagues. The buddy system helps to provide support,
monitor stress and reinforce safety procedures. Ensure that outreach
personnel enter the community in pairs. Initiate, encourage and monitor work
breaks. Implement flexible schedules for workers who are directly impacted or
have a family member impacted by a stressful event. Ensure you build in time
for colleagues to provide social support to each other.
14. If you are a team leader or manager in a health
facility, facilitate access to, and ensure staff are aware of where they can
access mental health and psychosocial support services. Managers and team
leaders are also facing similar stressors as their staff, and potentially
additional pressure in the level of responsibility of their role. It is
important that the above provisions and strategies are in place for both
workers and managers, and that managers can be a role-model of self-care
strategies to mitigate stress.
15. Orient responders, including nurses,
ambulance drivers, volunteers, case identifiers, teachers and community
leaders and workers in quarantine sites, on how to provide basic emotional
and practical support to affected people using psychological
first aid
16. Manage urgent mental health and neurological
complaints (e.g. delirium, psychosis, severe anxiety or depression) within
emergency or general health care facilities. Appropriate trained and
qualified staff may need to be deployed to these locations when time permits,
general health care staff capacity in mental health and psychosocial support
should be increased (see mhGAP Humanitarian
Intervention Guide)
17. Ensure availability of essential, generic
psychotropic medications at all levels of health care. People living with
long-term mental health conditions or epileptic seizures will need
uninterrupted access to their medication, and sudden discontinuation should
be avoided.
Care providers for children
18. Help children find positive ways to express
feelings such as fear and sadness. Every child has their own way to express
emotions. Sometimes engaging in a creative activity, such as playing, and
drawing can facilitate this process. Children feel relieved if they can
express and communicate their feelings in a safe and supportive environment.
19. Keep children close to their parents and
family, if considered safe for the child, and avoid separating children and
their caregivers as much as possible. If a child needs to be separated from
their primary caregiver, ensure that appropriate alternative care is provided
and that a social worker, or equivalent, will regularly follow up on the
child. Further, ensure that during periods of separation, regular contact
with parents and caregivers is maintained, such as twice-daily scheduled phone
or video calls or other age-appropriate communication (e.g., social media
depending on the age of the child).
20. Maintain familiar routines in daily life as
much as possible, or create new routines, especially if children must stay at
home. Provide engaging age appropriate activities for children, including
activities for their learning. As much as possible, encourage children to
continue to play and socialize with others, even if only within the family
when advised to restrict social contract.
21. During times of stress and crisis, it is
common for children to seek more attachment and be more demanding on parents.
Discuss COVID-19 with your children using honest and age- appropriate way. If
your children have concerns, addressing those together may ease their
anxiety. Children will observe adults’ behaviours and emotions for cues on
how to manage their own emotions during difficult times. Additional advice
available here
Older adults, care providers and
people with underlying health conditions
22. Older adults, especially in isolation and
those with cognitive decline/dementia, may become more anxious, angry,
stressed, agitated, and withdrawn during the outbreak/while in quarantine.
Provide practical and emotional support through informal networks (families)
and health professionals.
23. Share simple facts about what is going on and
give clear information about how to reduce risk of infection in words older
people with/without cognitive impairment can understand. Repeat the
information whenever necessary. Instructions need to be communicated in a
clear, concise, respectful and patient way. It may also be helpful for
information to be displayed in writing or pictures. Engage their family and
other support networks in providing information and helping them practice
prevention measures (e.g. handwashing etc.)
24. If you have an underlying health condition,
make sure to have access to any medications that you are currently using.
Activate your social contacts to provide you with assistance, if needed.
25. Be prepared and know in advance where and how
to get practical help if needed, like calling a Taxi, having food delivered
and requesting medical care. Make sure you have up to 2 weeks of all your
regular medicines that you may require.
26. Learn simple daily physical exercises to
perform at home, in quarantine or isolation to maintain mobility and reduce
boredom.
27. Keep regular routines and schedules as much
as possible or help create new ones in a new environment, including regular
exercising, cleaning, daily chores, singing, painting or other activities.
Help others, through peer support, neighbour checking, and childcare for
medical personnel restricted in hospitals fighting against COVID-19 when safe
to do so. in accordance with previous ones. Keep regular contact with loved
ones (e.g. via phone or other accesses).
People in isolation
28. Stay connected and maintain your social
networks. Even when isolated, try as much as possible to keep your personal
daily routines or create new routines. If health authorities have recommended
limiting your physical social contact to contain the outbreak, you can stay
connected via e-mail, social media, video conference and telephone.
29. During times of stress, pay attention to your
own needs and feelings. Engage in healthy activities that you enjoy and find
relaxing. Exercise regularly, keep regular sleep routines and eat healthy
food. Keep things in perspective. Public health agencies and experts in all
countries are working on the outbreak to ensure the availability of the best
care to those affected.
30. A near-constant stream of news reports about
an outbreak can cause anyone to feel anxious or distressed. Seek information
updates and practical guidance at specific times during the day from health
professionals and WHO website and avoid listening to or following rumours that make
you feel uncomfortable.
Stay
informed
Find the
latest information from WHO on where COVID-19 is spreading:
Advice and
guidance from WHO on COVID-19 https://www.who.int/emergencies/diseases/novel-coronavirus-2019
https://www.epi-win.com/
Addressing
Social Stigma:
https://www.epi-win.com/sites/epiwin/files/content/attachments/2020-02-
24/COVID19%20Stigma%20Guide%2024022020_1.pdf
Briefing
note on addressing mental Health and Psychosocial Aspects of COVID-19
https://interagencystandingcommittee.org/iasc-reference-group-mental-health-and-psychosocial-
support-emergency-settings/briefing-note-about
Regards
Rural Mental Health Team
RuReSA, RuDASA, RHAP, PACASA & RuNurSA
|
Sunday, 29 March 2020
WHAT TO DO IN THE PRESENT GLOBAL CRISIS OF COVID-19
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