Saving lives under the long shadow of the pandemic
Mains: General Studies-III: Technology, Economic Development, Bio diversity, Environment, Security and Disaster Management
World Mental Health Day (October 10): Along with fighting the virus, there is a growing need to make mental health and suicide prevention a priority.
How COVID-19 pandemic has ‘impacted populations multiple ways?
- The fear of being infected and anxiety about an uncertain present and future have impacted mental health severely.
- Lockdowns have led to isolation, in turn heightening anxiety and causing depression in societies, particularly in vulnerable communities’.
- While the novel coronavirus pandemic is ‘unprecedented in its scope and scale, previous studies suggest an elevated risk of suicide during such times’.
- There is some evidence that ‘deaths by suicide increased in the United States during the 1918-19 influenza pandemic, and among older people in Hong Kong during the 2003 Severe Acute Respiratory Syndrome (SARS) epidemic’.
- However, it has been noted that a rise in suicides in the wake of the pandemic is not inevitable.
- Preliminary information from New Zealand, Japan and the United Kingdom suggest lower suicidal behaviour at least in the early phase of the pandemic.
India’s dubious distinction
- Before the pandemic, India’s progress as one of the fastest growing economies led to large paradigm shifts in the daily lives of its citizens.
- Major lifestyle shifts led to the rise of many lifestyle disorders in the last decade.
- Mental health disorders are one of the disorders of most concern, which have been swept under the carpet of stigma and discrimination.
- Many suicides are related to psychological disorders and distress.
- India reported the first COVID-19-related suicide in the world, on February 12, 2020.
- While the pandemic has affected the entire country, case incidence rates are the worst in States such as Maharashtra, Andhra Pradesh, Tamil Nadu, Karnataka and Uttar Pradesh.
- some of the States are also major contributors to suicidal deaths per year — Maharashtra (18,916), followed by Tamil Nadu (13,493), West Bengal (12,665), Madhya Pradesh (12,457) and Karnataka (11,288).
- Dire socio-economic conditions arising from the pandemic — mass migration, unemployment and economic distress — make at-risk groups even more vulnerable during these times.
New normal: consequences
- The pandemic’s massive toll on human well-being — in a physical and mental sense — has completely changed the way people live.
- Necessary precautions such as social distancing, limited interactions and mask usage have become the new normal, with a huge social, physical, economic and mental consequences.
- Uncertainty as a result of the pandemic is to stay for the foreseeable future.
- The fear of getting infected, coupled with a lack of knowledge and the economic fallout has created a new level of stress not seen by many before.
- This is compounded by isolation from the community, causing high levels of mental duress and ultimately, COVID-19-related suicides for many.
- This situation is the worse among vulnerable populations who are susceptible to greater risks of infections such as:
- Health-care workers,
- Infected people,
- The elderly,
- Migrant workers,
- Those from resource-poor backgrounds,
- Women facing domestic violence,
- Individuals with compromised immunity,
- And those suffering from physical or psychological problems.
- A case series of newspaper reports of suicide in India during the early lockdown phase found that suicide was associated with the fear of infection, social isolation and pandemic-related economic concerns.
- The findings reveal that one in four of these deaths occurred among hospitalised patients, demonstrating the need for extra care and vigilance during institutional treatment for either COVID-19 or any other illness.
- The sudden closure of alcohol/liquor outlets resulted in an increase in alcohol-related suicides.
To help a person cope with the situation:
- There is a growing need to make mental health and suicide prevention a priority.
- At an individual level, any early signs of poor mental health such as a sudden change in behaviour, substance use, anxiety, disturbed sleep and difficulty in communication should not be ignored.
- While the feeling of uncertainty during this pandemic is normal, being informed and limiting ourselves to authentic sources of information and reducing exposure to distressing news is a good mechanism.
- Suicide prevention requires a mix of a top-down and a bottom-up approach, ensuring that all interventions are rooted in empathy.
- India has created a task force to develop a national suicide prevention strategy.
- The plan incorporates the three universal strategies, including a ban or reduction in access to highly hazardous pesticides, reduction in consumption and availability of alcohol, and a non-sensationalised and responsible portrayal of suicide by the media.
- The media would need to follow Press Council of India’s guidelines on reportage of suicideand also create awareness about suicide prevention.
Seeking support is key
- There is an urgent need for destigmatising suicide as a phenomenon and ensure there is an increase in the number of functional and accessible helplines and training of gatekeepers.
- a system intervention can focus on identifying, supporting and referring suicidal individuals at all levels of the health-care system.
- It is essential that if suicide has been attempted the individual has the required intervention and regular contact support.
- A majority of individuals who are suicidal do not really want to die but find living difficult. Support at the right moment can change this decision.
- Understanding, compassion and support, at both an individual and the systemic levels, can save a life.