A mental health pandemic is brewing in the midst of COVID-19. Globally, the rates of suicides are rising. This calls for urgent action to provide care and support to sufferers of mental health disorders and a plan to be proactive before the next infectious disease pandemic.
A silent pandemic is brewing in the midst of the COVID-19 pandemic – a mental health one. New research published by Nature Human Behaviour (1) shows monthly suicide rates increased in Japan by 16% during the second wave of the pandemic (July to October 2020), with larger rates of increase among females (37%) and children and adolescents (49%). The increase among women was about five times that of men. The increase in suicide rates was attributed to lost jobs, lost incomes and a sense of hopelessness.
The increase in suicides as a result of COVID-19 is not restricted to Japan. In South Africa, 1,781 suicide-related deaths occurred during lockdown between 27 March and 27 July 2020. In Malawi, there was a 57% increase in suicides in 2020 (162 recorded suicides versus 118 in 2019). In Las Vegas, spikes in death by suicide among teenagers is pushing schools to reopen despite the rising cases of COVID-19. In Nigeria, COVID-19 has also led to a spike in suicides.
COVID-19-related suicides should worry everyone because of the stigma associated with mental health disorders and the likelihood that sufferers may not seek care due to city lockdowns. People have lost jobs, have financial troubles and there is no end in sight for this difficult time. Understandably, people are anxious, panicky and may dabble in substance abuse.
Proactive Plans Needed to Provide Mental Health Care During Covid-19
Even with the availability of different COVID-19 vaccines, it will take time for the pandemic to be declared over. Financial woes will not end overnight, and the risk of suicide is still high. There must be short- and long-term plans to provide help to those in need of mental health care.
These are three ways to achieve that.
1. Creating equity in health education
To achieve equity in healthcare, there must be equity in health education. Governments, public health authorities, NGOs and other stakeholders must prioritize educating communities to improve knowledge of mental health disorders. They must explain that there is no shame in having a mental health disorder and teach the community the right words to use in describing these conditions. Information about where and when those who feel overwhelmed should seek assistance is also important.
Journalists should also be trained to report mental health issues ethically. They play critical roles in disseminating information to the public and must do it appropriately. For instance, in the Voice of America (VOA) article cited in the Malawi suicide statistics above, a quoted police officer mistakenly describes suicide as “people killing themselves.” This description not only perpetuates the stigma associated with mental health disorders, it also puts the blame on the victim and dissuades others from seeking care. The correct expression is “people die by suicide.” Community liaisons must learn to describe suicide properly.
2. Diversifying the pool of mental health counselors
We must diversify the mental healthcare human resources pool by training respected community members as mental health counselors. The Friendship Bench, which began in Zimbabwe, trains grandmothers to provide mental health support and diagnoses. A randomized clinical trial of this methodology in Journal of the American Medical Association (2) shows that the use of lay health workers in resource-poor countries like Zimbabwe may be effective in managing common mental disorders.
Using revered community members is increasingly relevant in this time when cities are on lockdown and people are at home. Community health workers live locally so are easy to call upon when needed. With the rising cases of COVID-19, community health workers must be protected from being infected themselves, especially because most of them are elderly and are already at a higher risk of contracting the virus and even dying from it. Best practices like those used by the Friendship Bench dictate that consultations with clients must take place outdoors, and that both health workers and clients must wear face masks at all times and maintain at least 6 feet of physical distance between each other. Community health workers should also sanitize their hands before and after consulting with their clients.
3. Mental health included in future epidemic preparedness plans
Future epidemic preparedness plans must include mental health support and care as important components. COVID-19 will likely not be the last pandemic, and the response to this one has shown many gaps in mental health support. Future pandemics would likely lead to similar job losses and city lockdowns that have mental health consequences. Public health authorities should be prepared to prevent suicides and provide support to those at risk.
Data across countries reveal that common risk factors for deaths by suicide include job loss, loss of income, and a sense of hopelessness. All are common elements of a pandemic. Mental health plans should include palliatives and other economic cushions that would enable individuals to take care of their daily needs while waiting for the economy to recover.
Suicides are Preventable
As project director of Nigeria Health Watch’s epidemic preparedness project, the economic link to suicide risk is a major lesson for my team as we continue to advocate to the Nigerian government to increase budgetary allocations to prevent epidemics in the country.
Suicides are preventable. Let’s ensure that COVID-19 doesn’t take even more people this way.
Ifeanyi M. Nsofor
References:
- Tanaka, T., & Okamoto, S., “Increase in suicide following an initial decline during the COVID-19 pandemic in Japan”, Nature Human Behaviour, 2021.
- Chibanda, D., et, al., “Effect of a primary care–based psychological intervention on symptoms of common mental disorders in Zimbabwe: a randomized clinical trial”, JAMA, 2016.
