Mental health amid Covid-19

An 18-year-old we have renamed Peter to safeguard him from picking stigma and discrimination was diagnosed with coronavirus on arrival from Zimbabwe in May.

The teenager, from Ntaja in Machinga, was among the eight returnees who escaped from Blantyre Emergency Treatment Unit before the expiry of their 14-day institutional quarantine, prompting health authorities to track and re-quarantine them.

“I had no choice, but to leave the isolation facility because I have a wife and a newborn who need my care,” says the returnee, who left for South Africa on March 14 this year.

Peter wandered off in search of new pastures after impregnating a girl in his rural setting, one of the main senders of migrants to South Africa.

However, the police in Zimbabwe detained him for travelling without a passport. He was among 10 young Malawians first held at Mutoko Prison before being transferred to Harare.

“We spent about two months in prison before being deported last month,” he says. “When I got home, I found nothing. My wife and child were starving. There was nothing I could do, yet everyone looks up to me for survival,” he narrates.

The situation has left Peter depressed as he is not allowed to interact with his family to cut the risk of transmitting the fast-spreading virus.

“People are calling me names and my family members are denied access to communal water points. The whole village has turned against us,” he states.

Psychiatrist Dr Saulos Gondwe says Peter’s mental breakdown could be silently haunting other Covid-19 patients, especially those with a history of anxiety, panic attacks and obsessive disorder.

“A person with anxiety already worries excessively and the added worry caused by coronavirus may worsen these symptoms,” says the mental health expert from St John of God Hospitaller Services.

He says people without a mental illness record may develop worrying distress.

“For example, the constant coronavirus messages may trigger anxiety which affects the individual’s health and the safety of those around him,” says Gondwe.

“Isolation and  related restrictions may bring extra stress likely to trigger mental illness.”

Psychologist Ndumanene Silungwe warns that the coronavirus pandemic is causing anxiety and panic among people without accurate information and positive coping strategies.

He is concerned that mental health and psychosocial support do not seem to be a priority in the national response.

“Where restrictions and lockdown are imposed, people are at risk of developing stress, reactions, anxiety and depression due to fast-changing social and environmental dynamics as well as disrupted economic inflow,” he says.

Malawi only dedicates one percent of the healthcare budget to mental health and most of it goes towards medication and salaries.

“There is zero deployments of mental health and psychosocial service professionals in major human service provisions in the country’s health, education and local government systems. Until recently, the training of mental health professionals was a luxury,” says Silungwe.

He commends higher learning institutions, including the University of Malawi, for introducing psychology and psychiatry courses.

Silungwe calls for a policy integrating mental health and  psychosocial services in  public health issues.

“Not just for Covid-19 only,” he says. “The take-home message is there is no health wirhout mental health. Physical illness in any form affects the way people think, feel, and act. When people are anxious and stressed, it also affects the immunity to physical illnesses.”

He reckons falling immunity exposes people that are perpetually stressed, fearful and panicky to coronavirus.

“It is easy for them to die not of the disease itself, but of the fear that leaves the body exhausted,” he says, calling for swift integration of mental health in public health.

The Ministry of Health has drawn a Covid-19 mental health response plan for primary healthcare workers. The guidelines for handling cases of mental distress list professionals on call in every district.

The mental health workers could be contacted for counselling and further referral.

Thus Gondwe wants the ministry to make the guidelines readily available for workers and tweak Covid-19 messages to include mental wellness issues.

He says mental health professionals should be fully involved in task forces at both national and district levels because neglect of mental health would slow the fight against coronavirus.

“Individuals with anxiety symptoms might find it difficult to seek appropriate care and those who develop a mental illness during the pandemic may not return to their previous level of productivity,” he warns.

In Ntaja, Peter is waiting for a day he will receive psychosocial support to bring his life to normalcy after the struggle with coronavirus infection.