Contributions by Academic Department of Psychiatry & Behavioural Sciences KEMU/Mayo Hospital Lahore

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 Mental Health Challenges in Pakistan and COVID-19
Contributions by Academic Department
of Psychiatry & Behavioural Sciences
KEMU/Mayo Hospital Lahore

LAHORE: The COVID-19 pandemic is one of the biggest public health challenges the world has faced in recent memory. World Health Organization says and everyone who has experienced 2020 agrees “Fear and stress are common and normal response to the uncertainty”. However, if we add other factors like lockdown, deaths of loved ones, people with existing mental health issues, financial insecurity including food insecurity specially in daily wagers, exhaustion in front line workers, and lack of physical interaction in this seemingly never-ending year, we get people with significant mental health problems and very few ways to cope up. So it is very obvious that we seem to have a mental health crisis on our hands. Neuropsychiatric manifestations of COVID-19 have also been proven through multiple studies. Even with hope of impending vaccines, we know from research after previous epidemics that there are significant long term effects including Post Traumatic Stress Disorders.

Mental Health professionals around the world have experienced very significant increase in new patients. This also extends to Pakistan where there is already a glaring lack of psychiatrists and psychologists. Most mental health professionals in Pakistan have started telemedicine following global lead but there is still a wide treatment gap. Pakistan doesn’t have any free public mental health or suicide helplines. A few private ones are not up to required standards nor supported by national public or private mental health organizations. So, a significant load has fallen to public hospitals and their support of telemedicine.

Academic Department of Psychiatry and Behavioral Sciences KEMU/Mayo Hospital is leading the charge against mental health tsunami of COVID-19 not only for Lahore, but also providing education, clinical services, innovation and public engagement for the local, national and global audience. It was among the first facilities in Pakistan and remains only public mental health facilities in the province to offer telemedicine services, free of cost. In addition to this, the department has provided 24/7 availability of psychiatric consults to admitted COVID patients for their mental health ranging from isolation anxiety, depression to ICU psychosis and neuropsychiatric manifestations of COVID. Furthermore, rejection by society as well as stigmatization are also consequences of strict isolation / quarantine and mandatory contact tracing in the illness and need psychosocial intervention. Many patients needed help with social issues and financial assistance and were linked with appropriate services.

Psychological first aid is a concept which highlights the need for reaching public and first responders after a disaster. In the case of this pandemic there was continual need for reaching health care workers in the whole country. Psychiatry Department at Mayo Hospital made sure to have weekly webinars to ensure appropriate psychological first aid to doctors at Mayo hospital. With UNICEF and provincial health department, it also organized master trainer workshops to train health care workers around the province to help others. The department also collaborated with psychiatrists in other provinces for national outreach. This work has been acknowledged by provincial and federal governments and NMDA. School teachers training of psychological impact on teachers and students in context of COVID-19 has also been conducted by Child Psychiatry team of Mayo Hospital, Lahore.

COVID-19 pandemic seems like it is here to stay for next year at the very least. It is essential that the government and health agencies start preparing for national and local health care systems for this duration. Mental health is a global concern echoed by WHO, UNICEF, CDC and other organizations. Pakistan’s mental health system is inadequate at its best. It is need of time to invest more resources in national and local mental health facilities especially in public sector so that we have some chance of preserving sanity of our people in a truly insane decade.

Report by Dr. Maryam Ayub (Post graduate resident Psychiatry) & Prof. Nazish Imran. (KEMU)

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