National  action,  specifically  the  expanded  community  quarantine  to  contain  the  spread  of COVID-19 dramatizes the need for every citizen to be part of the solution. What happens to the  individual  affects  his  community  and  what  happens  to  the  community  affects  the individual.. This  interconnectedness  is  at the  core  of  the  pursuit  and  promotion  of physical  health and psychosocial well-being, and the prevention and treatment of ill-health.

Needless to say, the COVID-19 pandemic poses a strain and stresses the individual’s healthIncluding their mental health.  Hence, the Philippine Council for Mental Health, (PCMH) calls attention to the vital need to address the mental health and psychosocial consequences of this crisis  along  with  the  quest  for  treatment  strategies  and  intervention  for  the  physical  and material consequences of this extreme life experience on individuals and their communities.

The suddenness of the impact of this experience and their psychosocial consequences on the Daily  lives of individuals in their respective communities cannot be ignored. Though expected these consequences can be overwhelming putting individuals to be at risk for mental health conditions. Such strategies recently imposed on every individual in the country such as physical  distance, self or community quarantine, school suspensions, working from home, etc. can have  short-term  and  long-term  effects  on  the  mental  and  psychosocial  wellbeing  of individuals ,families and communities . Community quarantine, magnifies the deficits in opportunities and material deprivation of those who have less in  life. In the extreme case, safety from the virus could come face to face with the reality of starvation.  in the case of starvation with families with limited  wherewithal to bring bread to the table.

Through  all  these,  the  PCMH  is  in  agreement  with  the  guidelines  set  forth  by  the  United Nations  Interagency  Steering  Committee  (UN-  IASC)  for  Mental  Health  and  Psychosocial Support Services (MHPSS) in Emergencies. The PCMH aims at providing support programs, to  protect  and  promote  psychosocial  well-being  and  to  prevent  and  treat  mental  health conditions.

In  this  regard,  the  PCMH  recommends  the  following  during  this  time  of  crisis  due  to the COVID-19 pandemic:

 

I. Promote Psychosocial Wellbeing in Everyone

  1. Recognize that crisis occurs when sudden and/or adverse circumstances affect a person’s ordinary life.  In epidemics and disasters these events put people in extreme stress  and  physical  and  psychosocial  reactions  are  expected  from  them.  These reactions include being sad, afraid, worried, angry, or confused, and although they are generally  unpleasant  they  can  be  expected  and  generally  therefore  considered “normal.” 
  1. It is okay not to feel okay. In situations of extreme stress, one can expect not to feel okay.  Talking  or  venting  feelings  to  somebody  you  trust  is  helpful  in  overcoming negative feelings due to stress. Talking with a mental health professional is also okay. People should not be afraid of feeling judged and stigmatized for doing so. 
  1. Engage in healthy activities that you enjoy and find relaxing. If one must stay home or in isolation, maintaining a healthy lifestyle, which includes a daily routine, exercise, eating healthy food, getting enough rest and good sleep, praying or finding quiet time for yourself,  and enjoying moments with family and loved ones, can help maintain positive mental health during this time. 
  1. Facts minimize fear. Gathering facts and accurate information from reliable sources will help in determining risks and planning appropriate precautions. However, people should  also  limit  their  daily  exposure  to  various  forms  of  media.  Overexposure  to negative and alarming news can be very upsetting. 
  1. Draw on  the  skills  that  have  helped  in  the  past  to  manage  previous  crisis/adversities, and use these  skills to  manage this present one.  One looks at his/her life  in  perspective  as  one  considers  the  options  one  needs  to  take  to  overcome  the crisis.
  1. Shift perspectives away from number of deaths toward number of recoveries. A change of perspective is necessary. In fact, a sense of hope instead of fear could allow leaders  and  every  citizen  to  better  cooperate  with  one  another  –  a  vital  element  in defeating this outbreak. 
  1. Words do matter. When talking about coronavirus disease, certain words (i.e.Suspect, case, isolation…) and language may have a negative meaning for people and fuel stigmatizing  attitudes.  They can perpetuate existing negative stereotypes or assumptions, create widespread  fear, or dehumanize those who have the disease. Do talk about “people who have COVID-19”, “people who are being treated for COVID-19”,  “people  who are  recovering  from  COVID-19”  or  “people  who  died  after contracting  COVID-19”.  DON’T refer to people with  the  disease  as  “COVID-19 cases” or “victims”.

 

II. Promote Psychosocial  Wellbeing  among  the  Team  of  Frontline  Workers  and their Agencies and Supervisors 

  1. Frontliners should  be  allowed  to  express  their  fears  and  apprehensions.  Their work  is  tough  and  highly  stressful  and  much  is  expected  of  them  at  this  time.  The demands on frontline health workers can stretch the limits of human endurance. They blame  themselves  for  not  doing  enough  and  push  themselves  to  work  harder. In helping  them  recognize  these,  they  should  be  guided  to  see  that these  psychosocial reactions  of frustrations, sadness, isillusionment, anger, etc. are expected and can be considered  “normal”. 
  1. Recognizing their hard work during this crisis is important. This includes, at the very  least,  ensuring  they  have  all  they  need  to  carry -out  their  work  properly  and efficiently  –  including  providing  them  with  personal  protective  equipment  and ensuring  that  appropriate  protocols  are  in  place  to  keep  them  safe.  Leaders and supervisors  are  encouraged  to  recognize  the  vital  contributions  of  frontline  health workers to the positive resolution of this crisis. They should listen to their concerns; give  them  credit  for  their  diligence,  commitment,  initiative,  innovativeness  and personal sacrifices in the conduct of their duties. Providing appropriate incentives will help make these expressions of support more tangible. 
  1. Frontliners need to be given time to take care of their own basic needs too. They must  be  able  to  rest  and  recover  from  work  through  regular  shift  schedules,  and encouraged to engage in physical activity, spend quality time with loved ones, pray or find quiet time with themselves, eat healthy food, and sleep well during breaks from work.
  1. Frontliners may be subjected to stigma due to the nature of their work at this time,  notwithstanding  their  possible  exposure  to  the  virus  itself.   They  may experience stigma from different sectors of society  –  even among their own families, close  friends,  co-workers  and  law  enforcers.  This  will  make  an  already  challengingand  stressful  situation  worse  and  can  interfere  with  their  ability  to  serve.  We  must care for them as we would any member of our society. 
  1. Finding time  to  reflect  is  important  to  maintaining  positive  mental  health. Drawing  on  skills  and  resources  that  have  helped  during  past  crises  can  help  in managing  the  current  crisis  and  minimizing  the  negative  impact  of  stress  on psychosocial wellbeing. 
  1. Frontliners are encouraged to be open to accept help from a friend whom he/she trust or seek A mental health professional and not be afraid that he’she will be judges a failure or   a  mental  patient.  Feelings of  guilt  arising  from  thoughts  that one  has  not  done enough can  worsen  the  stress.  This can  feel  very  overwhelming.  Changes  in  mood, such as feeling anxious, irritable or low and tired all the  time, may make it difficult to relax  even  outside  work.  Confiding  with  someone  being trusted  or  talking  to  a  mental health professional will help process these feelings.
  1. Policies and protocols of hospitals and other agencies involved in the frontlines should recognize and prevent burnout.  This is a common consequence of extreme stress. Work schedules and assignments and appropriate referral systems should be in place to ensure the provision of mental health and psychosocial support.

 

III. Promoting Psychosocial Well-being in Children 

  1. In times  of  crises,  it  is  common  for  children  to  seek  more  attention  and  be demanding  on  parents.  Children  also  often  observe  parent’s  behaviours  and emotions and derive from this for ways to manage their own emotions.  Keep them close and share simple  facts about what is going on. Discuss COVID 19 with them using honest language to ease up their fear and anxiety. 
  1. Maintain familiar daily routines at home, since they must now stay at home away  from  school.  Encourage  them  to  continue  to  have  physically  activities  like playing, even if only with family members because of restricted social contacts. 
  1. Create new routines by providing regular time for learning activities such as doing the work they would have had if they were in school. Encourage contact with friends/classmates, through phone calls or texts.  
  1. At all times, parents should respond  to  their  child’s reaction in a supportive gentle  way,  by  listening  to  them, and showing them  affection, not being  judgemental  and being  aware  that  children  respond  to  stress  in  various  ways  like  being  a clinger, anxious, fearful, or showing behavioural changes, being agitated or bedwetting.  Be  open  to  seek  help  from  a  mental  health  professional  if  these child’s behaviour is overwhelming.

 

IV. Psychosocial Well-being of Older adults, the elderly: 

  1. They may  find  it  difficult  to   keep  in  touch  with  their  loved  ones  and other supports during the quarantine.  This can make them feel lonely and cause  mental  distress.  Prepare  a  personal  safety  pack,  which includes  personal information  and  available  contacts  like  family  members,  list  and  supply  of regular medicines, storable food and snacks and bottles of water, for at least two weeks. 
  1. Provide emotional  support  through  informal  networks  of  families, neighbors, and health personnel.  Encourage family  members to call their older relatives as often as possible. 
  1. Encourage older  people  to  take  care  of  their  own  needs,  to  engage  in physical  activities,  age  appropriate  exercises  and  their  usual  ways  of  relaxing and enjoying themselves  with family members at home,  to keep regular  routines of eating, and sleeping,  and to ask or call for help if necessary. 
  1. A constant stream of news reports can cause anyone to feel distressed and anxious.  This can be more intense for older people.  When sharing information  use  words  that  will  help  older  people  understand  without  much stress.  Instructions need to be communicated in a clear, concise, respectful and patient  way. Share facts about what has happened, explain what is going on now and  give  them  clear  information  about  how  to  cooperate.  For older people, patience is necessary because this information may need to be repeated whenever necessary.  It  may  also  be  helpful  for  information  to  be  displayed  in  writing  or pictures.  This may be especially necessary if there are memory lapses observed in an older person.

 

IMPORTANT REMINDERS FOR EVERYONE:

There is no health without mental health.

THE WHO states that health is the state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity. The pursuit of Health for All necessarily involves the pursuit of the physical and psychosocial wellbeing of the human community during ordinary or extraordinary times.

Mental health and psychosocial support is therefore integral to a complete public health response to any crisis or emergency.

This crisis has only highlighted what we have known to be true all along – we are all connected as one human community. The Virus will only be contained if we ALL act as ONE. By being responsible and taking good care of ourselves, we are also taking care of each other.

Strength, determination, cooperation, kindness and prayers will see us through this extraordinary episode in our lifetime. Our connectedness with each other, not our differences is what matters NOW more than ever.