(Fiza waseem, Karachi)

The unprecedented widespread pandemic of the novel coronavirus (COVID-19) has continued to have a tremendous impact on nations around the world. Government controls and restrictions were put in place and are currently being updated to increase social isolation and social (physical) distancing to slow the spread of the virus. As a result, it is expected that there will be unparalleled psychological distress impacting individuals at a global level. Given that the COVID-19 pandemic is expected to continue for the coming months with the possibility of multiple waves, it is imperative to understand the magnitude of mental health issues that will arise during and after this public health crisis.

Numerous studies have been conducted to evaluate the issues emerging from the novel coronavirus, e.g. MEDLINE, PubMed, APA PsycInfo & CINAHL. They have reviewed many articles and worked for the betterment of the society. From these articles, important mental health themes identified were related to social isolation, social (physical) distancing, quarantine, caregiver stress, unemployment, and death/illness. The impact on frontline workers and those suffering from mental health disorders are also important factors during this pandemic. These themes provide important areas for mental health strategies and policies which will ultimately impact the burden of mental health in the months to come.

Mental health issues during pandemics are related to acute stress and fear associated to the outbreak, adverse effects from prolonged social distancing, social isolation, and quarantine, and the loss of loved ones or caring for the ill. It is expected that there will be a severe strain on mental health resources during and following the pandemic, putting extreme pressure on existing resources and potentially leading to untreated mental health concerns across populations worldwide. Specifically, if we talk about the elements of the society akin Medical sphere; Doctors and further paramedical staff is going through the mental catastrophe also on the stake of life on frontlines. For instance, they face mental breakdowns, lack of motivation, get distanced from their loved ones, disruptive salaries and so on. As per talking about their solutions many of the countries abroad are managing to establish the Psychological departments on every district hospital. The doctors can easily take guidance and motivation from the professional, well trained psychologists. Also can discuss their mental problems and patient’s mental condition as well. This step should be normalised in our country too.

To move forward with mental health considerations during and after the pandemic, there needs to be better understanding of the magnitude of psychological distress experienced by individuals. As a citizen of a country with full of complexity and diversity, every individual is also going through the severe or might minor mental maladjustment. Everyone is facing the disruption of routine, economic breakdown, self isolations, depression, anxiety, loneliness, illness and many more. Unfortunately, there's no Psychological departments available on every district hospitals or on local platforms. The local people have to overcome their mental hurdles by their own. Which would extremely hard for some people. Only Elites can have access to the well-known psychiatrist and a middle-class man keeps on fighting with the loneliness.

New cases are increasingly diagnosed in younger age groups, however less common. Given the rising number of cases and deaths around the world, there will be a significant toll on mental health across all age groups and populations. Such as, the youth of the population are facing all the above mentioned difficulties plus they are also bound to manage their E-learning programmes. Which is really not satisfying in under-developed countries. The educational departments do not have the proper facilities of online learning, their teachers are untrained, a huge number of population do not have the access to the internet. These are the really tough reasons which are probably producing a massive amount of mental illness in the youth all over the World. There is an urgent need to maintain E-learning resources to keep the mental health well in these large populations as the COVID-19 pandemic continues to progress at a large scale.

Psychological distress is also an important factor among caregivers who are parents to young children, those with elderly parents or looking after elderly family members, and those looking after the ill. As COVID-19 appears to have the most impact on elderly populations, there may be increased fear and anxiety among caregivers responsible for elderly individuals. There is also fear and anxiety when looking after young children or dependents. A previous study assessing psychological distress during a disease epidemic in Australia identified that families with one child had a 1.2 times higher risk of psychological distress than those with no children.

With the economy recessing during the pandemic, this will significantly affect the population’s overall health. The increase in unemployment due to the pandemic will result in financial strain, debt, and job-seeking challenges impacting individual mental health. Studies have shown that a recession period resulting in unemployment is associated to deterioration of a population’s self-reported health and a lower life satisfaction level . This in return increases population psychological distress and prevalence of depression and anxiety disorders. Studies have also shown associations between unemployment and suicidal behaviour. Economic stress not only impacts individual mental health but can decrease the overall mental health of families and communities collectively. As a result, there may be a decline in parenting quality and children mental health. The impact from unemployment can be long term if there is no financial support or economic improvement.

Thoroughly , Mental health preparedness for widespread pandemics should be developed with effective action plans worldwide, especially in countries where resources are abundant. When health resources are tremendously strained during a widespread pandemic, it is expected that mental health services will not be the principal priority during the pandemic. However, there will be significant challenges to the depth of the mental health impact following the pandemic, which will strain the health services even further. Psychological longitudinal surveillance may be necessary during this pandemic to identify important determinants of psychological distress and to improve understanding for future pandemics. As the course of the COVID-19 pandemic continues to unfold and is expected to affect global populations in multiple waves, there is an urgent need for mental health resource preparation. This will be especially apparent as the virus is contained or begins to slow down. Mental health issues need to be considered in order for appropriate programs and strategies to be developed. Direction and policies need to be put into place to effectively facilitate the burden of mental health in the months to come.

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