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Global challenges and assitance during the COVID-19 pandemic

For the poorest countries and refugees, preventive measures will be very challenging, and a large number of people around the world will experience increasing psychological consequences of the pandemic.

Marked i Dongola, Sudan
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As the pandemic seems to be about to hit the poorest countries and refugees, an increasing number of people will be affected by infection, disease, and the financial problems following the virus containment procedures. A large number of people around the world are at risk of suffering the psychological consequences of the pandemic.Most people with mental health problems live in the low and middle income countries, and it is estimated that 80% do not receive treatment. Poverty is a known risk factor for mental health problems. The pandemic will worsen the situation.

Although we do not know the mental consequences of the Corona virus, we do have data based on prior epidemics, including the SARS epidemic in 2008-2009. A serious viral epidemic can lead to major mental health challenges such as depression, anxiety and loneliness. Measures to contain the virus also cause serious financial concerns and fear for the future.. When a large number of people are isolated, they lose many of their sources of stimulation, distraction, and opportunities for social support and activity. The main sources of support and mitigation of stress are greatly reduced.

So what happens when this situation occurs in poor areas , or in contexts with nearly non-existent mental health care? It is only a matter of time before the pandemic reaches the poorest countries. Is it possible to  mitigate the psychosocial consequences?

There has been much  attention to mental health in Norway in the Corona situation. We can raise awareness of the importance of mental health and psychosocial factors, and prevent stigma and human rights abuse against people with mental health issues. Mental health considerations should be an integrated part of the overall efforts to manage the corona pandemic.

We do have knowledge of how psychosocial considerations can be integrated into other mitigation efforts and aid measures. Through cooperation among various organisations, and by learning from prior mistakes, guidelines for such efforts have been developed. It is important that measures taken are firmly rooted in the context in which the interventions will  be provided, and that they are adjusted to local needs and resources.

Evidence-based measures have been tested in  humanitarian settings to address mental health issues, strengthen health, manage stress, and support parents and other caregivers. These have been tried out in humanitarian settings over time. One example is a self-help program called Self Help Plus, where a  recent study conducted among female refugees in South Sudan found good results, even in difficult settings.

It is essential to understand the needs of vulnerable groups in each region or country. There are many reasons to focus on these groups when planning mental health measures.

 

Strategies may be needed to provide information and self-help advice to groups that do not use social media extensively, or who need specially adapted information, such as people who live with visual or auditory impairment or minority groups who do not speak the official language. organise Direct social contact with isolated groups, may be needed, such as telephone contacts, Skype meetings and other virtual meeting places. Some may need help to establish and maintain social contact via digital means. Special measures and advice should be designed for those who are isolated or quarantined. Women and children who are in isolation and quarantine, and who are at risk of partner violence or abuse, are at particular risk and need help to get to safety. Materials in the form of information packages and activity advice for families with children who are isolated can also play an important role. In many countries, large groups of children will be left to themselves, because schools are closed and parents still have to be at work. Programs for these could also be important. Most of the research on the psychological consequences of epidemics and quarantine has been done in the high income countries, but mental health problems are not a Western phenomenon. Crises increase risk directly and indirectly. There are many ways to deal with crises. We can learn a lot from people living under other social and cultural conditions. There is no health without mental health. This is an opportunity to build back better.

https://linkinghub.elsevier.com/retrieve/pii/S2214109X19305042