WHEN the World Health Organisation (WHO) declared Covid-19 as a global public health crisis, shortly after its surprise outbreak in Wuhan, China in December 2019, countries quickly reacted by activating their surveillance systems in a bid to protect their citizens.

The swift declaration was indicative of the massive impact of the pandemic on human life globally, which has seen more countries and international organisations shifting their budgets and channelling more resources towards health care services, so as to save lives.

While more attention has been directed to Covid-19 induced loss of life, disruption of normal business activity and subsequent adverse effects of these to overall economic performance, negligible notice has been paid to mental health issues of survivors and generality of citizens.

Mental health is a critical component at every stage of life, from childhood, adolescence and through adulthood. Unlike physical health, which is easy to detect, mental health speaks to the emotional, psychological and social wellbeing of a person.

These affect the way we feel, act and think – largely being determinants to human behaviour and how to handle stress, relate to others and make choices.

The International Journal of Mental Health Systems (IJMHS) states that Covid-19 mitigating measures such as quarantine, isolation, curfews, lockdowns and travel restrictions have resulted in loss of income, disruptions to daily routines and social isolation. These have laid the ground for negative mental health outcomes among societies.

Recently published reports indicate many African societies are experiencing a spike in incidents of domestic violence and alcohol use during the Covid-19 period, which emphasises the importance of behavioural strategies in containing the pandemic. This warrants a stronger mental health care response.

In Kenya, for instance, the IJMHS relates how that country’s government, through its Division of Mental Health, has initiated efforts to deliver mental health care during the pandemic. However, it explains that the mental health response was being hampered by an under-resourced mental health care system characterized by inaccessible services, an acute shortage of mental health workers and limited funding.

“This, coupled with the lack of a formal mental health response plan is hindering current efforts aimed at mitigating the mental health impact of Covid-19 in the community,” it said.

This scenario sounds true of several other African states where the uptake of mental health care services is generally low, with citizens left with no option but to rely on social resources, which have their own limitations.

According to the South African Journal of Psychology (May 2021), the outbreak of Covid-19 and its adverse impact on societies has magnified the global mental health crisis in the continent. Specifically, it notes that mental health issues are usually ignored and disregarded in times of infections and pandemics.

Health experts argue that mental health has serious socio-economic ramifications on a community, which may be more lasting than the overall physiological impact of the infections on frontline workers, leadership and for the average citizen. This is much more significant for wider Africa, where health systems are fragile and weak health budgets and remuneration pushing more experts to seek greener pastures outside of the continent.

United Kingdom-based mental health expert and founder of Lorac Healthcare, Carole Nyakudya, who is on record calling on Africa governments to prioritise mental health issues, says that the Covid-19 pandemic was causing increased stress and anxiety, especially on people with existing mental health problems.

"African governments must not ignore the mental health impact of the coronavirus because there is likely to be increased anxiety with more cases being confirmed,” says Nyakudya.

"The extreme stress and trauma associated with this stems from the fact that while trusted health experts are able to give information about Covid-19, there are no answers as yet in terms of vaccination to thwart this outbreak."

The World Health Organization has also acknowledged that the Covid-19 crisis was by far triggering stress or anxiety amid projections of a rise in depression, suicide and substance use.

For Nyakudya, who has been practicing as a mental health professional for 20 years, quarantine or self-isolation is likely to have a negative impact on mental well-being.

"Being separated from one's loved ones at a time like this is not easy, uncertainty over disease status, and boredom can also have a negative impact," she says.

Indeed, Covid-19 has necessitated a growing consideration of mental health implications, which has kindled more lobby efforts and engagements at different forums towards crafting of measures and proposals on mitigation strategies.

In developed countries, which boast of strong institutional health and research footprint, the pandemic has created a huge demand for mental health care specialist services as well as social science related support services.

Even the world’s leading economy, the United States, like all the other societies that battle social inequality, has had a relatively greater adverse mental health impact on disenfranchised and marginalised black Americans, according to WHO 2020.

Aided by research insight, there is now a growing push for mainstreaming of mental health components in Covid-19 interventions. This includes establishing a more supportive framework for frontline health care workers and other professionals as well as implementation of nationwide mental health care services to assist in dealing with the coronavirus-related mental health complications for individuals and communities.

Suggestions have also been made to the effect that a multi-disciplinary approach is needed to harmonise efforts to deal with physical, psychological, social, and neurological impacts of the virus, particularly on vulnerable populations.

It is clear, therefore, that the complications for individuals and communities emanating from the Covid-19 experience, require concerted efforts towards availing care and support, raising adequate public awareness and investing more towards mental health care workers and users.

_Tanya Nyathi is medical editor for FCB Health, a top Pharma Agency in New York. She holds an M.Phil in Communication Management from University of Pretoria in South Africa and an M.Sc in Journalism at Columbia University in New York. For seven years, she has been a regular health and science contributor to African news publications with a global audience.