Mental health in T&T challenged by pandemic stressors

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The COVID-19 health pandemic has brought financial, health and emotional distress to many in T&T and around the world.

According to a Washington Post report last November, Since COVID-19 arrived, depression and anxiety in America have become rampant. Federal surveys show that 40 per cent of Americans are now grappling with at least one mental health or drug-related problem.

T&T’s citizens, old and young, have been no less impacted by this pandemic which has wreaked social and economic havoc.

Dr Katijah Khan, lecturer in Clinical Psychology at the University of the West Indies (UWI) spoke to the Sunday Guardian about how the COVID-19 pandemic has affected the mental health of citizens.

Q. Has there been an increase in mental health issues since the COVID-19 pandemic hit T&T?

*What groups of people have been most affected? What are the demographics in terms of age, sex, race etc? What types of adverse mental or behavioural health conditions are being exhibited?

A. It was predicted that there would be an increase in mental health problems arising out of the pandemic and this has been seen in many different contexts. Organisations have reported an increase in reports of child abuse and gender-based violence. While not reaching levels requiring professional help, in all the outreach, seminars and public talk I have given, every single one, people report higher levels of stress, be it private sector professionals, healthcare workers, teachers, parents or students. They report more symptoms including worry, anxiety, depression, problems concentrating, irritability, headaches, aches and pains, changes in appetite, sleeping and substance use. Among university and secondary school students we have seen higher rates of anxiety and depression due to the pandemic as well as heightened concerns about the quality and future of their studies and a fear of failure.

Last week, a 14-year-old child died by suicide. How vulnerable is this age group? Has the vulnerability among children grown, especially since the COVID-19 pandemic hit?

Suicide is still a pressing social and public health problem in our country and unfortunately, children are also affected. The most recent Global School Health Survey of 2017 reported some alarming statistics for Trinidad in which 24 per cent of school children aged 13-17 seriously considered suicide in the last year, 14.4 per cent attempted suicide in the past year and 9.5 per cent said they did not have any close friends. This will continue to be a problem throughout the pandemic.

School not only provides an academic education but gives children opportunities to socialise, interact physically and develop important socio-emotional skills. Online schooling is not able to provide all of these and, as such, the isolation and stresses of online schooling can worsen stress and take a negative toll on children’s emotional and mental health. Like adults, many children also are experiencing frustration and “Zoom fatigue”. Children living in homes with limited resources and no access to devices or connectivity are even more vulnerable during the pandemic as they are at higher risk to fall behind academically and cognitively. Children in dysfunctional homes, homes with conflict are also likely to witness more domestic violence and themselves be subjected to more verbal, physical and psychological abuse.

What can be done to assist with or mitigate mental health issues among children/others during these times of crisis?

We need to continue to be wary of the signs and symptoms that our children are struggling with and respond by offering more care, patience, compassion and support. Children do not yet have fully developed emotional maturity and reasoning skills and as such, they may not know how to cope well or may overreact to things that seem minor to adults. Families and parents need healthy conflict resolution skills as children often model coping from their parents. The Office of the Prime Minister recently launched an online tool to help children cope with the pandemic. Schools and teachers can also devote more of their online schooling time to activities that help build socio-emotional skills. Kudos to those schools doing this already! Parents need to know where to reach out for help for their children, for eg, Child Guidance Clinics, School Counsellor, Student Support Services. Children can also call Childline, a 24-hour free helpline (dial 800-4321 or 4131) for support. We also need citizens to continue to be vigilant and call and report instances of child abuse when they see it.

There were also news reports this week about a nine-year-old child who died after taking up a TikTok challenge online. With children being online at home with less or no parents and less supervision, do you expect to see more incidents like this?

Children are spending more time on devices and, as such, it is critical for parents to be vigilant about the content and people that children are interacting with online. The Internet is a great tool to help children explore, learn and be entertained. But we also need to think of it as a vast unknown with areas unsafe for children, with potential predators and danger lurking around the corner. You would not let your child roam freely and alone in such a space, the same goes for the Internet. Have conversations with them about what is safe, inappropriate or dangerous. Especially for younger children and adolescents, check up on their Internet and social media use and utilise the parental controls that can limit their access to inappropriate content and sites. When you set limits, explain to them why you are doing so in ways they can understand and as such be more likely cooperate. Parents can get more information from CyberSafeTT, a local organisation doing great work to promote internet safety for children.

What kinds of support services are there for members of the public with mental health issues?

*Do you believe the Government is doing enough to make facilities available to the people who are vulnerable?

Members of the public can access mental health services across the country through health centres, wellness centres, hospitals and clinics and a list of these are located on the Ministry of Health’s website. However, due to the great demand and limited resources, it is often difficult to access these services, especially for children and adolescents.

As part of the response to the pandemic, the Ministry of Health through its MHPSS (Mental Health and Psychosocial Services) Technical Working Group, which I am a member of, has just launched a directory of mental health crisis support services which are free to the public and which can be accessed through findcarett.com. Many of these services were available virtually or by telephone to the public throughout the last year and continue to be so. Of course, there is more that can be done as the population’s mental health continues to be challenged by the ongoing stressors of the pandemic. This continued collaboration of government and stakeholders to identify priority areas to address, groups who are in most need of help and qualified professionals and effective interventions is a positive way forward. However, these efforts will be limited unless there is a tangible increase in the number of psychologists, psychiatrists and mental health professionals, and resources and services dedicated to mental health in the public sector.