In a UCL Lunch Hour Lecture, Dr Rochelle Burgess discusses the global social and mental health consequences of the pandemic.
Writer: Ebani Dhawan
Editor: Eva Lymberopoulos
Pandemics always have social consequences. Take HIV. It revolutionised how we talk about sex and protection and created the axiom that prevention is everyone’s problem. On the other hand, it created social divisions. Testing HIV-positive pushed the patient to the edge of society. The growing homophobia nowadays is a major barrier to ending the global HIV epidemic.
The thing is, with previous pandemics, we realised the importance of these social consequences a bit too late. Due to previous experience, once the COVID-19 pandemic swept the globe, academics didn’t take as long to consider the collateral damage in the mental health sector.
One area of focus has been the mental health of frontline workers. 56% of those surveyed by the British Medical Association felt only partially protected from the virus, leading to and exacerbating anxiety and depression amongst healthcare workers. In response to this, systems were rapidly established to support NHS workers.
The second area has been the direct mental health consequences of the coronavirus itself. It has been found that 25% of those who are hospitalised with COVID-19 suffer from delirium. Also, a staggering 30% of patients experience post-traumatic stress disorder (PTSD) once discharged.
The third and last focal point has been the mental health impacts of lockdown and other public policies born out of the pandemic. Researchers from Massachusetts Institute of Technology (MIT) released a preliminary report indicating that loneliness and hunger share signals in a deep part of the brain that governs basic impulses for reward and motivation. We have literally been starved for social contact.
It’s wonderful that mental health is getting the attention it deserves, Dr. Burgess points out, but we are forgetting “half of the equation”: the socio-political and economic factors that contribute to poor mental health. Mental health is not only a psychological concept, it is structural, relational and social. We cannot forget its context.
Looking at mental health in a global context, the complexity of the issue shoots up. The social and political realities that drive global mental health issues are dynamic and layered.
We often view the relationship between mental health and poverty as a linear relationship: either poor mental health leads to poverty, or poverty leads to poor mental health. That’s our biggest mistake, as it is in fact circular and highly complex. In order to get a holistic view of such a complex and circular relationship, understanding each of the factors is crucial. This is best visualised through the mental health and poverty cycle.
What does that mean for mental health in the COVID-19 pandemic?
All this means that we need to have interventions that take into account the complexity of the pandemic. As Burgess pointed out, good social policy equals good mental health. For instance, in the UK, the government announced they were offering loans for child support. In other countries, such as South Africa, this support came in the form of grants, meaning that families didn’t have to pay them back. This simple difference equates to huge financial relief in these households. Developing complex interventions and good social policy creates mental health-enabling societies.
Feelings of anxiety and sadness are normal during a period of crisis. However, this wave of poor mental health we are seeing as a consequence is not. We need to reduce the personal and communal suffering by pushing the boundaries of intervention so they match the reality of the situation. In the end, whether we can see it now or not, this kind of suffering will cost us the most.