We often don’t like to talk about mental health. Among Armenians, but not only, there can be a sense of shame associated with admitting the challenges one is going through. If we do talk about it, it’s almost always in hushed tones. We prefer to exert conformist pressure on both young girls and young boys, which can lead to destructive and long-lasting effects. Stereotypes and social stigmas surrounding psychological disorders discourage people from seeking counselling out of fear of being labeled. Public discourse about mental health is at best patchy and at worst completely ignored.

Mr. Dainius Pūras was the UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. In a 2017 report, he noted that Armenia should follow international best practices in managing mental health and “abandon the legacy of outdated mental health policies and services reliant on large psychiatric hospitals and long-term care institutions.” There are three major mental health institutions in Armenia: two in Yerevan, and one in Sevan with mostly permanent residents. Those suffering from mental health challenges are “too often hospitalized in psychiatric hospitals, tend to be overmedicated, and then confined for long periods of time in large institutions, labeled as chronic patients.”

Putting aside the structural and systemic issues with respect to the government’s handling of mental health services in the past, today the imperative must be to start re-evaluating how people with mental health issues will be treated and cared for. Perhaps a first step would be to start moving away from the Soviet legacy of institutionalizing people suffering from mental health issues and isolating them from society, to more community-based and outreach programs. Strategies and policies must be adopted, legislative gaps must be addressed to improve services and more professional training is imperative to ensure service provision at a community level. A good first step would be to start tackling the shame associated with it.

With the COVID-19 pandemic, many people are exhibiting high levels of mental and psychological distress. They include healthcare workers, seniors, people who have pre-existing health conditions, children, those living in unsafe domestic situations and the hundreds of thousands of people living under hazardous humanitarian conditions or conflict zones. And even those of us who felt invincible are struggling.

According to UN Secretary-General António Guterres, mental health services should be an integral component of all government responses to COVID-19. As families and communities are dealing with the grief of losing loved ones, loss of employment and income, isolation, restrictions on movement and uncertainty about the future, healthcare systems need to start preparing for the inevitable second-order fallout from the pandemic.

As the numbers of infected in Armenia keep increasing with no end in sight, the psychological burden - isolation, grief, anxiety - will manifest itself in ways that we are not currently prepared for. The pandemic highlighted shortcomings in Armenia’s healthcare system caused by decades of corruption and poor management: inefficient primary healthcare centers (polyclinics) and hospitals, the lack of equipment and training. The time is now for public campaigns to advocate for better mental healthcare strategies that would precipitate better care delivery and start addressing the social stigma so that we can help people cope with the stress of the pandemic and come out at the other end of the tunnel better prepared.

 

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Here are some tips and advice from the World Health Organization:

The new realities of working from home, temporary unemployment, home-schooling children and a lack of physical contact with other family members, friends and colleagues take time to get used to. Adapting to lifestyle changes such as these and managing the fear of contracting the virus, as well as worrying about people close to us who are particularly vulnerable, are challenging for all of us. They can be particularly difficult for people with existing mental health conditions.

Fortunately, there are things we can do to look after our own mental health and to help others who may need some extra support.

• Keep a routine. Maintain daily routines as much as possible, or make new ones.

• Get up and go to bed at similar times every day.

• Keep up with personal hygiene.

• Eat healthy meals at regular times.

• Exercise regularly.

• Allocate time for working and time for resting.

• Make time for doing things you enjoy.

• Minimize newsfeeds. Try to reduce how much you watch, read or listen to news that makes you feel anxious or distressed. Seek the latest information from reliable sources at specific times, once or twice a day if needed. The WHO’s official website is www.who.int.

• Social contact is important. If your movements are restricted, keep in regular contact with people close to you over the telephone and online channels.

• Alcohol and drug use. Limit the amount of alcohol you drink or eliminate it entirely. If you have not drunk alcohol before, now is not the time to start. Avoid using alcohol and drugs as a way of dealing with fear, anxiety, boredom and social isolation as they may exacerbate the issues. Drinking alcohol will not protect against the virus but will likely weaken your immune system and can lead to worse treatment outcomes. Also, be aware that alcohol and drug use may prevent you from taking sufficient precautions to protect yourself against infection, such as compliance with hand hygiene habits.

• Screen time. Be aware of how much time you spend in front of a screen every day. Make sure that you take regular breaks from on-screen activities and get up from your chair to move around.

• Video games. While video games can be a way to relax, it can be tempting to spend much more time on them than usual when at home for long periods. Be sure to keep the right balance with offline activities in your daily routine.

• Social media. Use your social media accounts to promote positive and hopeful stories. Correct misinformation politely and privately when you come across it.

• Help others. If you are able to, offer support to people in your community who may need it, such as helping them with food shopping and delivery.

• Support health workers. Take opportunities online or through your community to express gratitude to your country’s health-care workers and all those working to respond to COVID-19.

 

 

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