May is Mental Health Month, and the Department of Global Health is sharing an article from the Global Mental Health program, which features interviews with people from the UW community about mental health as well as information from relevant journal articles.

The current COVID-19 pandemic has resulted in widespread recommendations or mandates for physical distancing in countries across the globe. Stay-at-home orders, school closures, and abrupt changes to behavioral patterns have left millions with disrupted social networks.

Although the literature on the mental health effects of epidemics is limited and focuses primarily on the disease itself, we know that large-scale economic or social disruptions and group traumatic experiences can lead to a variety of common mental and behavioral disorders (1). Domestic and child abuse rates often rise in times of crisis, and school and institution closures can cause harmful disruption to routines and limit regular access to mental healthcare (1,2).

The importance of finding some sense of routine and community is now greater than ever, and many have come together to support others and offer hope in this global crisis. In cities around the world, we’ve seen messages of thanks and support for frontline healthcare workers; resources created to financially support those who have lost income sources; movements to ensure local businesses, artists, and freelancers can stay afloat; and countless individuals volunteering their time and resources to the populations most vulnerable at this troubling time.

This month, DGH’s Global Mental Health program spoke with several individuals in their community who are addressing the mental health effects of the COVID-19 pandemic. They asked them about their work and how they are coping with the pandemic’s effect on their own lives.

Amritha Bhat, MD, MPH

Dr. Bhat is a perinatal psychiatrist and Assistant Professor in the Department of Psychiatry and Behavioral Sciences, and completed the Psychiatry in Primary Care Fellowship Program at the University of Washington.  She established the perinatal psychiatry clinic at the University of Washington Medical Center and focuses on perinatal mental health.

How have you seen life change as a result of physical distancing, social isolation, or COVID-19?

In my clinical work with pregnant and postpartum people I have seen that they are particularly affected by the pandemic as there is uncertainty around so many important issues – is there vertical transmission of the virus? Can the fetus be infected? Are pregnant people more likely to develop a severe form of the illness? Will I be allowed to have a support person in the room with me when I go into labor? People spend several months planning for the important milestone of childbirth, and the pandemic has led to a change in many of these plans including baby showers and the presence of a doula during the birth and in the postpartum period.

We know from previous disasters and pandemics that women in the perinatal period are more prone to depression, anxiety, and post-traumatic stress disorder, so this is a high-risk group that clinicians should monitor closely.

What brings you hope in times like this? How do you see your community coming together in this time?

I have been very encouraged to see how quickly mental health and peer support services have transitioned to delivery by videoconferencing – this includes psychiatric assessment, psychotherapy, and peer support groups. And while there have been some hiccups in execution, ironically it has made these services more accessible to the perinatal population for whom transportation and childcare are major barriers to mental health care access.

Benjamin Trnka

Benjamin Trnka is a medical student at the University of Washington with experience in transcultural mental health research in Delhi, Beijing, and Sarajevo. His most recent work in Sarajevo considers cultural models of resilience in the generation after the armed conflict in former Yugoslavia. (Twitter: @bentrnka)

How have you seen life change as a result of physical distancing, social isolation, or COVID-19?

The natural world: To my eyes, nature looks more vibrant than ever before. Maybe this is due to new appreciation (having been limited to my back yard and local greenery), or perhaps it is truly that the flora and fauna are less encumbered by our human interference.

The human world: This period highlights our interdependence as a society, locally and globally. We feel the labor of the home still falling predominantly on women, the continued necessity of those who grow and provide food, and the entwinement of the global economy. COVID has also brought to light the incredible structural inequalities which mean that black & brown, poor & isolated, and elderly & sick people are still the most vulnerable, especially in the US. We have seen an immense outpouring of charity to address this, from businesses and individuals alike, but these attractive temporary fixes will not hold up against less glamorous systemic changes.

The virtual world: At once a necessity for the modern (white-collar) economy and a respite from social distancing, I am disturbed and delighted by the ways in which the virtual sphere continues to transform at this time. The immense divisions which support the rise of global fascism still distort and spin the pandemic, and social media platforms align themselves further with biopower by unprecedented restrictions to misinformation. At the same time, the virtual is being mobilized in ingenious and exciting ways to aid and entertain.

What brings you hope in times like this? How do you see your community coming together in this time?

To riff on anthropologist Panter-Brick’s work on resilience theory: we should not conflate resilience with the absence of psychosocial pathology in times of distress. Instead, we must think of the ‘moral values’ and ‘social aspirations’ which define it. COVID-19 asks of all of us what we need and what we value to feel whole. Perhaps this is hope, community cohesion, or something else entirely. Towards this end, I offer some wisdom from survivors of the Balkan Wars for times like this:

• “The War on Corona” is not a war. This sort of language limits our collaborative and healing imaginations and only serves to further the interests of the US military-industrial complex.
• The news will continue to repeat itself without saying anything useful or new. Do not center your sense of stability around the media.
• If you can imagine that things can get worse, things can get worse. This is a fact of life, and it’s best to just prepare for it. (On this note, the spring is a great season to start your own garden.)
• Uncertainty on this scale is revealing and its memory will imprint itself on global consciousness. Be prepared to reflect on the echoes of COVID-19 for a time to come and be mindful of how it is being invoked in discourse.
• Do not feel guilty about finding joy in times that feel otherwise bleak.

Linda Oseso, MPH

Linda Oseso is an alumnus of the MPH in Epidemiology program at the University of Washington. She has research interests at the intersection of HIV and Mental Health.

How have you seen life change as a result of physical distancing, social isolation, or COVID-19?

It’s strange walking outside and having to cross the street or walk on the main road when someone else is about to pass me on the sidewalk. It’s also strange walking into a grocery store with a mask and being hyper-aware of what direction I should be walking in or whether there are too many people in the aisle. I wonder about what the long-term impacts of COVID-19 will be on how we interact as human beings, where physical connection is good for our health, not only physically, but mentally. I find myself counting the number of days since I last hugged another human (77 days today) and yearn for the time when we are allowed to return to whatever our new normal will be.

What brings you hope in times like this? How do you see your community coming together in this time?

I am finding hope in virtually connecting with family and friends. Although it’s challenging having to be online for many hours it’s nice connecting more frequently with family who live abroad. We have all been forced to slow down, so it has provided a great space to connect and focus on what really matters, the people in our lives. It’s been beautiful to see people stepping up to help one another through this unprecedented time. So I encourage others to reach out to your community, someone could be silently struggling and unable to ask for help.

Anonymous Undergraduate

How have you seen life change as a result of physical distancing, social isolation, or COVID-19?

It has been strange to see how quickly many of the other undergraduate students left the city. Most of my friends are international and out-of-state students, and many of them have left, leaving the city to feel empty. I am unable to see the friends who remain in the city and it’s odd to feel so far away when we are only a few blocks from each other. I’ve seen the stress of isolation get to some of my friends and to myself as well. I am in recovery from an eating disorder and living with generalized anxiety disorder, and interventions like ‘shelter in place’ orders and physical distancing have taken away many of my healthy coping mechanisms. It was challenging to adjust to seeing my treatment team through video meetings, and even more challenging to find new coping mechanisms. As strange as it may sound, I am grateful to have been challenged to focus on my mental health and even more grateful to have access to the care I do when I know so many do not. While physical distancing and social distancing have been difficult, it has helped me to connect to the gratitude I have for life.

What brings you hope in times like this? How do you see your community coming together in this time?

I find it uplifting to see and hear the ways people have found to stay connected with one another during this trying time. I’ve seen the creativity of youth shine through as we find new ways to connect with one another. From movie nights via Netflix Watch party, Yoga dates through video calls, and virtual parties through zoom, I’ve seen people do whatever they can to find that connection we all need. Even if it isn’t how we would choose to see each other, there are ways to stay connected. It brings me hope to see how our desire to be around each other has led people to find new creative ways to connect.

Looking for more resources on COVID-19 and mental health? The UW Global Mental Health Program has compiled the following web pages.

• Mental Health and Psychosocial Considerations During COVID-19 Outbreak (WHO)
• Social stigma associated with COVID-19 (WHO)
• What to Do If You’re Feeling Anxious About the Coronavirus (UW Medicine)
• Mental Health and Coping During COVID-19 (CDC)
• Addressing Mental Health and Psychosocial Needs during the COVID-19 Outbreak (MH Innovation Network)
• Youth-focused COVID-19 mental health and well-being resource page (citiesRISE)

 

1. Galea S, Merchant RM, Lurie N. The mental health consequences of COVID-19 and physical distancing: The need for prevention and early intervention. JAMA Internal Medicine, 2020
2. Lee J. Mental health effects of school closures during COVID-19. The Lancet Child & Adolescent Health, 2020.