Lockdown deepens mental health crisis

While other citizens and businesses operating in the informal sector spend hours on any given day running battles with law enforcement for violating lockdown regulations – there are some that simply break down.
They cannot cope.
In Zimbabwe, lockdowns come with a lot of financial strain to an already socio-economically burdened populace, leaving the country in a mental health dilemma.
Depression and substance abuse problems have spiked in the past year, according to specialists in the field. This rise is linked to the current coronavirus pandemic and national lockdown that saw many people out of jobs.
In the past year, many companies closed down while those that remained open cut down their workforce as they had lost business to unproductivity during the period.
Workers that have remained at work are poorly paid.
It is, however, the informal sector that is most hit as it employs most of the populace.
Giving a context on the background of mental health in a Special Initiative for Mental Health Situational Assessment published last year, the World Health Organisation (WHO) said, “The majority of Zimbabwe’s economy comes from the service sector (65.8%), followed by industry (22.2%) and agriculture (12%).
“Zimbabwe’s informal economy is responsible for 60% of all income; the rate of formal unemployment is extremely high.”
The report goes on to mention the country’s high poverty.
“Poverty is endemic in Zimbabwe: an estimated 70% of the population is living below the poverty line, and 34% are living in extreme poverty. Shortages in fuel, electricity, drought, and climate related events have drastically impacted the agriculture sector and inflation rates in recent years,” reads the WHO assessment.
“Having experienced years of austerity policies, economic decline, and the 2008 hyperinflation crisis, Zimbabwe’s health system – which was once one of the most robust in the region – has suffered decreased government spending, high workforce emigration, and human rights violations.”
Sudden poverty has been cited among one of the triggers of mental health issues.
“Triggers are numerous and multifaceted. The most common trigger is being overwhelmed by life’s challenges and problems and subsequent failure to cope,” said Innocent Sifelani, an Educational Psychologist and member of Zimbabwe Psychological Association.
“If one’s coping mechanisms can’t withstand the challenges being faced, mental health issues are experienced.”
Covid-19 plunged many people to overnight huge financial strains.
This was worsened by lack of savings, planning and a lack of Government support in form of viable safety nets to those who lost an income.
Recent media reports are that for the current strict lockdown that runs until February 5, the Ministry of Public Service, Labour and Social Welfare has budgeted $3,5 billion to cushion over 500 000 vulnerable households that will receive cash payouts to mitigate the impact of Covid-19.
The programme is set to run for six months and will see households receiving foodstuffs during the lockdown period and beyond.
The money will however not be enough as it equates to just an equivalent of US$10 per month which cannot cater for one individual let alone a family for a whole month.
Depression is high as people are not sure what the future holds. As uncertainty grips, Sifelani suggests that as social beings, social capital is vital.
“Even during the lockdown, people must be encouraged to remain in touch with their significant others for support. In promoting this, Covid-19 precautions must be adhered to,” he said.
“Positive thinking is also one way of lessening mental health issues, for example this can be achieved through deliberate efforts such as transforming negative self-talk into positive self-talk, focusing on things which one can control.”
Among other things, Sifelani encouraged people to exercise as, “exercises and relaxation techniques are useful because of their mood boasting effect”.
“People must be encouraged to avoid too much/unnecessary Covid-19 related information which raises their anxiety levels.
“The most important information is precautionary measures, there’s no need therefore for individuals to devote much of their energy in look for example death statistics.”
There is great need for Government to avail services for people to reduce mental health implications which may include suicide, alcohol and drug abuse.
“Those with mental health issues must get help from qualified mental practitioners that is psychologists, psychiatrists, and counselors,” said Sifelani.
“For psychologists’ directory, it can be obtained from Zimbabwe Psychological Association.”
Another research paper published by leading psychiatrists Walter Mangezi, a lecturer at the Department of Psychiatry, Faculty of Health Sciences, University of Zimbabwe and Dixon Chibanda a consultant psychiatrist at Sally Mugabe Hospital point to inadequate service providers.
“There are six public institutions with psychiatric beds: Harare Hospital Psychiatric Unit, Parirenyatwa Hospital Annexe, Ingutsheni Hospital, Mpilo Hospital Psychiatric Unit, Ngomahuru Hospital and Mutare Hospital Sakubva Unit,” reads the paper.
“In addition, three facilities provide forensic psychiatry services: Mlondolozi Special Institution, Harare Central Prison and Chikurubi Special Institution.
“The facilities available are not suitable for children or the elderly. Parirenyatwa Hospital Annexe and Harare Hospital Psychiatric Unit are the only institutions with a psychiatrist.
“The staff of Zimbabwe’s mental health services comprise: a deputy director, a mental health manager and nine provincial mental health coordinators, plus seven psychiatrists – one working for the government, two for the medical school and the others in private practice. They all work in Harare.”
Dr Kudzai Masunda, City of Harare’s Acting Health Services director, however, said all council health centres now offer mental health services. Nhau/Indaba