It is essential that governments include mental health responses in their plans to address coronavirus.

From health workers, to children, to those stuck in cramped homes, the coronavirus will likely have a detrimental impact on mental health. Credit: Hugh Mitton

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Like others across the world, countries in Africa are scrambling to curtail the spread of the coronavirus through measures such as lockdowns and border closures. The global pandemic and the responses to it are affecting people in countless ways: in terms of their physical health, freedoms, livelihoods, education and much more.

The coronavirus is also having a potentially huge impact on people’s mental health.

Whether affected directly by COVID-19 or indirectly through the policies to address it and their consequences, the mental wellbeing of several different groups will be affected in different ways. Here are some of them.

The mental health impacts on different groups

Those who catch the coronavirus

It may be some time before we know the full ramifications of contracting COVID-19 on mental health, but those who have tested positive are at a higher risk of developing disorders such as anxiety and depression due in large part to uncertainty over what course the illness will take. For those who go into intensive care and their relatives, the experience may be traumatic, later leading to acute stress reactions or post-traumatic stress disorder.

Those with existing mental illnesses

With several hospitals only running skeletal and emergency services as a precautionary measure, many patients with existing mental illnesses are in a difficult position. They will be unable to access care and may struggle to get prescription refills, potentially trigger relapses. In other parts of the world, people might be able speak to healthcare providers by phone or digitally as an alternative, but these systems are under-developed or non-existent in most of Africa.

Healthcare workers

Healthcare professionals are also worried. They understand that health systems could be quickly overwhelmed with even a modest number of severe COVID-19 cases. Protective personal equipment is not readily available and running water in many hospitals is scarce, so the health risks to hospital staff is great, leading to anxiety and low morale.

Those under quarantine

To help contain the virus, governments have quarantined those who have recently returned from countries with high rates of infection. Many quarantine facilities are uncomfortable and, because of limited testing kits, only those with symptoms are tested. Spending two weeks in quarantine without knowing if one has COVID-19 or not is a significant stressor.

Poor people

Poor communities are particularly affected by lockdowns. An important factor affecting mental health in these conditions is the quality of housing. Many families live in urban settlements with entire families living in a single room. Houses can have up to 100 people sharing a single kitchen and bathroom. These residents also likely depend on their daily earnings to buy food and other necessities. There are also often high rates of domestic violence and physical, sexual and psychological abuse. Reports of unrest and looting in some poor areas such as parts of Lagos further compound this myriad of mental health challenges.

Children and adolescents

Attending school is generally good for students’ mental health. Even when they are less than ideal, they offer places for children to learn and grow in a structured environment. While affluent families with children in private schools can access educational facilities online, most Africa’s children do not have this luxury.

Anxious onlookers

Alongside the coronavirus itself, a pandemic of fear is spreading. Many are anxious from hearing daily fatality reports from better-resourced countries and are concerned that their communities will be next. Some people have turned to psychoactive substances, sleeping pills and anti-anxiety drugs to calm their nerves.

Wild conspiracy theories and fake news are making matters worse. In Nigeria, for example, entire families have been admitted to hospital with chloroquine poisoning after reports that the drug can help treat COVID-19. Some psychoactive substances are also being misused as prophylactics; there are reports of an old lady drinking local gin to stave off the virus.

Those who have lost their communities

Religious and social gatherings are the heartbeat of African communities. People gather to pray, share their burdens, sing, and dance to mitigate their stress, but this is now absent.

Those who have lost their livelihoods

Businesses that have been designated as nonessential and that cannot function online have been shut down and there is uncertainty about when lockdowns will be lifted. Some business owners and out-of-work employees may be driven to despair.

What can be done?

It is essential that governments include mental health and psychosocial responses in their plans to address the coronavirus pandemic. They should liaise with mental health organisations to develop them.

Much can to be done. Patients who have recovered, and their relatives, need to be followed up with. Services for those with existing mental health conditions must be maintained as far as possible, while systems to continue medical consultations by phone should be instituted. The government could also create psychosocial response teams to advise them on the best ways to support frontline workers.

Governments should also broadcast messages to the general public promoting and providing information about mental health. The media can support this by with their own programming acknowledging the difficulties of lockdowns. Mental health strategies for coping with self-isolation should be disseminated and include child appropriate content. Individuals, communities and religious groups meanwhile should be encouraged to reach out to each other. Helplines should be provided for all, and some specifically for frontline health workers.

The coronavirus pandemic will affect the mental health of many different communities in Africa. It is essential that responses to the crisis include coordinated and well-thought strategies to address the mental health challenges that will affect each at-risk community.