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COVID-19 and mental health: War on two fronts for the Pacific

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On October 10th, many people across the globe will mark World Mental Health Day with the objective of raising awareness of mental health issues. World Mental Health Day is a day set aside globally for mental health awareness and education and is commemorated annually through varying events and programs. This year though (like much of 2020), it is exceptional. Two public health crises collided: the coronavirus and the mental health epidemic. The first has triggered a record-breaking surge of the second.

There are indications that the coronavirus has affected everyone around the world in some way, with more than 36 million people infected and over a million people having lost their lives. To make matters worse, this pandemic has threatened not just physical but also psychological health, with experts warning that this will show in increased suicide rates.

Health experts have dubbed this "the perfect storm", warning that the coronavirus pandemic is likely to have a "profound and pervasive impact" on mental health globally as billions struggle to cope with isolation and anxiety. Without question, the world is facing a time of unprecedented uncertainty and many people have had to make changes to the way they live their lives as a result of the coronavirus, adding to the impact on society's mental well-being. Mental health experts are concerned by the mounting combination of deaths, illness, joblessness and uncertainty that is fueling a global mental health crisis as the pandemic drags on.

In conflict zones, the effects of lockdown restrictions, coupled with the existing scarcity of water and healthcare are forcing people to flee to displacement camps which are already overcrowded. The International Committee of the Red Cross (ICRC) Director-General Robert Mardini said more than one in five people living in a conflict zone are experiencing some kind of mental health condition; that's three times more than in the general global population. He went on to stress that, "for thousands of people affected by armed conflict, the pandemic has exacerbated their psychological distress. On top of concerns about health and wellness, the combined effects of lockdown restrictions, the absence of social interactions, social outlets, and the aggravation of economic challenges are further impacting mental health and access to care."

Here in the Pacific, the ICRC funds communication programs for 12 National Red Cross Societies – those in Cook Islands, Fiji, Kiribati, Marshall Islands, Micronesia, Palau, PNG, Samoa, Solomon Islands, Tonga, Tuvalu and Vanuatu. This funding enables these Red Cross Societies to develop and disseminate key messages on mental health and psychosocial support (MHPSS) on social media and throughout their communities.

The ICRC has identified a particular need for MHPSS messaging and support services to those affected by COVID-19 in Papua New Guinea (PNG). From January to September this year, ICRC provided MHPSS training and other support services to over 335 across PNG, equipping them with knowledge on how to provide support in turn to those affected by COVID-19 in their respective communities. The ICRC first undertook MHPSS action in PNG to address the mental health and psychosocial needs of people affected by violence, including sexual violence, in relation to tribal fighting. However, in the current pandemic, we have seen that there is a need to expand this MHPSS messaging and support to those affected by COVID-19.

Our MHPSS Delegate based in Mount Hagen, Western Highlands Province of PNG, Charlotte Blackman, says there have been many rumors about the coronavirus circulating in the community. These have been heightened by the news of more cases in the capital, Port Moresby. This has all added to the challenges which health workers already confront. Charlotte has observed that "the levels of fear and anxiety are much higher, and I think with health workers, who will be in the front line, it will be a very significant mental health challenge for them - both dealing with your own emotions because when you are stressed yourself it is much harder to deal with the emotions of others."

Concerns around the effects of climate change also undoubtedly continue to impact the mental health of Pacific Islanders. Psychological distress may arise from environmental concerns, lack of confidence in the future and even the potential to be displaced from their islands due to climate change effects. Again, this is compounded by the threat of COVID-19 and the associated changes. Even though the number of COVID-19 cases in Pacific countries is limited, the economic impacts of the pandemic are causing significant distress in small island nations whose economies rely heavily on tourism and remittances. In September, Fiji's Health Ministry confirmed that about 90 Fijians have died from suicide this year while there have been 82 attempted suicides, amidst the COVID-19 pandemic. With the pandemic imposing an extraordinary level of stress and suffering on communities around the world, this year's World Mental Health Day is an opportunity for us to highlight the importance of MHPSS, and the need for everyone to be able to access the support and care that they require.

By Vincent Ochilet, ICRC's Head of Regional Delegation in the Pacific