Year : 2021 | Volume
: 37 | Issue : 1 | Page : 1--2
Marginalized and neglected psychosocial aspects related to COVID-19: Some reflections!
Achal Bhagat1, Nitin Gupta2, Shikha Tyagi3,
1 Apollo Hospital, Delhi; Senior Consultant, Department of Psychiatry and Psychotherapy, Apollo Hospital, Delhi and Chairperson, Saarthak and AADI, New Delhi, India
2 Gupta Mind Healing and Counselling Centre, Chandigarh, India
3 Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
Dr. Achal Bhagat
A1/266 Safdurjung Enclave, New Delhi - 110 029
|How to cite this article:|
Bhagat A, Gupta N, Tyagi S. Marginalized and neglected psychosocial aspects related to COVID-19: Some reflections!.Indian J Soc Psychiatry 2021;37:1-2
|How to cite this URL:|
Bhagat A, Gupta N, Tyagi S. Marginalized and neglected psychosocial aspects related to COVID-19: Some reflections!. Indian J Soc Psychiatry [serial online] 2021 [cited 2021 Jun 15 ];37:1-2
Available from: https://www.indjsp.org/text.asp?2021/37/1/1/312804
Last year, COVID-19 brought in its wake isolation, adversity, anonymity, and trauma. People experienced a loss of dignity, loss of purposeful activity, and loss of relatives and friends. Above all, people lost their identities. Lonely, hypervigilant, predicting the worst, and fearing the uncertain, the world stood squirming, yet still!
It is no surprise then that there was a focus on the mental health and psychosocial impact of COVID-19. A parallel pandemic was predicted. Mental health conversations seemed to have found a way to be released from their echo chamber. The communities were abuzz with “woke” acceptance of mental health. Early on it also looked as if the policy response was going to give a degree of parity to mental health, and there would be interventions that would go beyond tokenism.
Riding this wave of enthusiasm, coupled with optimism, the Editorial Team of this very Journal (IndJSP) had put together a Special Online Supplement (First Compendium) on COVID-19. It can be called a collector's item as the collection of articles was variegated yet comprehensive in coverage and had been written by invited experts in the field of social psychiatry from India. Apart from this, an explosion of information on the various socio-clinical and policy aspects had been released across various national and international journals.
However, as one looks back, mental health has retreated back into the shadows. The society's dual assumptions of incapacity and dangerousness about those facing mental health difficulties are edifices which have not even begun to erode. The policy response has overlooked the fact that mental health problems are determined by a matrix of factors. Mental health is beyond the biology and psychology. Inequity and poverty are both determinants and impacts of mental health difficulties.
The management and subsequently the medical prevention of COVID-19 have taken up priority with the focus shifting in recent times to vaccination and related issues of “vaccine hesitancy” and “vaccine nationalism.”
Nevertheless, the Editorial Team (read as IndJSP) has continued in its quest is trying to discuss about, and highlight, the psychosocial aspects related to COVID-19. One of the themes this issue highlights is the interface between inequity and mental health; aptly brought out in the four Invited Perspectives/Commentaries.
Writing about women, COVID-19, and mental health, Chatterjee from SEWA brings the narratives of survival of women in villages which became repopulated due to reverse migration, with increased loss of lives and livelihoods, increased domestic violence, and increase role in caregiving as well as decreased access to health resources. Does a diagnosis of depression do justice to the someone who has experienced all of the above? Treatments need to give way to solutions, and these solutions need to be look at the psychological and social.
It is not a thinking distortion when you cannot trust if you have been sold for labor or sexual exploitation. Krishnan from Prajwala reminds us that more women were exploited through human trafficking during the pandemic. More pornography was generated, and there was more web-based recruitment of potential victims. The disability related to mental health impact of human trafficking is not measurable. It will be some time before mental health systems reach survivors of human trafficking or address the internalized and normalized discriminatory hierarchies.
Railway children in India reached out few thousand children whom they had placed back with their families. Sellaraju worries about the fact that children did not even having the option of getting away from traumatic experiences in their homes by going to school. He advocates that the way forward is to reach the child early. He advocates for access to education and strengthened child-care and protection processes.
Finally, Vani and Banerjee have discussed and highlighted the difficulties faced and plight of the healthcare workers (HCWs), especially focusing on the stigma surrounding the HCWs while they have continued to discharge their duty in the wake of COVID-19. They discuss the need for a multipronged approach in handling their issues.
In fact, these perspectives bring forward a common theme. Mental health interventions cannot exist as a silo. For the world to recover from the mental health and psychosocial impacts of COVID-19, mental health interventions need to be integrated with other processes of inclusive development. Children, women, people facing risks of violence and abuse, people facing discrimination through caste and religion, people living with mental illness, people living with disability, and unemployed young people facing helplessness require mental health solutions. Solutions and not treatments help people to continue to believe in their ability to survive and also provide access to opportunities and resources to survive. No amount of inherent mental strength can cope with the prevailing inequity by itself.
These “Invited Perspectives/Commentaries” are followed by a rich conglomerate of 27 articles submitted by authors to the IndJSP comprising of 2 reviews, 3 perspectives/viewpoints, 1 commentary, 10 original articles, 1 brief communication, 2 case reports and 8 letter to editors. It is difficult to talk about every contribution here, but needless to say that they are every bit important in themselves. Each article has its own relevance and value. They have not only focused on areas related to the theme of the issue, viz., “Marginalized and Neglected Psychosocial Aspects Related to COVID-19,” but have even tried to highlight the infinitesimal and homuncular issues that tend to get ignored or lost among the bigger picture of the pandemic wave.
Last but not the least, the Issue winds up with 2 Invited Book Reviews related to the COVID-19 Pandemic. The books under review have been carefully selected, and the reviewer is a Social Psychiatrist par excellence. The first review is for a book written by Chinmay Tumbe from Ahmedabad, and an alumnus of the London School of Economics and Political Science, and IIM Bangalore. This book is special as it presents an “in-depth” understanding of the pandemics in India during the period of the 1st century (1817–1920). The second review is for a book written by Fareed Zakaria, a columnist for The Washington Post from New York City, and a global thinker who has tried to foresee the nature of a postpandemic world through a myriad of views, such as the human history, politics, economics, development, technology, and human nature, and helps the reader to make sense of the complex situation.
The psychosocial aspects associated with COVID-19 are infinite in extent and prodigious in impact; yet, the studies on them are relatively infinitesimal. This may appear to be too strong a statement to make, but we do believe that mental health (and related aspects) is not being talked about as much as it was in the initial wave of the pandemic.
Authors and contributors had been concerned that their contributions will lose relevance due to the delay between submission, acceptance, and final publication. We do not believe so: data may seem a bit outdated (i.e., from 2020, i.e., initial days of the COVID-19 pandemic), but it remains relevant…now and in the future too! The second wave of the COVID-19 pandemic had already started in other parts of the world in the early 2021 and has seemingly started in India in the early March 2021.
We also believe that probably, the readers will be able to make more sense of our assertions once they have read this “special” second compendium on COVID-19!
|1||Available from: https://www.indjsp.org/showBackIssue.asp?issn=0971-9962;year=2020;volume=36;issue=5;month=October; supp=Y. [Last accessed on 2020 Mar 23].|
|2||Gupta N, Basu D. The “World Association of Social Psychiatry Position Statement” revisited in light of COVID-19 vaccination. World Soc Psychiatry 2020;2:177-80.|
|3||Chatterjee M. Safeguarding the mental health of the women of our country: Identifying challenges and ways forward. Indian J Soc Psychiatry 2021;37:3-6.|
|4||Krishnan S. Human trafficking, mental health and COVID-19. Indian J Soc Psychiatry 2021;37:7-9.|
|5||Sellaraju SN. Mental health crisis amongst children: A parallel pandemic. Indian J Soc Psychiatry 2021;37:10-13.|
|6||Vani P, Banerjee D. “Feared and Avoided”: Psychosocial effects of stigma against health-care workers during COVID-19. Indian J Soc Psychiatry 2021;37:14-18.|
|7||Murthy RS. The age of pandemics (1817–1920): How they shaped India and the World. Indian J Soc Psychiatry 2021;37:133-5.|
|8||Murthy RS. Ten lessons for a post-pandemic world. Indian J Soc Psychiatry 2021;37:136-7.|