Mental health: Learnings from the pandemic

Many employees are feeling a burnout working from home due to online exhaustion and additional home responsibilities, while finding it difficult to draw boundaries with colleagues and family members.

OCTOBER is Mental Health Month to raise awareness about mental health.

The theme for the World Mental Health Day 2021, which fell on Oct 10, is Mental Health in an Unequal World as announced by the World Federation for Mental Health. The World Health Organisation’s campaign slogan similarly calls for “Mental Health Care for All: Let’s Make It a Reality” this year.

The focus on disparity and inclusivity this year is appropriate given Covid-19 has brought to the fore growing inequalities in society, including limited mental health care access for those in need.

Pandemic learnings

The last eighteen months have taken a serious toll on our mental health with deaths of near ones, working from home, job insecurity, social isolation and other stressors amidst a growing uncertainty about our future.

We have witnessed rising trends of suicides and early indications of long-term psychological risks, which raise concerns that the next pandemic is in fact mental health.

Though Covid-19 has aggravated existing challenges, there is nevertheless more awareness than ever before on mental health in society. This is a unique situation in which policymakers and practitioners are part of the wider population affected by the pandemic.

As the pandemic becomes an endemic, it is time for us to reflect on what we have learnt about mental health in so far and what can we do better to improve mental health in society.

(i) We are feeling exhausted, isolated and sometimes demotivated – workplace mental health is important for wellbeing, productivity (and profits)

Working from home can be a boon or bane, but it comes with increasing risks of burnout, poor work-life balance and isolation from colleagues.

Many employees are feeling a burnout due to online exhaustion and additional home responsibilities, while finding it difficult to draw boundaries with colleagues and family members. In some cases, there is growing workplace tension due to online communication gaps, including feedback from managers and supervisors.

Surveys in Malaysia and elsewhere confirm Gen-Zs (aged below 25) are struggling most with work during the pandemic, while workplace stressors are often compounded by family challenges.

The workforce is at risk of feeling demotivated, which may affect their creativity, innovation and turnovers within the organisation.

Employers cannot afford to ignore the wellbeing of employees – particularly Gen Zs – influencing their level of productivity, which in turn impacts on profitability to make a strong business case for mental health in the workplace.

The current situation requires organisations to collaborate with mental health providers in developing needs-based tailored workplace interventions, including a combination of individual consultations, helpline support, peer support groups, leadership trainings and awareness seminars.

Moreover, organisations need to adopt a preventive approach by fostering an emotionally sensitive workplace culture with appropriate mental health policies and safeguards in place beyond the traditional Employee Assistance Program (EAP).

(ii) We are facing growing conflict within the family and children’s emotional needs are being neglected – we need better communication with children

Many families are experiencing escalating tension due to spending either too much (stay at home) or too little (long distance) time with each other during the pandemic.

Family stress has often spilled over to work lives (and vice versa) with difficulties of separating one from another, even more so while working from home.

In some cases, family conflicts have escalated to abuse, trauma and violence, which pose long-term risks of mental health conditions for survivors and children.

Children’s emotional needs are often neglected as parents are embroiled in their own challenges.

Moreover, the emotional wellbeing of children across all ages has been affected by frequent school closures during the pandemic.

Schools play an important role for children in their social and emotional learning as well as serving as a support system for development needs, which has been largely disrupted during this period.

Many children are overwhelmed experiencing their own stressors related to online schooling, isolation from friends and lack of physical activities, while bearing the brunt of challenges like job insecurity and martial conflict affecting their parents.

Notwithstanding family conflicts, families can conversely serve as a vital source of emotional strength and support during the crisis.

The current situation requires parents and caregivers to become more emotionally sensitive and responsive to their children, which can help them reduce long-term risks of mental health conditions and improve overall psychosocial functioning, including academic performance.

Though traditional parenting has often focused primarily on physical and material needs, parents need to create emotional safe spaces within families for their children’s feelings to be heard, acknowledged and validated.

(iii) The mental health care system needs an integrated model for diverse providers, services and interventions, particularly for at-risk populations

Mental health professionals are experiencing unprecedented demands for client services, often leading to waiting lists for appointments.

This indicates the scale of the mental health crisis we are facing now, which adds further pressure on the shortage of mental health professionals in Malaysia and elsewhere even before the pandemic.

Mental health services consequently remain out of reach for large segments of at-risk populations, while community centres serving marginalised and disadvantaged groups are overstretched with their resources.

In addition to more emotionally responsive workplaces and families, the current situation calls for expanding mental health care access by developing an integrated model for diverse providers, services and interventions.

In this revamped mental health care system, diverse providers will provide different levels of interventions to improve emotional wellbeing and resilience in society, while leaving relatively more severe challenges and conditions for individual consultations with mental health professionals.

This triage system will see more collaboration between counsellors, psychologists, psychiatrists and other service providers greater mental health access in society.

Early interventions by trained first responders, community members and other professionals (e.g. crisis helplines, peer support, self-help strategies) can reduce risks of long-term mental health conditions, while lessening the pressure on the existing mental health infrastructure primarily dependent on mental health professionals.

In developing an integrated model, we can take a leaf from “stepped care” mental health services in Australian primary care.

This model entails a staged approach with a hierarchy of mental health interventions matched with individual needs, particularly for at-risk populations.

Independent organisations serve as Primary Health Networks (PHNs) to streamline and coordinate mental health care services, allowing individuals to access the appropriate level of support with the option of stepping up or down based on their evolving needs in the recovery process.

Transforming crisis: Healthier environments and integrated care

There is no doubt that the pandemic has caused major upheavals in society, including a mental health crisis.

Though mental health providers remain under-resources, there is an opportunity for us to develop emotional resilience through healthier workplaces and families, while expanding mental health access with coordinated service delivery in an integrated model.

The current crisis is an opportunity for us to rethink how we valuate workplace mental health, develop safe emotional spaces for children in families, and reconfigure the mental health system for more integrated service delivery with diverse interventions and triaging severe cases for mental health professionals.

For healthier environments and integrated care, it is imperative to bring different public, private, mental health and community stakeholders for policy change and coordinated interventions.

The National Coalition for Mental Wellbeing established by the Malaysian Rotary can serve as a platform for stakeholder engagement on how to make mental healthcare more affordable and accessible.

If we can rise to the occasion in responding to workplace, family and mental health systemic challenges differently today, we will emerge stronger as a society with more preventive, efficient, coordinated and sustainable approaches for improving mental health in the future.

Dr Arman I Rashid is a mental health therapist, researcher and advocate. He is Co-Founder of the Empowerment Group, a global partnership of mental health providers in Malaysia, Australia, Singapore and Indonesia. He serves as a Co-Chair of the Task Sharing Working Group in the National Coalition for Mental Wellbeing formed by Rotary Malaysia, and previously served as the Project Manager of Humankind Buddy Bear and Director of Research & Advocacy of SOLS Health.

Humankind Buddy Bear 1800 18 2327 is Malaysia’s only child-dedicated helpline during the pandemic.

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