Indian Journal of Health Social Work
MENTAL ILLNESS BECOME A GLOBAL BURDEN IN CURRENT PANDEMIC
Narendra Kumar Singh
The global burden of mental disorders is enumerated by applying four strategies: the prevalence of disorders, their burden as measured in disability-adjusted life years, inequities in the distribution and impact of disorders, and their impact on other health conditions. It is estimated that about 10% of the adult and child population at any given point of time suffer from at least one mental disorder and cases has been increased after Covid-19 pandemic. However, it is also evident that there are large variations in the prevalence of mental disorders between, and within, populations. At present mental disorders such as unipolar depression, bipolar disorder, schizophrenia, epilepsy, alcohol and drug addiction, dementia and Alzheimer’s diseases, anxiety disorders and mental retardation account for over 12% of the global burden of disease. In case of developing countries about 10% of the total burden of disease is ascribable to mental disorders, and this statistic further rises to 11% if self-inflicted injuries are included. All the mental disorders, unipolar depression is the leading neuropsychiatric cause of burden of disease. The burden of mental disorders is highest in young adults (Demyttenaere et al., 2004). The social costs of mental disorders to families and society would be quite high at present. In addition to that, stigma associated with mental disorders is likely to lead to considerable under-reporting of mental disorders in developing world (Rose, 1985).
Covid-19 pandemic outbreak has drastically distorted the lives of millions of people around the world. These ‘unprecedented times’ have resulted in social distance, job insecurity, food insecurity, financial loss, housing insecurity, schools are closed, children are unable to play outside, psychosocial stress and depression leading to severe economic and social crisis. The children, aged, poor people, persons with mental illness, disabilities, other chronic physical illness, and migrants have been badly affected. This unprecedented time occurs for a large number of people, it is a social or health emergency or pandemic consequently the urgent need of involvement of concerned professionals is needed (Cifuentes-Faura, 2020). There are many social factors determining the course & outcome of mental illness and many researchers found that there is a significant between poverty or economic inequality and mental health. Anxiety about financial instability, debt and loans might also have some temporal relationship with the onset of depression symptoms among the people belong to poor families (Reading and Reynolds, 2001). Studies investigating the relationship with social class and mental illness have had varied observations. In subsequent times researchers like Clausen and Kohn (1959) investigated over the relationship between isolation and psychosis and they could not find the definitive relationship between these two. Many studies had been done in past for exploring the fact of high concentration of mentally ill people among economically backward segment of the population. Three notable hypotheses had been proposed by researchers regarding this issue. Firstly, ‘the drift hypothesis’ which suggests that severe mental illness incapacitates the social competence of the affected people let them shift to poorer urban areas and also drift down the social scale. The explanation here is that patients from all classes above that of the lowest stratum (the unskilled and the unemployed) who become mentally ill cannot maintain their class position and they sink to the bottom of society, in class terms. Secondly, the social causation/stress hypothesis claims that social factors such as poverty, low social class, housing, etc. act as stressors on individuals to produce higher rates of mental disorder. Thirdly, the social selection hypothesis has been arguing that individuals developing mental illness as they are predisposed to it and to lower expectations and ambition. The social selection hypothesis speculates that those with poorer psychological adjustment are less likely or less able to rise out of the lower social classes, or they are more likely to become part of the lower social classes as a result of psychological disorders. But regarding the relationship between homelessness and mental illness there are two sets of arguments. After Covid-19 pandemic homelessness might have some relationship with mental illness. Presence of macro socio-economic problems like poverty, unemployment, underemployment, low income, and low consumption of essential commodities can become the precursor of many psychiatric disorders. In post Covid-19 pandemic, most of the studies showed poverty, low educational levels, low income,lack of material possessions, lack of employment, sleep problem, Anxiety, Depression, Suicide, fear and housing difficulties had close relationship with common mental disorders.
The Professional social work is well fortified with great values and historical legacies and social workers are in a unique position to address emerging public health disease outbreaks such as COVID-19 pandemic. With regard to the COVID- 19 pandemic, Professional social workers have vast roles to play as it requires critical awareness from the social work profession, which includes the provision of adequate social support for the general population with regard to specific at-risk populations such as the infected patients and their caregivers, quarantined individuals, medical professionals. Professional Social Worker is also involved in advocacy for social inclusion for the most vulnerable, creation of awareness on the pandemic, implementation of mental health supporting strategies and community-based strategies to support plasticity and psychologically vulnerable individuals and groups during the COVID-19 pandemic. Professional Social Worker also help to identified the public health priority due to pandemic and networking with authorities and policy makers and effort to give clear behavioral strategies to reduce the burden of disease and the dramatic mental health consequences of this outbreak is to be rapidly accepted and implemented.
Cifuentes-Faura, J. (2020). The role of social work in the field of education during COVID-19. International Social Work , 63(6), 795- 797.
Clausen, J.A. & Kohn, M.L. (1959). Relation of schizophrenia to the social structure of a small city, in B. Pasamanick (ed.) Epidemiology of Mental Disorders . Washington, DC: American Association for the Advancement of Science, 56-59.
Demyttenaere, K., Bruffaerts, R., Posada-Villa, J.(2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. Journal of American Medical Association, 291(21), 2581-2590.
Reading, R. & Reynolds, S. (2001). Debt, social disadvantage and maternal depression. Social Science and Medicine, 53(4), 441–453.
Rose, G. (1985) Sick Individuals and Sick Populations. International Journal of Epidemiology, 14(1), 32-38.
(Narendra Kumar Singh)