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SRI LANKA COLLEGE OF PSYCHIATRISTS

COVID-19, Mental Health and Sri Lanka

 

The situation in the world

World Health Organization (WHO) declared the outbreak of a new coronavirus disease to be a Public Health Emergency of International Concern January 2020. In March 2020, WHO declared that COVID-19 has reached the status of a pandemic. At the time of writing this statement, over 200,000 people in 170 countries have been infected by COVID-19 with around 80,000 recoveries and over 8,000 deaths.

 

The situation in Sri Lanka

Sri Lanka is still at the end of first week of the active phase of COVID-19. By the first week, there are 50 patients who have  contracted COVID-19.

 

Impact on mental health

The impact on mental health due to COVID-19 significant. This document which has been prepared based on guidelines by WHO and Royal College of Psychiatrists, UK addresses some issues anticipated in Sri Lanka and what to do about them.

 

General population

People with COVID-19 have not done anything wrong. They too require our support, care and compassion.

There are no people as  “COVID-19 cases”, “victims” “COVID-19 families” or the “diseased”. They are “people who have COVID-19”, “people who are being treated for COVID- 19”, “people who are recovering from COVID-19”.  

While you should be updated about the disease, disease status and preventive measures, you should not be overwhelmed with worry and anticipation particularly with overload of information.

            Limit the number of times you seek information

            Seek information from reliable sources

            Do not share and disseminate information which lacks credibility

            Be responsible for yourself and others

 

Patients with COVID-19

Trust medical professionals who are treating you

It is not your fault that you contracted  COVID-19

It is alright to be scared and anxious but don’t be overwhelmed – request a referral to a mental health professional if you need help

 

People who are in quarantine facilities and who are being self-quarantined

You are doing the right thing – however, distressing and uncomfortable it may be

Stay connected and maintain your social networks

Even when isolated, try as much as possible to keep your personal daily routines or create new routines

During times of stress, pay attention to your own needs and feelings

Engage in healthy activities that you enjoy and find relaxing

Exercise regularly, keep regular sleep routines and eat healthy food

Seek information updates and practical guidance from credible sources

 

 

People with existing mental health issues

Do not neglect your own mental health

Take your medications as usual

Call your psychiatry unit to find out how you can obtain medications and follow-up

Call 1926 for further advice

Stop smoking

 

People who smoke

Stop smoking 

Smoking is always bad for your physical, mental and psychosocial wellbeing. 

However, the evidence is that COVID-19 affects badly on those who smoke may be due to several reasons

Smoking it self

People who smoke already have compromised lung functions

They have other co-existing illnesses 

 

Health care workers

It is quite normal to be feeling stressed in the current situation.

Feeling stressed does jot mean that you cannot do the job or that you are incompetent.

Managing your mental health and psychosocial wellbeing during this time is as important as managing your physical health.

Take care of yourself 

Try and use helpful coping strategies such as ensuring sufficient rest and respite during work or between shifts, eat sufficient and healthy food, engage in physical activity, and stay in contact with family and friends.

Avoid using unhelpful coping strategies such as tobacco, alcohol or other drugs. 

Healthcare workers and their families may unfortunately experience stigma or fear

Do not hesitate to seek help if you are too stressed – you are not immune to stress
 
Stop smoking if you are a smoker

 

To mental health professionals

If COVID-19 is considered possible when in an inpatient or outpatient consultation is already in progress, withdraw from the room, close the door and wash your hands thoroughly with soap and water.

Avoid physical examination of a suspected case.

The patient, any accompanying family, belongings and any waste should remain in the room with the door closed.

Advise others not to enter the room.

If entry to the room or contact with the patient is unavoidable in an emergency, wear personal protective equipment (PPE) in line with standard infection control precautions, such as gloves, apron and fluid resistant surgical mask (FRSM) and keep exposure to a minimum. All PPE in full should be disposed of as clinical waste. 

Address the mental health issues and try to minimise patients coming to clinics in accordance to a plan developed by your unit

Address unhealthy habits – particularly smoking as smoking is a bad prognostic factor

 

Some useful links and documents

COVID-19 CPG_MARCH 2020 MoH SL_New.pdf From the Ministry of Health

https://www.facebook.com/hpbsrilankahpb.health.gov.lk/web/index.php/en/home

https://www.cdc.gov/coronavirus/2019-ncov/index.html

https://www.rcpsych.ac.uk/news-and-features/responding-to-coronavirus/guidance-for-psychiatrists-and-other-professionals-working-in-mental-health-settings-(covid-19)

http://covidsl.com/embed.html