The COVID-19 health pan­dem­ic has brought fi­nan­cial, health and emo­tion­al dis­tress to many in T&T and around the world.

Ac­cord­ing to a Wash­ing­ton Post re­port last No­vem­ber, Since COVID-19 ar­rived, de­pres­sion and anx­i­ety in Amer­i­ca have be­come ram­pant. Fed­er­al sur­veys show that 40 per cent of Amer­i­cans are now grap­pling with at least one men­tal health or drug-re­lat­ed prob­lem.

T&T's cit­i­zens, old and young, have been no less im­pact­ed by this pan­dem­ic which has wreaked so­cial and eco­nom­ic hav­oc.

Dr Kati­jah Khan, lec­tur­er in Clin­i­cal Psy­chol­o­gy at the Uni­ver­si­ty of the West In­dies (UWI) spoke to the Sun­day Guardian about how the COVID-19 pan­dem­ic has af­fect­ed the men­tal health of cit­i­zens.

Q. Has there been an in­crease in men­tal health is­sues since the COVID-19 pan­dem­ic hit T&T?

*What groups of peo­ple have been most af­fect­ed? What are the de­mo­graph­ics in terms of age, sex, race etc? What types of ad­verse men­tal or be­hav­iour­al health con­di­tions are be­ing ex­hib­it­ed?

A. It was pre­dict­ed that there would be an in­crease in men­tal health prob­lems aris­ing out of the pan­dem­ic and this has been seen in many dif­fer­ent con­texts. Or­gan­i­sa­tions have re­port­ed an in­crease in re­ports of child abuse and gen­der-based vi­o­lence. While not reach­ing lev­els re­quir­ing pro­fes­sion­al help, in all the out­reach, sem­i­nars and pub­lic talk I have giv­en, every sin­gle one, peo­ple re­port high­er lev­els of stress, be it pri­vate sec­tor pro­fes­sion­als, health­care work­ers, teach­ers, par­ents or stu­dents. They re­port more symp­toms in­clud­ing wor­ry, anx­i­ety, de­pres­sion, prob­lems con­cen­trat­ing, ir­ri­tabil­i­ty, headaches, aches and pains, changes in ap­petite, sleep­ing and sub­stance use. Among uni­ver­si­ty and sec­ondary school stu­dents we have seen high­er rates of anx­i­ety and de­pres­sion due to the pan­dem­ic as well as height­ened con­cerns about the qual­i­ty and fu­ture of their stud­ies and a fear of fail­ure.

Last week, a 14-year-old child died by sui­cide. How vul­ner­a­ble is this age group? Has the vul­ner­a­bil­i­ty among chil­dren grown, es­pe­cial­ly since the COVID-19 pan­dem­ic hit?

Sui­cide is still a press­ing so­cial and pub­lic health prob­lem in our coun­try and un­for­tu­nate­ly, chil­dren are al­so af­fect­ed. The most re­cent Glob­al School Health Sur­vey of 2017 re­port­ed some alarm­ing sta­tis­tics for Trinidad in which 24 per cent of school chil­dren aged 13-17 se­ri­ous­ly con­sid­ered sui­cide in the last year, 14.4 per cent at­tempt­ed sui­cide in the past year and 9.5 per cent said they did not have any close friends. This will con­tin­ue to be a prob­lem through­out the pan­dem­ic.

School not on­ly pro­vides an aca­d­e­m­ic ed­u­ca­tion but gives chil­dren op­por­tu­ni­ties to so­cialise, in­ter­act phys­i­cal­ly and de­vel­op im­por­tant so­cio-emo­tion­al skills. On­line school­ing is not able to pro­vide all of these and, as such, the iso­la­tion and stress­es of on­line school­ing can wors­en stress and take a neg­a­tive toll on chil­dren’s emo­tion­al and men­tal health. Like adults, many chil­dren al­so are ex­pe­ri­enc­ing frus­tra­tion and "Zoom fa­tigue". Chil­dren liv­ing in homes with lim­it­ed re­sources and no ac­cess to de­vices or con­nec­tiv­i­ty are even more vul­ner­a­ble dur­ing the pan­dem­ic as they are at high­er risk to fall be­hind aca­d­e­m­i­cal­ly and cog­ni­tive­ly. Chil­dren in dys­func­tion­al homes, homes with con­flict are al­so like­ly to wit­ness more do­mes­tic vi­o­lence and them­selves be sub­ject­ed to more ver­bal, phys­i­cal and psy­cho­log­i­cal abuse.

What can be done to as­sist with or mit­i­gate men­tal health is­sues among chil­dren/oth­ers dur­ing these times of cri­sis?

We need to con­tin­ue to be wary of the signs and symp­toms that our chil­dren are strug­gling with and re­spond by of­fer­ing more care, pa­tience, com­pas­sion and sup­port. Chil­dren do not yet have ful­ly de­vel­oped emo­tion­al ma­tu­ri­ty and rea­son­ing skills and as such, they may not know how to cope well or may over­re­act to things that seem mi­nor to adults. Fam­i­lies and par­ents need healthy con­flict res­o­lu­tion skills as chil­dren of­ten mod­el cop­ing from their par­ents. The Of­fice of the Prime Min­is­ter re­cent­ly launched an on­line tool to help chil­dren cope with the pan­dem­ic. Schools and teach­ers can al­so de­vote more of their on­line school­ing time to ac­tiv­i­ties that help build so­cio-emo­tion­al skills. Ku­dos to those schools do­ing this al­ready! Par­ents need to know where to reach out for help for their chil­dren, for eg, Child Guid­ance Clin­ics, School Coun­sel­lor, Stu­dent Sup­port Ser­vices. Chil­dren can al­so call Child­line, a 24-hour free helpline (di­al 800-4321 or 4131) for sup­port. We al­so need cit­i­zens to con­tin­ue to be vig­i­lant and call and re­port in­stances of child abuse when they see it.

There were al­so news re­ports this week about a nine-year-old child who died af­ter tak­ing up a TikTok chal­lenge on­line. With chil­dren be­ing on­line at home with less or no par­ents and less su­per­vi­sion, do you ex­pect to see more in­ci­dents like this?

Chil­dren are spend­ing more time on de­vices and, as such, it is crit­i­cal for par­ents to be vig­i­lant about the con­tent and peo­ple that chil­dren are in­ter­act­ing with on­line. The In­ter­net is a great tool to help chil­dren ex­plore, learn and be en­ter­tained. But we al­so need to think of it as a vast un­known with ar­eas un­safe for chil­dren, with po­ten­tial preda­tors and dan­ger lurk­ing around the cor­ner. You would not let your child roam freely and alone in such a space, the same goes for the In­ter­net. Have con­ver­sa­tions with them about what is safe, in­ap­pro­pri­ate or dan­ger­ous. Es­pe­cial­ly for younger chil­dren and ado­les­cents, check up on their In­ter­net and so­cial me­dia use and utilise the parental con­trols that can lim­it their ac­cess to in­ap­pro­pri­ate con­tent and sites. When you set lim­its, ex­plain to them why you are do­ing so in ways they can un­der­stand and as such be more like­ly co­op­er­ate. Par­ents can get more in­for­ma­tion from Cy­ber­SafeTT, a lo­cal or­gan­i­sa­tion do­ing great work to pro­mote in­ter­net safe­ty for chil­dren.

What kinds of sup­port ser­vices are there for mem­bers of the pub­lic with men­tal health is­sues?

*Do you be­lieve the Gov­ern­ment is do­ing enough to make fa­cil­i­ties avail­able to the peo­ple who are vul­ner­a­ble?

Mem­bers of the pub­lic can ac­cess men­tal health ser­vices across the coun­try through health cen­tres, well­ness cen­tres, hos­pi­tals and clin­ics and a list of these are lo­cat­ed on the Min­istry of Health’s web­site. How­ev­er, due to the great de­mand and lim­it­ed re­sources, it is of­ten dif­fi­cult to ac­cess these ser­vices, es­pe­cial­ly for chil­dren and ado­les­cents.

As part of the re­sponse to the pan­dem­ic, the Min­istry of Health through its MH­PSS (Men­tal Health and Psy­choso­cial Ser­vices) Tech­ni­cal Work­ing Group, which I am a mem­ber of, has just launched a di­rec­to­ry of men­tal health cri­sis sup­port ser­vices which are free to the pub­lic and which can be ac­cessed through find­carett.com. Many of these ser­vices were avail­able vir­tu­al­ly or by tele­phone to the pub­lic through­out the last year and con­tin­ue to be so. Of course, there is more that can be done as the pop­u­la­tion’s men­tal health con­tin­ues to be chal­lenged by the on­go­ing stres­sors of the pan­dem­ic. This con­tin­ued col­lab­o­ra­tion of gov­ern­ment and stake­hold­ers to iden­ti­fy pri­or­i­ty ar­eas to ad­dress, groups who are in most need of help and qual­i­fied pro­fes­sion­als and ef­fec­tive in­ter­ven­tions is a pos­i­tive way for­ward. How­ev­er, these ef­forts will be lim­it­ed un­less there is a tan­gi­ble in­crease in the num­ber of psy­chol­o­gists, psy­chi­a­trists and men­tal health pro­fes­sion­als, and re­sources and ser­vices ded­i­cat­ed to men­tal health in the pub­lic sec­tor.