Along with COVID-19 came another pandemic i.e. mental trauma associated with it. Suicide cases have experienced a significant rise lately in almost all COVID-19 affected nations. People across the world have been suffering from mental trauma since the COVID-19 has been declared a pandemic. There are 3 incidents of suicide in India among other cases that amply represent the ongoing mental health crisis. The first incident was of a 29-year old woman who was a resident of Worli in Mumbai. She committed suicide in the bathroom of Nair Hospital by hanging herself after she tested positive for COVID-19[1]. The second incident is of a 52-year-old man Uttar Pradesh’s Banda district. He hanged himself from a tree on the border of Jaari village on 11th April; 2020 due to his failure to get any labour to harvest his wheat crop[2]. The third incident is of a 30-year old member of Tablighi Jamaat who committed suicide in the washroom of a hospital in Akola in Maharashtra on 10th April; 2020 after a medical examination that revealed he was a positive case of COVID-19[3]. All the 3 cases show how COVID-19 has directly as well as indirectly is the cause behind the mental trauma of Indians. Association of mental trauma and suicide is not a new phenomenon. One example of this is the SARS epidemic in Hong Kong. The SARS epidemic led to a 30% increase in suicide cases among old-aged persons. In the US as well, an increase in suicides was observed during the 1918-19 influenza pandemic[4].
Almost every person is going through psychological issues but the most vulnerable are migrant workers and Indians stranded across various nations in the world. Migrant workers have been the most vulnerable sections because they are not with their families but at their places of work. A huge portion of migrant workers has been retrenched, laid-off or dismissed from their workplaces by their employers due to the COVID-19 crisis. Migrant workers usually move to urban or suburban settings in order to seek better work opportunities and send their wages or salaries back to their families who stay in their home States. The COVID-19 has made migrant workers the most helpless section of our society as they don’t have their wages in their hands but their responsibility to send money back to their homes still exists.
In India, the nation-wide lockdown announced with less than four hours’ notice[5] made migrant workers to immediately leave the urban settings through buses and trains. But the movement of public buses and trains ceased as well which made lakhs of migrant workers to walk thousands of miles to reach their homes[6]. The Centre then passed orders to the State Governments to stop the migrant workers walking on feet and keep them in quarantine for 14 days before letting them enter their home States[7]. Though the government and NGOs collectively tried to mitigate the hardships of migrant workers in camp settings at the outskirts of States, still a large portion of migrant workers stand deprived of the benefits of relief schemes of Centre and State Governments. Migrant workers in camp settings were desperate to go to their homes to mitigate their hardships and hence, discovered ways to escape the urban settings. Few migrant workers swim across the Yamuna river to cross the Haryana State Border to reach Uttar Pradesh[8]. The Nepali migrant workers also swim across the mahakali river in to reach Nepal. Some workers even hid in the cement mixer and trucks to travel back to their home states without getting noticed. The human rights of the migrant workers were not present anymore and it seemed like their human rights became dead.
This was all about the migrant workers in camp settings. The plight of migrant workers in non-camp settings still did not receive much attention from the world. The workers in non-camp settings are not either living with much comfort. Their homes are usually congested. Hence, it becomes difficult for them to observe the guideline of social distancing and even if they somehow find ways to observe it, staying in the home with no idea about till when they have to stay also causes depression, anxiety, fear. In the early stage, they show symptoms like lack of sleep, harsh eating, fast palpitations, anger and irritability. Their plight is not much different from those migrants who are stranded in camp settings but just like the ones in camp settings are worried about the food, shelter, healthcare, fear of getting infected or spreading the infection, loss of wages.
The mental trauma faced by domestic workers also receives no attention. 80% of domestic workers are females. A great portion of domestic workers is temporarily dismissed by their employers and hence, currently live with their abusive partners. Domestic violence experienced by domestic workers due to the conduct of their husbands isn’t merely a fiction in movies. The mental trauma faced by the domestic workers due to the domestic violence by their husbands stands aggravated for now they have no place to escape[9]. Their relatives, friends or NGOs who used to come to their rescue at the time of such incidents, cannot come for them because of the lockdown.
The migrant workers who belong to northeastern India are going through stigmatisation as well. They are considered as the ones responsible for COVID-19 because their facial features are similar to those who live in China. Hence, they are to deal with the stereotypes as well[10]. Those migrants, who belong to other parts of India also fall prey to stigmatisation for when they return to their villages or hometowns, they are socially excluded by the locals. The reason behind their social exclusion is that people believe that they may carry COVID-19 and transmit it to other people as well.
Every person in the class of migrant workers, contractual workers, construction workers, domestic workers and similar groups is groped by depression, anxiety, stress, fear and hence, need psycho-social support.
How the Government is dealing with the mental trauma of migrant workers?
The Government of India recognised the mental trauma of migrant workers and sub-classes of migrant workers. Hence, the Ministry of Health and Family welfare suggested some measures[11] that may be adopted to deal with the mental trauma of migrant workers in our nation:
- Every migrant worker must be treated with respect, dignity, empathy and compassion.
- One must listen to their concerns with enough patience and try to interpret them.
- One must refrain from generalisation and realise that every person or family has specific and varied needs.
- Migrant workers should be informed that this is a situation of uncertainty but it won’t last long and the normal life will resume soon. This will give them new hopes so it will become easy for them to cope up with their issues.
- A great proportion of migrant workers in India are either not aware of the relief schemes launched by the Central & State Government and NGOs. Even if they know about such relief schemes, they don’t know how to seek benefits under these schemes. They should be made aware of such relief schemes and how they can get access to the benefits of such schemes.
- Migrant workers must be informed of why quarantine and social distancing are necessary. Though migrant workers are concerned that even if they don’t die from COVID-19, they may die due to hunger, their deviance from the guidelines of social distancing and quarantine will risk the lives of others as well.
- Migrant workers must be appreciated for their role in the development of society and they must not feel unworthiness as it leads to depression.
- They must be reminded constantly that they are brave souls for they suffered a lot to earn their wages, gained the trust of their employers, send their limited wages back to their families and hence, they deserve respect from everyone.
- They must be reassured that even if their employers turn their back to them, they still have local administration and charitable institutions who will look after them.
- One must be patient while talking to a migrant worker because they may lose temper as they are dealing with more serious issues like food insecurity, braving police lathis, poor access to relief schemes and healthcare services, etc.
Shortly afterwards, the guidelines provided by the Ministry of Health and Family Welfare did not prove much effective to cope up with the mental trauma of the migrant workers due to COVID-19. The Ministry of Health and Family Welfare (MoHFW) asked National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bangalore and Central Institute of Psychiatry (CIP), Ranchi and State Governments to provide mental health support, counselling services and other services for migrant workers who are housed in camp settings across the country.
NIMHANS has worked effectively to deal with the mental trauma of migrant workers due to COVID-19. It provided a COVID-19 helpline to provide mental health counselling services in 21 states and has shown results as well[12]. It has so far provided its counselling services over psychological and mental health issues to 16,000 callers and their family members in 21 States[13]. NIMHANS has worked efficiently in collaboration with local authorities. Naveen Kumar of NIMHANS has answered the Karnataka High Court that 300 workers are spread across the nation who manage the calls through a cloud-based interactive voice recording system of NIMHANS and provide counselling services to those who need it[14]. Counselling services are being provided to persons of all age groups and on domestic violence and substance withdrawal symptoms as well.
In Bengaluru, some 200 mental health professionals under the District Mental Health programme work day and night to address the mental health issues[15]. The teams of these mental health professionals reached out to migrant workers in camp settings across the State. It was observed that alcohol withdrawal symptoms are common among migrant workers[16].
Will the mental trauma last beyond pandemic?
Experts throughout the world have said that COVID-19 isn’t going anywhere any soon and even if it may go, the mental trauma that people experienced due to COVID-19 will stay beyond the pandemic as well.
A comment published in The Lancet Psychiatry, member of International COVID-19 Suicide Prevention Research Collaboration mentioned that distress among various groups faced during COVID-19 will surely leave a great portion of world population vulnerable to mental health problems and suicidal behaviour. The repeated exposure to the news of crisis has increased the fear and heightened the risk of suicide.
Many psychiatrists have said that people may suffer PTSD i.e. Post-traumatic stress disorder and anhedonia-a situation where a person is not able to experience any emotions. These symptoms will be most likely developed among those persons who suffer from psychosis.
Article Written By- Muskan Sharma
Law Student– Jamia Milia Islimia
(HRDI Work From Home Internship)
[1] “COVID-19 lockdown: A recipe for mental health crisis”, Deccan Herald, available at: https://www.deccanherald.com/specials/insight/ksdc-will-provide-skilled-manpower-as-per-industry-needs-c-n-ashwath-narayan-835686.html (Last visited on 10th May; 2020)
[2] Ibid.
[3] Ibid.
[4] “Mental health and suicidal problems likely to last beyond pandemic: Lancet Psychiatry”, The Week, available at: https://www.theweek.in/news/health/2020/05/02/mental-health-and-suicidal-problems-likely-to-last-beyond-pandemic-lancet-psychiatry.html (Last visited on 10th May; 2020)
[5] “Modi orders 3 week total lockdown for all 1.3 billion Indians”, The New York Times, available at: https://www.nytimes.com/2020/03/24/world/asia/india-coronavirus-lockdown.html (Last visited on 10th May; 2020)
[6] “In India, the world’s biggest lockdown has forced migrants to walk hundreds of miles home”, The Washington Post, avaliable at: https://www.nytimes.com/2020/03/24/world/asia/india-coronavirus-lockdown.html (Last visited on 10th May; 2020)
[7] “Centre orders quarantine camps for migrant workers”, The Economic Times, available at: https://economictimes.indiatimes.com/news/politics-and-nation/centre-orders-quarantine-camps-for-migrant-workers/articleshow/74880761.cms?from=mdr (Last visited on 10th May; 2020)
[8] “Migrants stuck in Haryana swim across Yamuna to UP”, The Times of India, available at: https://timesofindia.indiatimes.com/city/meerut/border-roads-sealed-migrants-stuck-in-haryana-swimming-yamuna-to-cross-over-to-up/articleshow/75363432.cms (Last visited on 10th May; 2020)
[9] “A New COVID-19 crisis: Domestic abuse rises worldwide” , The New York Times, available at: https://www.nytimes.com/2020/04/06/world/coronavirus-domestic-violence.html (Last visited on 10th May; 2020)
[10] “Northeast people battle racism amid coronavirus pandemic”, The Week, available at: https://www.theweek.in/news/india/2020/03/28/coronavirus-pandemic-fuels-racism-against-northeast-people.html (Last visited on 10th May; 2020)
[11] https://www.mohfw.gov.in/pdf/Advisoryforquarantineofmigrantworkers.pdf (Last visited on 10th May; 2020)
[12] “Helpline providing COVID-19 mental health counselling in 21 states: NIMHANS tells SC”, The Hindu, available at: https://www.thehindu.com/news/national/karnataka/helpline-providing-covid-19-mental-health-counselling-in-21-states-nimhans-tells-hc/article31466837.ece (Last visited on 10th May; 2020)
[13] Ibid.
[14] Ibid.
[15] “Mental health professionals reach out to patients, migrant workers”, The New Indian Express, available at: https://www.newindianexpress.com/cities/bengaluru/2020/apr/19/mental-health-professionals-reach-out-to-patients-migrant-workers-2132129.html (Last visited on 10th May; 2020)
[16] Ibid.
