Mental health is an essential human right that needs to be recognized by every civil society, but the problematic situation that has arisen from the COVID 19 has made this necessity more clear than ever. Hundreds of suicides and homicides along with a lot of suicidal attempts during this lockdown and the recent death of Dhaka University student Imam Hossain have brought the issue into the discussion again. Different life experiences affect a person’s risk of suicide. For example, suicide risk is higher among people who have experienced violence, including child abuse, bullying, or sexual violence. Feelings of isolation, depression, anxiety, and other emotional or financial stresses are known to raise the risk of suicide. People are more likely to experience these feelings during a crisis like COVID 19 pandemic.
According to the World Health Organization (WHO), Health is a state of complete Physical, Mental and Social well-being, and not merely the absence of disease. This holistic approach is relatively new and is indicating a shift in how “the right to a standard of living adequate for health and well-being”, first enshrined in the Universal Declaration of Human Rights (UDHR) 70 years ago, is now understood. The Government of Bangladesh has also passed a new Mental Health Act 2018, which replaced the outdated 105-year-old Lunacy Act, 1912 with an approach to accommodate Mental Health as a Human Right but any progress in encountering the socio-economic challenges of recognizing this issue has not been observed yet.
Unfortunately, the new act has appeared as a barrier to empathetic and proactive mental health-care delivery instead of increasing access to the services in reality. Moreover, this act does not address this enormous economic burden of mental health care, which remains a major weakness of the act. Most importantly, the new act has failed to acknowledge issues such as confidentiality, accountability, and other human rights aspects of mental illnesses.
With the effects of COVID-19 on our physical health increasingly documented, we can no longer collectively fail to notice its effects on our mental health. COVID-19 has the seeds of a major mental health crisis. Some people are showing high degrees of psychological distress, such as healthcare workers, older adults, and people with pre-existing conditions, children, those in precarious domestic situations, and fragile humanitarian and conflict settings. Pandemic-related restraints (e.g., spatial distancing, isolation, home quarantine, etc.) is impacting on economic sustainability and well-being, which may induce psychological mediators, such as sadness, worry, fear, anger, annoyance, frustration, guilt, helplessness, loneliness, and nervousness among the underprivileged people of Bangladesh right now.
More than 10 people committed suicide in April, at the starting of lockdown in Bangladesh and the condition has been worsened in the following months. On 6 April, an adult man from Mohespur Upazila in Jhenaidah committed suicide by hanging himself due to the pressure of unpaid debts. Again on 10 April, a female adolescent aged 10 years from Belkuchi municipality of Sirajgonj committed suicide by hanging herself because she was rebuked by her father for asking for food. Such a miserable incident does not stop there. On 13 April, a young adult man aged 27 years from Noldangga village in Natore committed suicide by hanging himself. He was a day laborer and he became unexpectedly unemployed as a result of the lockdown. On 24 April, a poverty-stricken husband aged 30 years and wife aged 24 years from Keshapur committed suicide both hanging themselves from the roof of their house due to lockdown-related economic distress. At this moment, suicides are not only confined in the economic crisis, rather students having anxiety and depression due to their career, academic life, and personal relationships are also attempting and committing suicides.
COVID-19 has instilled a level of fear and anxiety in us all. As it has isolated us physically, we have felt isolated mentally. We have all felt feelings of depression as we missed friends, family, and loved ones. WHO Director-General Dr. Tedros Adhanom Ghebreyesus’s consistent plea has been for nations’ coronavirus responses to be based on empathy. “Compassion is a medicine,” he said in March. That compassion and solidarity apply just as much to our approaches to mental health. The unfortunate incidents like suicides, homicides, suicidal attempts, self-harm, domestic violence, and other issues in Bangladesh are just the lack of a Humanitarian approach from both national and societal and personal levels. Not only clinical facilities but also a few words of compassion may help a person with mental health issues.
Community based mental health facilities need to be strengthened through broadening the existing training of primary health care physicians and primary health workers have become an emergency right now in Bangladesh. Strengthening of existing outpatient and inpatient psychiatric facilities in the general hospitals and creation of such facilities in private medical college hospitals and big general hospitals existing at the divisional and greater district level may be considered important steps for the development of community mental health services. Initiatives for the development of qualified and trained manpower are also urgently needed. A technology-based approach to resolve this issue is also required right now. Online Mental Health Support should be made available to the citizens of Bangladesh, especially to the youths who have been suffering from severe mental health issues. Awareness and promotional campaigns on mental health involving relevant sectors are also needed.
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