Chhimi Dema 

The Covid-19 mental health response team helped more than 800 people in the last nine months.

The team, which was formed in March to provide psychosocial support to those affected by the Covid-19 pandemic, received more than 70 calls in the eight days since the second lockdown. It responded to 378 calls in the first lockdown in August.

Of the 70 calls, maximum calls were regarding medical cases and other psychiatric issues. It also received calls regarding anxiety, depression, self-harm, alcohol and substance abuse.

The total calls recorded by the team were 1,254 calls (403 follow-up calls and 851 individual client calls).

From the callers, about 400 were male and more than 300 were female. Other callers did not mention their sex.

More than 200 individuals, who called the team, were aged from 19 to 29 years, 12 minors, about 100 individuals aged between 30 to 40 years and about 60 individuals were above 40 years. About 500 callers did not mention their age.

Apart from the general population, the team received calls from those in quarantine facilities and isolation as well.

Team members said the highest calls were on issues regarding psychiatrist history and treatment.

People sought help experiencing alcohol and drug withdrawal, trauma and posttraumatic stress disorder symptoms, violence, grief and loss, self-harm and suicide threat and stigma.

The response team facilities the cases according to the Standard Operating Procedures (SoP) they developed, according to psychiatrist Dr Chencho Dorji, who is the response team leader.

He said the team provides crisis mental health and psychosocial counselling on mobile phones and through social media platforms. “The strategy used while talking to the callers were by always accepting and normalising feelings an individual was experiencing, allowing the callers not to feel ashamed of different experiences like ‘panic and anxiety’.”

He said the team tries different strategies to help people to stay calm.

Dr Chencho Dorji said that for some people reflecting on the year, how they coped and withstood the difficult circumstances helped to change their perspective and move on in life.

“Some people get preoccupied attempting to control things that are not in their control and get unnecessarily worked,” Dr Chencho Dorji said. “This jeopardises their mood and interferes with the appropriate response.”

The team also developed three mappings of resources with contacts of focal person in all the dzongkhags to contact during the pandemic situation.

What makes people stressed or anxious?

Dr Chencho Dorji said that when individuals feel threatened, they react with fight or flight response.

“The nerve centre in the brain called amygdala gets alarmed and it sends messages to the body through the hypothalamus to pituitary then to the adrenal axis to prepare for the danger,” he said.

Human bodies prepare for the danger by breathing faster to get more oxygen, heart beating faster to push more oxygen to the peripheral limbs and the muscles tighten to fight or to flee.

He said that this was considered an acceptable and protective mechanism to safeguard lives when there was a real danger.

However, Dr Chencho Dorji said that some people may feel that the threat was more than they could handle and start panicking and get emotionally overwhelmed by these circumstances. “Their emotions hijack their thinking process. Some of them may need short courses of anxiolytic- a drug used to treat symptoms of anxiety, and tranquillizer medications to help them cope.”

Dr Chencho Dorji said that few sessions of counselling on psychoeducation to understand the stress and symptoms could benefit people. “Mindfulness practice- breathing slowly and completely, focusing the mind on the breathing and learning how to relax their muscles can help to relax.”

As the pandemic tolls the mental health of adults, children are likely to experience mental stress and breakdown as well.

Dr Chencho Dorji said children with limited understanding about issues and coping skills reply and copy what adults do and say. “Therefore, it is important that parents and families understand and accept that some of their children may behave a little abnormally or eat and sleepless.”

He said teaching deep slow breathing, relaxation of muscles, setting routines for meals and sleep would help maintain diurnal rhythms and maintain good physical and mental health.

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