We must not forget about the mental health consequences of the pandemic

How quickly will we forget about the mental health consequences of the pandemic?

Fairly quickly judging by the passion we give to debates over pubs and holidays while mental health gets a passing nod.

Those consequences could be profound for some people.

That they could all too easily be forgotten isn’t a question of callousness. The desire for normality can push us towards forgetfulness.

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This may be why the Spanish flu, which began in 1918 and killed more than 50 million people, has been more or less forgotten about, as historians have noted.

I grew up in Co Kildare which, according to Ida Milne in the Journal of the Co Kildare Archeological Society, had the highest death rate in Ireland from the pandemic – we don't know how many died because, she found, doctors didn't have the time to do the paperwork to register deaths.

Twenty years ago I heard from a barber in Dublin that his father in Newbridge had been given a medal for helping to dig a mass grave on the Curragh. Yet, growing up less than 10 miles away, I heard next to nothing about the Spanish flu. I heard about the Black and Tans but not about a pandemic which left morgues unable to accommodate the numbers of the dead.

Spanish flu

I’m dwelling on this because I want to make the point that concern for the mental health effects of coronavirus will quite possibly evaporate when the pandemic ends and we want to put the whole thing behind us. It seems to me that some sort of commission or agency needs to be set up now to carry forward the provision of treatment for these effects.

But what are the effects? We don’t have any sort of clear picture yet.

Judging by previous pandemics, including the Spanish flu and the SARS outbreak of 2002 they could include:

– Post-traumatic stress with its sleeplessness, nightmares, memories of events that feel like they are happening right now and “jumpiness”. Nurses, social care workers and doctors could be among those affected.

– Delirium might affect some people who have been through ICU treatment – or, at least, this has been reported in the US – or people isolated for long periods from familiar family and places.

– Anxiety, depression, grief (complicated by the conditions in which people died and were buried or cremated) could be widespread and could lead to increases in suicide. For people in nursing homes or other institutions who spent weeks or months in isolation as their friends died around them, these effects could be magnified.

– People with intellectual disabilities, cut off from their normal stimulation and relationships and perhaps at a disadvantage in their capacity to think through what is going on must also be suffering emotionally.

– Those whose work has vanished or become precarious but whose debts continue to mount up are in a very stressful situation which, for some, could lead to deeper anxiety and depression.

I mentioned health professionals above. We like to think they’re as strong as if they were made of iron. Well, there are no iron women or iron men. Many will need emotional support from community, family and friends and, possibly, professional help.

Challenges

I imagine – though this is speculation on my part – that foreign healthcare workers with no family here could do with a lot of TLC from colleagues and neighbours.

I haven’t mentioned children whose familiar world vanished suddenly, whose spontaneity with people outside the household has had to be suppressed, and who may worry that their parents and grandparents could be killed by the virus. Nor have I mentioned teenagers who face greater stresses and challenges than they should have to face at their stage of development.

Many of the mental health issues mentioned here will still be affecting some people while everyone else is back to the new normal.

What the affected people will need, so that they too can enjoy life in the new normal, will be support, not amnesia.

My main, though not only, source for this article is The Psychiatry of Pandemics edited by Damir Huremovic.

– Padraig O'Morain (@PadraigOMorain) is accredited by the Irish Association for Counselling and Psychotherapy. His latest book is Daily Calm. His daily mindfulness reminder is free by email (pomorain@yahoo.com).