Global Health Asia-Pacific July 2020 July 2020 | Page 44

Cover Story
The great depression
The psychological fallout of the coronavirus pandemic calls for a rethink of how we confront mental distress
The severe acute
respiratory
syndrome
(SARS) epidemic
that spread
to Hong Kong
from China in
2003 similarly
contributed to
a spike in the
number of Hong
Kongers who
took their lives
As countries around the world begin to reopen,
it’s natural that the economic impact of the
coronavirus pandemic is dominating public
discourse, but medical experts and commentators
are also sounding the alarm about another bleak
after-effect of the current crisis � a mental health
pandemic.
Along with reports of a possible second wave of
COVID-19 infections, medical practitioners around the
world are also witnessing increased levels of anxiety
and depressive symptoms.
“The impact of the pandemic on people’s mental
health is already extremely concerning,” said Dr
Tedros Adhanom Ghebreyesus, Director-General
of the World Health Organization (WHO), in a news
release. “Social isolation, fear of contagion, and loss
of family members is [sic] compounded by the distress
caused by loss of income and often employment.”
In response, the WHO is recommending that
governments boost spending in this area in order
to avoid “a massive increase in mental health
conditions.”
But given that depression and other mental health
disorders have plagued our societies for centuries and
will still be around long after the pandemic is gone,
it’s fair to ask whether the distress many of us are now
facing is simply a straightforward medical disorder
or something more fundamental since there are clear
signs that other socio-economic forces are also at
work.
“The idea that we are facing two simultaneous
pandemics � a physical health one and, by tragic
coincidence, a mental health one as well � isn’t
just nonsense. It’s dangerous,” Dr Lucy Johnstone,
a psychologist who practised in the National Health
Service in the UK, wrote in Mad in America.
Labeling “our understandable human reactions
[to the pandemic] as mental health problems or
disorders” pushes us towards the wrong path of
focusing on individual treatments, be it psychiatric or
psychological, while �we would do far better to offer
practical and financial support,� she wrote.
“Diagnostic labels and the ‘mental health’
discourse actually prevent us from dealing with the
wider reasons for our distress, by disconnecting our
responses from the threats,” Dr Johnstone explained.
“In more normal times, those threats typically include
things like abuse, neglect, violence, discrimination and
poverty.”
In its devastating effects, the current economic
crisis triggered by the pandemic has been compared
to the Great Depression of 1929, which lasted a
decade. Taking a cue from this apt comparison, we
should now be placing more emphasis on the social
and economic roots that contribute to psychological
distress, rather than comparing mental problems to
infectious diseases.
Forms of human distress like depression, in other
words, aren’t clear-cut medical problems, but complex
phenomena strongly linked to their social context.
Catastrophes amplify psychological problems
History is rich in examples of catastrophic events that
take a significant psychological toll on human life, with
financial ruin being a key catalyst.
It should therefore not be surprising that the Great
Depression of 1929 and the Great Recession of 2008,
which both led to mass unemployment, have also
been associated with increased suicide rates.
The severe acute respiratory syndrome (SARS)
epidemic that spread to Hong Kong from China in
2003 similarly contributed to a spike in the number of
Hong Kongers who took their lives.
As one of the worst-hit places globally, the semiautonomous
city saw a combination of mass panic
and strict public health measures that battered the
economy and brought it to a near standstill.
The psychological ripple effects of the �AR�
epidemic became abundantly clear after researchers
analysed the rise of suicides in the city.
“During the SARS epidemic in 2003, we saw
an increase in the number of suicides, especially
among middle-aged and older adults, because of the
unfavourable economic conditions,” Professor Paul
Yip, director of the Centre for Suicide Research and
Prevention at the University of Hong Kong, told Global
Health Asia-�acific.
As the unemployment rate rose, the number of
suicides reached a record high, with 18.6 per 100,000
people taking their own lives in 2003.
“We’re talking about 1,264 people who died,
and a 20 percent increase compared to 2002,” said
Professor Yip.
He believes the current crisis could lead to even
42 JULY 2020 GlobalHealthAndTravel.com