ANNEXURE I

MENTAL HEALTH DURNIG COVID-19

By

Naveenkumar Subramanian

Register No.

2019271025

A PROJECT REPORT

Submitted to the

DR.A.K. SHEIK MANZOOR

In partial fulfillment for the award of the degree of

MASTER OF BUSINESS ADMINSTRATION

ANNA UNIVERSITY
 ANNEXURE II

BONAFIDE CERTIFICATE

Certified that the Project report titled MENTAL HEALTH DURNIG COVID-19
is the Bonafide work of Mr. Naveenkumar Subramanian (2019271025) who
carried the work under supervision. Certified further that to the best of my
knowledge the work reported herein does not form part of any other project report
or dissertation on the basis of which a degree or award was conferred on an earlier
occasion on this or any other candidate.

Signature of Student Signature of Guide

Name: Naveenkumar Subramanian Name:

Roll No: 2019271025 Designation:

 ABSTRACT

The COVID-19 pandemic has been creating a panic and distressing situation
among the entire population globally. No study has been conducted assessing the
psychological impact of this pandemic on the general public. The objective of this
study is to assess the mental health status during COVID-19 outbreak and explore
the potential influencing factors among the population. It is also to study the
impact of covid 19 on young children, school/college going students and
adults/employed people and identify various strategies how to tackle mental stress,
anxiety and psychosis. This study also provides data/stats related to mental health
in the times of covid 19
 TABLE OF CONTENTS

Chapter – 1: Introduction.

Chapter – 2: Objectives.

Chapter – 3: Methodology.

Chapter – 4: Impact on young children

Chapter – 5: Impact on school and college going students

Chapter – 6: Impact on adults and employed people

Chapter – 7: Depression, Anxiety, & Psychosis: “Positive” Numbers

Increased Dramatically in May-Aug (bar chart)

Chapter– 8: Suggestions

Chapter – 9: Conclusion
INTRODUCTION
The World Health Organization (WHO) reports that as of June 26, 2020,
worldwide Covid-19 has killed 492,085 with a total of 9,724,146 individuals
confirmed infected, and the death toll is still rising. The scale and severity of the
COVID-19 pandemic has threatened public health globally. The world has been
reeling, even with high income countries in havoc as a result of the global spread
of this potentially fatal disease. The WHO declared COVID-19, a Public Health
Emergency on 30th January 2020 a month after the outbreak of the virus in
Wuhan, China alerting the global community with particular concern to the high-
risk countries having poor health systems. India in an example of a country that
lacks adequate resources to tackle the COVID-19 outbreak. The government has
not been able to assure the public that they are capable of handling the situation,
and this has been created panic and distress throughout the entire population.
India detected the first case of corona virus infection on 23rd January 2020 and the
second case two months later, on 23rd March 2020 that surged to 11,700 affecting
all 77 districts across the country with a total 28 reported deaths from COVID-19
by the end of June 2020 . The government strategy included a country-wide
lockdown to prevent a widespread outbreak of the disease and this came into effect
on 24th March 2020. This lockdown was partially lifted on 14th June 2020. In
addition to the illness itself, the entire population particularly the middle and low-
income groups are already seriously affected through COVID-19 related issues
such as lost jobs, restricted mobility and loss of freedom due to the nationwide
lockdown as well as the on-going fear of disease susceptibility. Moreover, the
government’s poor risk communication mechanisms and the strong influence of
incorrect and misleading social media rumors has been creating further terror. All
of these factors have negative mental health impacts on the public.

Previous studies that assessed the psychosocial impact of epidemics or pandemics

such as SARS and COVID-19 found high levels of mental distress including panic
attacks, and psychotic symptoms among healthcare workers and the general public.
Evidence also shows that in addition to the stress of high numbers of people
getting sick or dying, epidemics and pandemics also cause vast economic losses
which are associated with further high psychosocial risk. It should also be noted
that the most vulnerable groups–people who are poor, women, children, the
elderly, persons with disability and the homeless, are reported to suffer during
these public health emergencies and have the greatest difficulty rebuilding their
means of subsistence and social support networks after such catastrophes. The
effects on mental health are usually more marked among populations living under
precarious circumstances, who have limited resources, and limited access to social
support and healthcare services. The recent studies conducted in different settings
during the COVID-19 pandemics reported comparable findings, with the highest
levels of distress among women, rural inhabitants, elderly populations, groups with
lower levels of education, migrant workers. The Impact of COVID-19 on mental
health outcomes among hospital fever clinic attendants across India PLOS ONE
having unstable incomes. Moreover, perceived disease susceptibility and perceived
disease severity, social isolation, and spending longer time watching COVID-19
related news and social media are also found associated risk factors with increased
level of mental distress. WHO reports that the burden of distress, depression and
other mental health conditions such as suicide is on the rise globally? It further
reports that long-lasting moderate or severe depression related to COVID-19
pandemic may become a serious public health concern .
The burden of COVID-19 related mental disorders continues to grow with
significant impacts on health and major social, human rights and economic
consequences globally. Furthermore, mental health disorders, fear-related
behaviors, stigmatization, and negative effect on access and quality of care during
and in the aftermath of the epidemics are commonly reported. In summary,
COVID-19 has the potential to create devastating social, economic and mental
health crises which may have long-term impact, particularly in a country like India.
In light of this, it is urgent to understand the current level of anxiety and stress due
to COVID-19 in India and to recommend evidence based mental health
intervention policies to cope with this efficiently. It is further urgent that evidence-
driven strategies be developed to reduce adverse psychological impacts and
psychiatric symptoms during and after COVID-19. This study is intended to
contribute to this effort by identifying potential factors that affect the mental health
status of fever clinics patients with the symptoms of COVID–19. We hypothesized
that the prevalence and levels of depression and anxiety as indicated on the
respective Depression, Anxiety, and Stress Scale (DASS) subscales may be
elevated among the study population.
OBJECTIVES
The overall objective of this study is to analyze the Impact of COVID-19 on
mental health of general public. In particular, this study will examine:

i. How mental health is facing the Impact of COVID-19 in young children,

school/college going students and adults/employed people.
ii. Strategies to tackle against the impact of covid 19 on mental health on
the children and adults

METHODOLOGY
Data and information presented in the study are collected from various reports and
articles published by national and international agencies on impact of COVID-19
pandemic. Information is also collected from various authentic websites. Some
journals are also referred relating to impact of COVID-19 on educational system
are referred.

Impact on young children

Stress starts showing its adverse effect on a child even before he or she is born.
During stress, parents particularly pregnant mothers are in a psychologically
vulnerable state to experience anxiety and depression which is biologically linked
to the wellbeing of the fetus. In young children and adolescents, the pandemic and
lockdown have a greater impact on emotional and social development compared to
that in the grown-ups. In one of the preliminary studies during the on-going
pandemic, it was found younger children (3-6years old) were more likely to
manifest symptoms of clinginess and the fear of family members being infected
than older children (6-18 years old). Whereas, the older children were more likely
to experience inattention and were persistently inquiring regarding COVID-19.
Although, severe psychological conditions of increased irritability, inattention and
clinging behavior were revealed by all children irrespective of their age groups.
Based on the questionnaires completed by the parents, findings reveal that children
felt uncertain, fearful and isolated during current times. It was also shown that
children experienced disturbed sleep, nightmares, poor appetite, agitation,
inattention and separation related anxiety.

Impact on school and college going students

Globally, the pre-lockdown learning of children and adolescents predominantly
involved one-to-one interaction with their mentors and peer groups. Unfortunately,
the nationwide closures of schools and colleges have negatively impacted over
91% of the world's student population. The home confinement of children and
adolescents is associated with uncertainty and anxiety which is attributable to
disruption in their education, physical activities and opportunities for socialization.
Absence of structured setting of the school for a long duration result in disruption
in routine, boredom and lack of innovative ideas for engaging in various academic
and extracurricular activities. Some children have expressed lower levels of affect
for not being able to play outdoors, not meeting friends and not engaging in the in-
person school activities These children have become more clingy, attention seeking
and more dependent on their parents due to the long term shift in their routine. It is
presumed that children might resist going to school after the lockdown gets over
and may face difficulty in establishing rapport with their mentors after the schools
reopen. Consequently, the constraint of movement imposed on them can have a
long-term negative effect on their overall psychological wellbeing

A study found that older adolescents and youth are anxious regarding cancellation
of examinations, exchange programs and academic events. Current studies related
to COVID-19 demonstrate that school shut downs in isolation prevent about 2-4%
additional deaths which is quite less if compared to usage of other measures of
social distancing. Moreover, they suggest to the policy makers that other less
disrupting social distancing strategies should be followed by schools if social
distancing is recommended for a long duration .However, in current circumstances,
it is controversial whether complete closure of school and colleges is warranted for
a prolonged period.

It has been reported that panic buying in times of distress indicate an instinctual
survival behavior. In present pandemic era there has been a rise in the hoarding
behavior among the teenagers. It is also found that among youth social distancing
is viewed primarily as a social responsibility and it is followed more sincerely if
motivated by prosocial reasons to prevent others from getting sick. Further, due to
prolonged confinement at home children's increased use of internet and social
media predisposes them to use internet compulsively, access objectionable content
and also increases their vulnerability for getting bullied or abused .Worst of all,
during lockdown when schools, when legal and preventative services do not
functioning fully, children are rarely in a position to report violence, abuse and
harm if they themselves have abusive homes.

Impact on adults and employed people(stats)

➢ From 2020 June to August around 4,00,000 people screened moderate to severe
for depression or anxiety over and above what we would have expected prior to the
COVID-19 pandemic.

➢ From 2020 June to August an additional 60,000 people screened at risk for
psychosis over and above what we would have expected prior to the COVID-19
pandemic.

➢ Since March 1, 2021 around 131,122 depression screeners reported suicidal or

self-harm thinking. Thoughts of Suicide & Self-Harm at Epidemic Levels

➢ In August 2020 nearly every day, with 24,009 screeners reported thinking of
suicide or self-harm on more than half of days to these thoughts nearly every day.

➢ Despite a dramatic jump in screeners in July and August (314,600 in August

versus 69,626 in April), severity continued to track higher than our pre-pandemic
baselines.
➢ Special populations are also experiencing high anxiety and depression,
including LGBTQ, caregivers, students, veterans/active duty, and trauma
survivors.

➢ This isn’t just affecting people with anxiety and depression, but other mental
health conditions, too. Among psychosis screeners in August, over 21,000 were at
risk, and the percentage at risk (76%) also increased.

BACKGROUND INFORMATION ON MENTAL HEALTH

Coronavirus: Mental Health and Returning to the Workplace. Nearly a third of
INDIAN employees are absent due to mental health issues.
SOME STATISTICS

▪ Two thirds of INDIAN employees do not report the reason for their absence.

▪ Nearly a quarter of employees have considered taking their own life.

▪ 60% of employees experience mental health issues because of work.

▪ 31% of the workforce have been formally diagnosed with a mental health issue.

▪ Only 13% feel able to disclose a mental health issue to their manager.

▪ 91% of managers agree that what they do affects the wellbeing of their staff.

▪ Only 58% of employees believe their manager is concerned about their wellbeing
Coronavirus: Mental Health and Returning to the Workplace

▪ Long hours and the challenges of constant communication mean Britain’s

managers are facing specific mental health issues their organizations are likely to
be overlooking.

▪ An increased tendency to work unpaid overtime, and the ‘always on’ digital
culture in workplaces, is negatively affecting managers’ wellbeing.
▪ One in 10 of managers surveyed took time off work for mental health issues in
the past year.

▪ 24% of managers have received training in mental health and wellbeing.

 SUGGESTIONS
Suggestion for fighting against mental stress during covid times

Behavioral strategies
• Work / physical activity

• Relaxation / breaks /downtime

• Avoid excessive alcohol use (effects on sleep and immunity)

• Exercise / physical / outdoor activity

• Meditation / Yoga / Deep breathing / prayer

• Keep up with all pleasurable / comforting activities (hobbies, pets, social

activities)

• When overwhelmed, take short breaks, find time - limited distractions, or

practice here -and -now exercises

Social strategies
• This is not social distancing, it is physical distancing - Only change the format of
social interaction, not the quality or frequency

• Laughing is mandatory

• Social media can be helpful, but conversations are still vital

• Share your feelings, experiences and stories with others; listen to others

• Do not judge yourself or anyone else for reactions – everyone handles fear and
dramatic change differently
 • This is a time of intense social connectedness – everyone on the planet is
experiencing the same general feelings and experiences

Mental and emotional strategies

Prevention and Intervention strategies may be necessary:

• For those with any MH history, engage with a mental health provider now. Begin
working on prevention

• If medications or psychotherapy was helpful before, consider re-starting now

• Note differences between “normal’ anxiety, sadness, fear, stress reactions and
signals for mental health relapse

• Severity

• Duration

• Interference with any normal activities

• Thoughts/ plans/ intent to harm oneself

 CONCLUSION:
COVID-19 has impacted immensely on the mental wellbeing of general
public of the world Although the rate of COVID-19 infection among young
children and adolescents is low, the stress confronted by them poses their
condition as highly vulnerable. Many cross-sectional studies have been
conducted to analyze the impact of COVID-19 and lock down on children,
youth and adults. The results of these studies show that the nature and extent
of this impact depend on several vulnerability factors such as the
developmental age, educational status, financial status, pre-existing mental
health condition, being economically underprivileged or being quarantined
due to infection /fear of infection. Studies show that young children show
more clinginess, disturbed sleep, nightmares, poor appetite, inattentiveness,
and significant separation problems and adults shows signs of stress,
depression and anxiety.

References:
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