The Double Burden of Mental Health and NCDs

The global pandemic has toppled the world with a steep rise in deaths due to COVID-19. This new world scenario not only affects the economies but also poses an additional burden on the healthcare infrastructure across countries.

While working at a breakneck pace to develop a vaccine for the novel coronavirus, medical professionals are also labouring to mitigate the impact of COVID-19 on citizens. These professionals aim to support those already affected by other health conditions, including individuals living with non-communicable diseases (NCDs) and those whose mental health is suffering as a result of the pandemic. The most prevalent NCDs are heart disease, cancer, diabetes and hypertension.

Mental health and NCDs

Already designated as one of the top 10 global health threats by the World Health Organization in 2019, NCDs are responsible for nearly 5.8 million deaths annually in India from chronic conditions such as diabetes, hypertension, heart disease, cancer and more. This translates to the chilling statistic that one in four Indians is at risk of dying from an NCD before they reach the age of 70.

In terms of mental health, the pandemic is leaving multitudes feeling overwhelmed and experiencing confusion, fear, loss, loneliness, and uncertainty. Notably, a recent survey found that 61% of Indians have reported an increased toll on their mental health as a result of the COVID-19 crisis.

As this public health crisis has brought about a colossal shift in India’s everyday focus and understanding of health – all within the initial months of the outbreak – we need to broadly explore how to mitigate the country’s health risks not only now, but in the future.

A vicious circle

Experts believe that people battling the emotional toll created by the global health crisis are susceptible to addictive behaviours, and those with underlying substance abuse disorders are at even greater risk of magnified behaviours. This, in turn, makes these individuals more vulnerable to contracting NCDs.

Ultimately, those living with NCD and mental health comorbidities are at a greater risk for more severe outcomes during COVID-19 as evidenced by reporting from the state of Gujarat, where
71% of those who died after contracting COVID-19 between March 23 and April 25 suffered from some form of a concurrent condition.

Hence, in order to develop an effective, streamlined response to address COVID-19, there needs to be a concerted focus on the prevention and control of mental health and NCDs.

What measures can be taken to address mental health and NCDs?

It is critical for the government, the medical establishment and civil society to work together to develop multi-pronged strategies to drive awareness and prevention of NCDs and mental health issues as a subset of the battle against the novel coronavirus.
As beginner steps in this direction, there needs to be:

1. A shift to remote care via telemedicine options to ensure timely and hassle-free access to healthcare services.

2. Adequately trained healthcare staff, especially those posted at quarantine sites; these providers must be able to provide basic emotional and practical support to affected people, including individuals with intellectual, cognitive or other differences.

3. Most importantly, there needs to be a shift in attitudes surrounding mental health, particularly as India’s mental healthcare capabilities are still emerging. The stigma associated with mental health conditions needs to be replaced with empathy and support, underscoring the importance of mental health in the greater scope of overall health.

Since March this year, Rotary Club of Bombay has been running a project Mental Wellbeing, in association with Wellbeing Volunteers United (WVU), to address the rising distress due to pay cuts, job losses, family issues/violence as a result of lockdown. The free helpline no. 18001210980 aims to aid those in distress in six vernacular languages across India, and also to NRIs outside India. It’s staffed by over 700 volunteers and a team of clinical psychologists.

Another key initiative by Rotary in India has been Project Positive Health (PPH): Stop NCDs, an effort focused on debunking myths around NCDs that also advocates for better health practices across rural and urban spaces. The campaign advocates ‘Ek Chammach Kum, Char Kadam Aage’, which means one spoon less of salt, oil and sugar every day and 30 minutes of exercise daily.

The road ahead

The COVID-19 pandemic has changed the way we live and work. It has also altered the way we respond to situations, and more importantly, it has brought forth the indomitable nature of the human spirit that prevails in even the most difficult conditions.

COVID-19 has also highlighted the need to address mental health and NCDs and the way in which we perceive both. And so, in the post-pandemic world, we will not just have to change the way we work, but also the very way we interact with others as we step out of our homes to socialise with the outside world. Empathy, acceptance and care—will sum up the golden rule in the new world.

This column is part of a series on #mentalhealth in the run-up to World Mental Health Day 2020

Dr Bharat Pandya is a practicing general and laparoscopic surgeon based in Mumbai, who is currently treating patients with concerns of mental health and NCDs. He is also currently serving as a Rotary International Director, and in this capacity, is leading ‘Project Positive health –Stop NCDs’ in India. 

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Regards,
The CSR Journal Team

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