Role of Information, Education and Communication in addressing psycho-social aspects of Covid-19 – Preparation and implementation

1 Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India

2 Department of Child and Adolescent Psychiatry, National Institute of Mental Health Education (NIMHANS)

3 Deputy Editor, Journal of Mental Health Education 1Assistant Professor, Department of Mental Health Education, NIMHANS

4 Department of Clinical Psychology, National Institute of Mental Health Education (NIMHANS)

5 Department of Psychiatry, National Institute of Mental Health Education (NIMHANS)

6 Department of Nursing, National Institute of Mental Health Education (NIMHANS)

7 Centre for Disaster Management, National Institute of Mental Health Education (NIMHANS)

8 Associate Professor, Department of Mental Health Education, NIMHANS, Bangalore

9 Senior Professor of Psychiatry, Dean, Behavioral Sciences & Head, Department of Mental Health Education, NIMHANS

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* Author of Correspondence: Dr. Meena KS, Additional Professor and Head, Department of Mental Health Education, NIMHANS, Bengaluru, India

E-mail: meenaksiyer@gmail.com

A crisis as never experienced before, the Covid-19 pandemic has resulted in a major shift in how we live our lives. It has resulted in impediments in all aspect of living, and mental health complications is one of the major challenges that it has brought about. The precautionary measures such as the lockdown and social distancing also has been found to have a negative impact on the mental health of an individual.[1] In this regard, Precautionary measures and timely interventions are found to be of can great help in handling the incidence and the consequences of this pandemic.

Information, Education and Communication materials, commonly known as IEC are vital during the times of any disaster or pandemic, especially so when there is not much known about the situation among the general public, as in the case of the current novel corona virus pandemic. These materials would help in providing the right information to the public and also aids in curbing the spread of misinformation and rumours. IEC materials are most effective when it is prepared keeping in mind the preferences and interests of the target population.

There was a growing concern and uncertainty about the course and outcome of the covid-19. There was increase sense of fear, panic which could have led to an array of mental health problems across the community. With this view, The Ministry of Health and Family Welfare, Government of India has designated NIMHANS as the centre for preparation for IEC materials on COVID-19 -Psycho-social and Mental Health issues. The ministry has suggested 16 broad areas to be looked into while preparing the IEC (Table-1).Faculties from different behavioural science departments of the institute were nominated and a core committee was formed to facilitate the process. The committee members contacted the specialists in the respective areas within the institute for the content. This content were then reviewed by the core committee and necessary changes were to different IEC materials. For some topics core committee themselves created content for the same. They dedicated themselves for about two weeks to create print and mass media materials to ensure that appropriate information reaches the population. The materials included posters, videos, photographs, brochures and infomercials (Table-2). Videos were shot at the institute Mental Health Education department, and to enact the content in-house faculty and staff were used. These materials were then made available through different media platforms. An effort was taken to ensure that these materials covered all the relevant information, including the psychological and community aspects such as Stigma, Self-Care, Handling burnout among the community members and vulnerable population.

A brief overview of the topics covered are given below:

Stress Management

Videos were prepared for managing one’s stress. In addition, to stress management videos, one minute, two minute and five-minute guided videos on Yoga and Meditation were created, to soothe the mind and be more aware of the physical and mental environment. The videos were made available in English and Hindi.

Social Stigma

According to WHO, Covid-19 pandemic has resulted in the concept of social stigma where individuals and communities were targeted with stigmatizing and discriminatory practices. Left unchecked, these practices can hamper the efforts taken to curb the ill effects of the outbreak. IEC materials were prepared for addressing social stigma associated with Covid-19 in Hindi and English in the form of Posters, Brochures and Videos. The stressors that could be faced by the persons diagnosed with Covid-19, their family members and the frontline workers involved were explained in detail in the materials. Videos are also made available to assist the healthcare professionals in better taking care of themselves.

Elderly

The impact of the current outbreak has been especially devastating on the older adults of the population. In addition to high incidence and mortality rates, they were found not to have adequate access to mental health care facilities and other resources currently.[2] Given this, posters and Brochures were made covering the aspects to be kept in mind while dealing with the elderly and their mental well being.

Children and Adolescents

Posters, Videos and Brochures were prepared for disseminating information about the potential issues faced by children and adolescents and how to tackle them. Special attention was also given to preparing materials on dealing with postponement of exams and disruption of the usual routine. Considering that parents also go through stress currently, an informative video was made to address their possible concerns. A Brochure dealing with the well-being of children and adolescents during the pandemic was also prepared.

Pregnant and Postpartum Women

The Covid-19 pandemic has also created anxiety and emotional distress in pregnant and postpartum women. Concerns regarding delivery plan, inability to visit their physician due to travel restrictions and worries about the new born child were needed to be addressed, and hence, videos containing information on handling these difficulties were made available to the public.[3]

Police Professional

Brochures, Videos and Posters were made for the personnel working with the police department to promote their mental well-being considering the strenuous and overwhelming work hours that they have to put in the present scenario. Available in both Kannada and English, these resources provide information about handling stress and taking care of oneself.

Migrants

Migrant workers have been chronicled as being highly vulnerable to stress due to displacement, undernutrition, low rate of immunization coverage and various physical and mental health conditions.[4] Migration has also been found to be a leading cause of mental health issues[5] and suicide.[6] Posters where prepared for the migrant workers to address the psychosocial issues that they face and explaining the steps that they can take to ensure their safety and well-being.

Domestic Violence

The Covid-19 pandemic has also seen a rise in reports of Domestic Violence and Child Abuse. The Government has set up helplines and services specifically for looking into this and it can be availed by individuals in need (National Commission for Women – 7217735372, 181 and Childline number -1098). Resources in the form of videos are made available online that assists the individual to manage the acute crisis – such as making a safety plan and staying connected with family and friends – and receive psychosocial support.

Persons with Disability

The United Nations opines that Persons with disabilities generally have more health-care needs than others – both standard needs and needs linked to impairments – and are therefore more vulnerable to the impact of low quality or inaccessible health-care services than others. Any programme targeting the persons with disability have to attend to the specific needs of the persons with disabilities to help maintain their health, safety, dignity, and independence in the community during the current pandemic. Brochures and Video providing psychosocial support has been prepared while keeping these nuances in mind.

Substance Use

Individuals who use substances, especially in the dependent pattern would also require assistance in dealing with cravings and withdrawal during this time. Keeping this in view, brochures on quitting Tobacco and videos on addressing dependence have been prepared and circulated to the public.

Apart from the spread of these materials, Text messages mentioning the contact of the mental health care helpline was also sent to the public, for them to avail the psychosocial support services offered.

Providing the right information at the right time can be immensely helpful in dealing with a health crisis. However, due to the extent of mental health impact secondary to the pandemic, more efforts are to be made in effectively handling the outbreak, especially in countries such as ours where there is less developed mental health infrastructure. Hence, precautionary measures and community services maybe the way forward.

In conclusion, the psychological preparedness for the communities to handle disasters and pandemics is of paramount importance. The advantages of IEC materials prepared were:

  1. They were able reach to the large masses
  2. Addressed various aspects related stigma and discrimination associated with Covid-19
  3. As the ministry repeatedly broadcasting/uploading the material, the mental health aspects in the messages were reinforced.
  4. The literacy related psycho-social aspects associated Covid-19 possibly may have increased
  5. The IEC contents were brief and crisp which was easy to disseminate.

The communities need to be trained, educated and empowered in getting access to accurate and reliable information. This vast resource of materials developed for novel corona virus, COVID-19 acts as a model that can be reproduced for future pandemics.

Table -1: Broad areas suggested by the Ministry of Health and Family welfare

S. No Topics
1 Social Stigma associated with Covid – 19
2 Coping with stress during Covid -19
3 Psycho-social support to persons with disabilities during Covid-19 pandemic
4 Activities for adults during isolation-quarantine
5 Adolescents in home or hospital quarantine setting
6 Mental Health in elderly during Covid-19
7 Emotional issues after recovery from Covid-19
8 Recognizing mental health problems in your near and dear ones and dealing with it
9 Dealing with persons with mental illness: Challenges faced by persons with mental illness due to self-isolation or Covid-19 infection
10 Stress management among health care workers fighting Corona virus
11 Stress of police and other essential service providers
12 Yoga for stress reduction and well-being (Video)
13 Meditation for stress Management (Video)
14 How to manage alcohol and tobacco during self-isolation?
15 Stress from the experience of being monitored by others for the symptoms of Covid-19
16 Management of anxiety/stress while self-monitoring for symptoms of Covid-19

Table -2: IEC Development on Covid-19 And Mental Health

 

  1. POSTER/FLYER

 

Sl.No. Subject
1. Taking care of Mental Health of elderly during COVID-19
2. Taking care of Mental Health of children during COVID-19
3. Social stigma associated with COVID-19
4. Psychosocial support for migrant workers – Promoting Mental Health
5. Dealing with stress related to postponement of exams in view of COVID-19 pandemic
6. Promoting mental well-being of Police Personnel during COVID-19- Kannada and English
7. Children and adolescent well-being during COVID-19

 

  1. BROCHURE

 

Sl.No Subject
1. Social stigma associated with COVID-19-Two fold- Hindi and English
2. Psychosocial Support to Persons with Disabilities During COVID-19 Pandemic-3/4 fold
3. Mental health of police personnel during cOVID-19- Kannada and English
4. Promoting mental well being of Older adults during COVID-19- English
5. Quitting tobacco at the time of COVID-19
6. Children and adolescent well being during COVID-19
7. Children and adolescent well being during COVID-19- For parents or caregivers
  1. VIDEOS

 

Sl.No Subject
1. 1.One minute video on Yoga for stress management[English]

2. One minute video on Yoga for stress management[Hindi]

3. One minute video on Meditation for stress management[English]

4. One minute video on Meditation for stress management[Hindi]

5. Two minute guided video on Yoga for stress management Part 1[English]

6. Two minute guided video on Yoga for stress management.-Part 1 [Hindi]

7. Five minute guided video on Yoga for stress management Part 2[English]

8. Five minute guided video on Yoga for stress management.-Part 2 [Hindi]

9.Text

 

2. Social Stigma associated with COVID-19-English
3. COVID-19 kesaathjudesamajikbedhbaav [Social Stigma associated with COVID-19]- Hindi
4. Issues related to postponement of entrance exams associated with COVID-19 with text
5. How pregnant women can handle COVID-19 related anxiety
6. How postpartum women can handle COVID-19 related emotional distress
7. Handling substance dependence during COVID-19
8. Psychosocial Support to Persons with Disabilities during COVID-19 Pandemic
9. Psychosocial Support for women suffering from Domestic violence during COVID-19 Pandemic
10. Issues related to postponement of entrance exams associated with COVID-19

15 minute panel discussion

11. Promoting mental well being of Police Personnel during COVID-19
12. Handling parental stress during COVID 19
13. Helping children and adolescents handle stress during COVID-19
14 Stress management for Frontline health worker

 

  1. SMS
Sl.No Message
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2. Panicked by the Pandemic. You are not alone. Connect with us @ 080-4611 0007
3. To de-stress from distress, engage with us @ 080-4611 0007
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7. Stay home & address your physical health, call us to help you address your mental health @ 080-4611 0007
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Acknowledgement

This work was carried out under the direction of the Director and Registrar of NIMHANS. The authors acknowledge the inputs received from various mental health professionals/faculties from various departments within the institute and at the Health Ministry, Government of India. The authors also acknowledges the efforts and technical support received from all the staffs in the Department of Mental Health Education and student volunteers, Sobin George and Shreyas, in developing Videos, Brochures, SMSs and Flyers.

References

  1. Galea S, Merchant RM, Lurie N. The mental health consequences of COVID-19 and physical distancing: The need for prevention and early intervention. JAMA internal medicine. 2020 Jan 1.
  2. Yang Y, Li W, Zhang Q, Zhang L, Cheung T, Xiang YT. Mental health services for older adults in China during the COVID-19 outbreak. The Lancet Psychiatry. 2020 Apr 1;7(4):e19.
  3. Fakari FR, Simbar M. Coronavirus Pandemic and Worries during Pregnancy; a Letter to Editor. Archives of Academic Emergency Medicine. 2020;8(1).
  4. Nitika AL, Nongkynrih B, Gupta SK. Migrants to urban India: need for public health action. Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine. 2014 Apr;39(2):73.
  5. Firdaus G. Mental well-being of migrants in urban center of India: Analyzing the role of social environment. Indian journal of psychiatry. 2017 Apr;59(2):164.
  6. Anil RA, Nadkarni A. Suicide in India: a systematic review. Shanghai archives of psychiatry. 2014 Apr;26(2):69.

VIDEOS

Addressing Social Stigma Associated with COVID-19 (English)

Social stigma in the community has become an immediate social problem due to COVID-19. This video explains how one can be more helpful towards others in the community so that stigma can be reduced.

To watch: https://www.youtube.com/watch?v=1GCv8_BIWeY

Addressing Social Stigma Associated with COVID-19 (Hindi)

Social stigma is a major problem associated with COVID-19 in the community. This video in hindi attempts to educate people not to believe in rumours and follow proper guidelines to be safe

To watch: https://www.youtube.com/watch?v=ca0gl2C3SVI&t=6s

Meditation for Stress Management during COVID-19

The COVID-19 lockdown and its effects have greatly increased stress level of people. Through this video, an attempt was made to help people manage stress and anxiety through the practise of meditation

To watch in English: https://www.youtube.com/watch?v=5wr4hq-4HQk

To watch in Hindi: https://www.youtube.com/watch?v=gur9p17XBFk&t=4s

Yoga for Stress Management due to COVID-19

The pandemic has affected the people in the community to a great extent. Involving yoga in daily routine can help one stay calm and manage stress and anxiety better. This video snippet shows how to include yoga in daily routine to manage stress

To watch in English: https://www.youtube.com/watch?v=NkWbaBYabwo

To watch in Hindi: https://www.youtube.com/watch?v=3uvcqsLKnw0