The Pandemic of COVID-19 has taken a toll, all over the world in terms of an increase in mortality, infections, economic disruptions, and vaccine distribution. On the front line in controlling the infections and dedicating to save the infected people, the healthcare workers face the maximum risk of getting infected, isolation which went on for months and also took a severe hit on their mental health. Even while setting for age, sex, relationship status, and working hours, physicians are at higher prone of occupational burnout when compared to other jobs. Even during the SARS’03 outbreak, there was a higher prevalence of depression, anxiety, PTSD, and sleep disorders were noted among the health care workers. After a decade later when the Ebola outbreak occurred in West Africa and 2/3rd of medical staff in the initial stages of Middle-East Respiratory Syndrome (MERS), in both situations similar health conditions were reported.
A review across the 21 countries found a high prevalence of moderate depression, anxiety, and PTSD among health care workers, during the COVID-19 pandemic. Though we don’t need hard evidence that the frontline medical staff and workers, who are vulnerable to poor mental health; but with just historical insight and a bit of common sense. However, with a slower understanding of this, the percolation of this into the Indian Health Policy arena. Several pieces of evidence indicate the alarming number of low help-seeking behavior among the public health workers who themselves perceive to be affected with probable mental health conditions. Attributing to a wide array of factors, stigma, potential deleterious career implications, poor social support, and job-related constraints. For India, this could be worse given the shortage of workers and lack of infrastructure for mental health. With the systematic default of support for mental health support to health care workers (HCWs), the problem hasn’t been addressed this issue and most of the mental illness burden could present over the long term, even after the pandemic gets subsided. In a study to examine the prevalence and correlates among HCWs in the State of Karnataka, those who attended workshops to improve mental health conditions during pandemic completed an anonymous online questionnaire. A total of 3083 HCWs who took the survey, it was found that anxiety, depression was highest at 26.6% and 23.8% respectively. The number was significantly higher among those with clinical responsibilities in comparison to supportive responsibilities (anxiety 23.9% vs 15.5%, and depression 20% vs 14%).
In terms of economic justification, it is compelling enough to put us into action for not investing in the mental health of workers which will be a disastrous policy decision. These are more acute in the context of India, which is already plagued by shortages in human resources and a lack of infrastructure to support it. Investment returns indicate that for every dollar spent on evidence-based care for depression and anxiety the returns are up to five dollars. The returns are likely to be higher when it is directed towards HCWs, who in turn caters to public health, which creates a positive domino effect. India as a developing nation, small investments could lead to larger yields in terms of improvement in the mental health of the public.
All that needs to be done is to provide a more emphatic voice to the health care workers in matters of decision-making at all levels, not just concerning remunerations and regulations. For India, various approaches of self-care, psycho-social support, and reduction of stigma must be included in the organizational culture of the health care system through policy or legislative orders. As a developing country looking for a significant shortfall of the health of human resources over the next decade and we should not make another disaster in decision making.
