COVID-19 and mental health in informal settlements: How bad is it and what can be done?

Growing attention is being given to the potential implication of the COVID-19 pandemic for people’s mental health and well-being. The purpose of this panel discussion is to bring together mental health experts living and working in informal settlements to discuss mental health in the time of the COVID-19 pandemic and to provide recommendation for managing and mitigating mental health challenges in these communities.

Prior to the pandemic, rates of depression, anxiety, psychological distress, substance abuse, and suicidality—all conditions that are likely being exacerbated by the challenges of the COVID-19 pandemic—were already higher in informal settlements than in other communities. This pandemic may exacerbate or create new mental health challenges for residents in informal settlements.

The purpose of this panel discussion is to bring together mental health experts living and working in informal settlements to discuss mental health in the time of the COVID-19 pandemic and to provide recommendations for managing and mitigating mental health challenges in these communities.

Program Moderator:

Prof. Yamile Martí – Professor at the School of Social Work at Columbia University

Panelists:

Dr. Julia Kagunda – Founder and Director of Elim Trust in Kenya

Milkah Gakuru – Community Mobilizer and Local Human Rights Activist in Kenya

Vanessa de Souza – Psychologist at Clínica da Família Maria do Socorro Silva e Souza in Rio de Janeiro

Flávia Pitella – Psychologist at Terapia para Todos in Rio de Janeiro

Webinar Highlights:

Prof. Yamile Martí – Mental health is a global matter that affects us all in very different ways based on culture, environment, contact, social, and political context. But we that it has been exacerbated by the global pandemic that we’re suffering. (Time frame from minute 02:34-02:48)

Dr. Julia Kagunda – As we think about COVID-19 and we think about African-specific informal settlements, a number of issues come to play, starting with the fact that even before COVID-19 mental health is one those to really have been stigmatized. We are living in a context where especially in their own informal sectors that mental health is not understood. (Time frame from minute 05:28-05:52)

Dr. Julia Kagunda – With COVID-19, which comes with lockdown to have to stay at home especially in the informal sectors where the people mainly depend on casual jobs and all that. Doubt that it means they have no form of source of income. Because of that, we have seen that there very many challenges, like violence has gotten up and depression has gotten up. This is signified by a number of things like suicide rate that has gotten up. (Time frame from minute 06:53-07:25)

Dr. Julia Kagunda – Because people are caught up in this setup where there are so many issues, mental health is least prioritized. Because it’s least prioritized, people are not even seeking services, and even if they are to seek for services, those services are not there with very few psychologists and with very few mental health service providers. (Time frame from minute 07:49-08:16)

Milkah Gakuru – The youth crime has been rampant and is affecting their community. Among the children and their school going, teen ages has been so challenging to cope up with the situation as no one was prepared mentally about their situation. This has created our school children in the informal settlement to engage in behavior such as drug abuse and sexual practices, alongside that their informal are parents are juggling in struggling to aid them, put food on the table, or look after their children. (Time frame from minute 09:46-10:50)

Flávia Pitella – About Brazil, I’m going to start talking about numbers because I think this is something in particular that Brazil is achieving something that is extraordinarily dangerous, and the government is doing nothing about it. I think with numbers, maybe we can work a little bit more because mental health still goes on but ‘favelas’ in Brazil don’t have so much freedom and access to mental health. (Time frame from minute 13:28-14:01)

Flávia Pitella – Although we have in our Constitution of Brazil that says that all Brazilians have the right to have health in general (physical, biological and mental health), we don’t have it practically. (Time frame from minute 15:54-16:27)

Flávia Pitella – When people think about favelas, they think about all the thieves and smugglers and stuff like that and that’s not the real stuff. The reality is that our population who live in the favelas are the ones that need the most, they are the ones that spend the most amount of money inside our state, and they should have more attention to their health in general. (Time frame from minute 17:10-17:44)

Flávia Pitella – In favelas, we have CAPSes. CAPSes is like these little clinics that have the psychiatrics, psychologists, and all kinds of areas to have the favelas. Inside, one CAP, we only have one psychologist for all the community. This means that these people nowadays in times of COVID-19 are not having mental health taking cared. (Time frame from minute 19:23-19:57)

Milkah Gakuru – Poverty has increased during this COVID-19 season. There was a woman who was expecting and she had to give birth from home. The lady lost her job, so did the husband, and so they had no any other option of getting to the hospital and better care. (Time frame from minute 25:02-25:34)

Dr. Julia Kagunda – The support system in Kenya in informal sectors, people tend to be very communal where they come together during the crisis and they work together. But because of social distancing that comes with it, you find that the support system that is there in the community is no longer there. In terms of a crisis, you are a neighbor, you are in charged, and you are women in groups which we call them Tamas. In terms of loss and grief, it becomes even double tragedy because for one, you have lost a loved one after is sick but then you have no support system. Because of that, we are seeing the level of depression going very high and panic attacks. (Time frame from minute 29:34-30:35)

Milkah Gakuru – There’s basically no debriefing before they go into this scenario. No person comes in and no specialization that addresses these kinds of issues for first responders in this COVID-19 issue. But they work amongst themselves. So you talk to your colleague or someone else who does the same kind of work that you do. (Time frame from minute 39:06-39:42)

Flávia Pitella – Paradizoo is one favela in São Paulo that they did inside the favela something that is very important and they did for themselves because they do not have ambulances. What they did is that for each part of the favela, they would have a chief that was looking for everyone in that space. As they don’t have ambulances, they were looking for to buy one. (Time frame from minute 41:11-41:53)

Dr. Julia Kagunda – One of the organizations I’m affiliated with, one of the things we do is to support community structures like pastors, religious leaders and all that and to equip to them so that we are able to go an provide mental services within our communities and also provide psychosocial support to them. But again, this thing is very tricky because of the social distancing as you can do online. But there is the challenge of finances that are required in order for you to buy bundles. (Time frame from minute 45:01-45:33)