Trying to calm nerves 24×7, this team needs nerves of steel
“We want to go out and help people but we can’t. The only option is to listen to the problems and solve through tele-psychiatry intervention.”
NEW DELHI: “Depending on the way Covid-19 behaves, the number as well as nature of the calls also change. On April 13 and May 1, when extensions of the lockdown were announced, we received about 6,000 calls.” Dr Sanjeev Kumar M, who is part of the helpline launched by the National Institute of Mental Health and Neurosciences (NIMHANS) to tackle mental health and psychosocial issues related to the Covid-19 lockdown, can sum up his challenging new assignment easily. But what he cannot do is spell out the real challenge of keeping those who are under different types of stress because of the unprecedented global lockdown from cross the threshold.
Life has never been as hectic and frenetic in Sanjeev Kumar’s 10-year-old career as an assistant professor at NIMHANS in Bengaluru, which launched its national helpline (8046110007) on March 30 to provide counselling on mental health and psychosocial issues related to the pandemic and lockdown. The ongoing situation at the NIMHANS control room, from where the helpline functions with 10 young mental health professionals, is best summarised by the 42-year-old himself: “24×7 we have Covid-19 on our minds because as the number of cases goes up there is a spike in our calls also.”
Kumar’s gruelling schedule starts at 6 am and stretches on till 10 pm. The first session is usually counselling of police personnel and health workers. “Our life has been confined to this control room. We want to go out and help people but we can’t. The only option is to listen to the problems and solve through tele-psychiatry intervention,” says Kumar, adding that this is challenging too since the callers are not physically present. “Anxiety, uncertainty, insomnia, loneliness, depression, suicidal thoughts and panic attacks have been the commonest reaction to the pandemic,” he elaborates.
Besides tending to mental health patients and those with substance withdrawal symptoms, the helpline also receives calls from stranded migrants demanding food and those facing domestic violence. The maximum number of calls have been received from the Hindi belt states of Uttar Pradesh, Delhi, Bihar, Madhya Pradesh and Rajasthan.
Till May 20, the mental health helpline has received more than 2.60 lakh calls related to 90,000 cases, says Dr K Shekhar, head of Centre for Disaster Management (psychological support) and registrar of NIMHANS. Shekhar, who heads the team, says the helpline runs on two levels. “The first responders are PhD scholars and junior psychologists. If we sense a caller with a threshold or requiring further help, we have a second line of senior professors,” he said.
Dr Shekhar feels what has exacerbated matters is the flurry of fake news and rumours doing the rounds on social media and WhatsApp. “Ninety per cent of people are facing fear and anxiety, more because of unscientific and fake information on social media,” he reasons.
Besides facing hundreds of anxious callers, Dr Kumar has to deal with the fears of his family too, who stay 100 km away in Mysuru. “It’s like we ourselves are in a form of isolation. Imagine not knowing when I can see my aged parents next. They are worried about me spending time at the hospital the whole day and want me to take leave and come home,” Dr Kumar says.
The lockdown and isolation have brought its own set of challenges for people with pre-existing mental health issues. Kumar recalls one such conversation with a teenager suffering from anxiety. Things came to such a point that he was not able to do daily activities, could not sleep and became irritated with family members.
“The situation was going out of control. I had four sessions with him and taught how to manage his anxiety and develop coping skills. I asked him to be socially connected. After the fourth session, things started looking up,” Kumar said.
However, Kumar’s toughest test was dealing with a 40-year-old person who used to run a small mess that delivered food to college students and employees of a private organisation. The business used to earn him Rs 8000 per month, barely enough to feed his two children and wife. However, with business shut due to the lockdown, his savings dried up, leaving him dependent on government schemes. Adding to his stress was daily threats and calls from those he had borrowed money from.
“It was a very sensitive case. The person said he now feels as if it would be better to die. As he was more worried about his financial burden and managing the family, we instilled hope by reassuring him that once his area becomes a green zone, he can resume running his mess and can even avail the PDS supply. Also, we reached out to an NGO to help him out,” Kumar says of the “emotionally draining” case.
However, dealing with such high-octane situations for hours at a stretch comes with its own pitfalls, leaving even mental health professionals exhausted and facing burnouts. While Dr Kumar knows the battle has just begun, the pressure peaks when there are over 50 calls to attend an hour. “We have formed a WhatsApp group where we share our difficulties and list our hourly number of calls. Whenever anyone complains of fatigue, he/she is replaced immediately and shift timings are cut short.”
Being the head of the team, Dr K Shekhar also has to manage the toll this process takes on mental health professionals and two of them even had to be pulled out from the team due to fatigue. “We have a debriefing session for every frontline professional every other day and talk to them about the good things they have done for the day. We also give them a day off when the burden is less,” Dr Shekhar explains.
To address the evolving issue, NIMHANS has roped in 50 mental health institutes across the country like the Lokopriya Gopinath Bordoloi Regional Institute of Mental Health in Tezpur, Assam and Central Institute of Psychiatry, Ranchi, among others.
NIMHANS director Dr BN Gangadhar says about 250 other mental professionals across the country have been connected to the institute’s interactive voice response (IVR) system and the helpline has been made available in 13 different languages from this week. “To lessen the burden on our doctors manning the helpline, we have started a separate helpline for our registered patients. Besides, we are conducting online live yoga sessions two times a day for patients to improve resilience and anxiety,” Dr Gangadhar says.