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Lesson 4: Psychological Impact of Quarantine on Relationships, Education etc

Lesson 3: Psychological Impact of Quarantine on Relationships, Education; The lecture applies to relationships.

(Mrs Sarah Chukukere)

All types of relationships including

  • Romantic
  • Friendship
  • Family
  • Etc

In the era of the Covid-19 virus, stringent methods like quarantine and social distancing will make us redefine and recalibrate our relationships. Mandatory quarantine which is being used across the globe to control the spread of the virus has the potential of putting immense stress on relationships as people end up being stuck in together in a sometimes-uncomfortable situation with no options.

In this context, I am not just talking about romantic relationships, but relationships that involve a shared living situation which includes but is not limited to;

  • Married/unmarried couples living with or without children &/or siblings.
  • Friends or roommates living together.
  • Grown kids living with/or taking care of their aged parents

This new living situation may be why there has also been increased reports of domestic violence around the world. One report from the UK says that there has been a 30% increase in reports on domestic violence. Though we were built to be social and live with each other, we were not programmed to be next to each other every waking moment of the day. Consequently, there are several psychological effects that quarantine could have on an individual.

In fact after this pandemic is over people will need a lot of counselling for

  • post-traumatic stress symptoms
  • confusion
  • anger
  • avoidance behavior

So, what are the things that could put stress on relationships?

  • longer quarantine duration
  • Financial loss or no finance
  • Loss of jobs
  • infection fears
  • frustration
  • boredom
  • inadequate supplies
  • inadequate information
  • and stigma.

To mention a few

  • If there are children in a house,
  • more things will be broken,
  • they may start misbehaving for attention
  • One person may get tired of doing all the house work and lash out

STRATEGIES FOR COPING 

Maintaining a good healthy relationship during this period will take a lot of willpower, patience & positivity. However, here are some not-so-obvious tips for coping.

The Rule of 4: For every 1 bad trait, think of 4 good ones: We all have bad traits we may/or may not know about, however the quarantine may become a magnifying glass on these traits. During this time, it is advised not to dwell on the bad traits, instead think about 4 other good traits the person has. Doing this as a regular mental exercise could help you maintain a good relationship.

Nostalgia: Think about the good times and spend a few minutes every day reminiscing about precious moments. Remind yourself of memorable events in the past or why you fell in love or have a deep bond. This can help you see how far you have come and, help you look forward towards a brighter future.

Pinch of salt: Instead of striving for a better partner by commenting on every single thing or mistakes , concentrate on avoiding or overlooking elementary mistakes or “take it with a pinch of salt” as they say. Know that you are also far from perfect and probably make your own mistakes too.

Fight to control your own negative reactions, this period is a great time for emotional learning to increase our emotional intelligence. Negative reactions to situations on make them worse. If the affront is one you can’t endure, then say something, but do it calmly without retaliating, because the negativity effect can quickly turn a small disagreement into a raging battle.

Take some time out to play couples games. Most couples don’t realize how much they don’t know about each other rather, they usually assume certain things. For example, a couples Q&A session could reveal that a boyfriend actually does not prefer to sleep on the left side of the bed, but does so to make it easier for his girlfriend to sleep next to the window because she gets really hot at night.

Here is a fun game I like to give couples I counsel to play.

  • What’s your partner’s least favorite body part?
  • When your partner was a child, what did they want to be when they grew up?
  • Name a country your partner would love to visit.
  • Did your partner have a nickname as a child? What was it? Bonus point: Did they like the nickname? Why?
  • Which of your partner’s aunts or uncles are they closest to? [Skip if not applicable]
  • What disappointment or rejection from your partner’s past still stings?
  • Which of your partner’s achievements are they most proud of?
  • What is your partner’s least favorite housework task?
  • Name two of your partner’s grandparents. Bonus point: Can you name all their grandparents?
  • Outside of their career, what’s something your partner considers themselves naturally talented at?
  • What is your partner’s favorite smell?
  • What is your partner’s favorite flavor of ice cream?
  • What is a personality trait your partner dislikes about themselves, and that they share with a parent?
  • Of all the ways there are to die, which does your partner fear the most?
  • What type of music does your partner secretly like? What’s a musical taste they have that most people wouldn’t know they enjoy?
  • What does your partner typically look forward to most about the weekend?
  • Who is someone your partner considers to be a mentor, or who has been a strong positive influence on their professional development?
  • How did your partner spend their summers as a child?
  • What is your partner’s favorite and least favorite aspects of their work?
  • Does your partner consider themselves more like their mother or their father in terms of personality? In what way?
  • What purchase is your partner currently considering?
  • What’s on their wish list?
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Covid19 Uncategorized

Lesson 3: Mental Health Psychosocial Support.

Lesson 3: Mental Health Psychosocial Support.

Mr Zion Ameh Abba

Introduction

Let’s understand that the composite term ‘Mental Health and Psychosocial Support’ (MHPSS) refers to any type of local or outside support that aims to protect or promote psychosocial well-being or prevent or treat mental disorders. Among humanitarian agencies the term is widely used and serves as a unifying concept that can be used by professionals in various sectors. MHPSS interventions can be implemented in programs for health & nutrition, protection (community-based protection, child protection and SGBV) or education. The term ‘MHPSS problems may cover a wide range of issues including social problems, emotional distress, common mental disorders (such as depression and post-traumatic stress disorder), severe mental disorders (such as psychosis), alcohol and substance abuse, and intellectual or developmental disabilities.

Protection objectives we must keep at heart:

  1. To ensure that emergency responses are safe, dignified, participatory, community owned, and socially and culturally acceptable.
  2. To maintain the protection and well-being of persons of concern by strengthening community and family support.
  3. To ensure that persons distressed by mental health and psychosocial problems have access to appropriate care.
  4. To ensure that persons suffering from moderate or severe mental disorders have access to essential mental health services and to social care.
  5. MHPSS core principles to work with regardless of the sector you are deploying mental health and psychosocial support include;

Principle 1: Ensure human rights and equity Humanitarian actors should promote the human rights of all affected persons and protect individuals and groups who are at heightened risk of human rights violations and at the same time ensure participation.                                                                                                                                               

Principle 2: Do no harm Humanitarian aid is an important means of helping people affected by emergencies, but aid can also cause unintentional harm. Work on mental health and psychosocial support has the potential to cause harm because it deals with highly sensitive issues. In addition, it lacks an extensive evidence base that is available for some other disciplines. Humanitarian actors may reduce the risk of harm in various ways, such as: o Participating in coordination groups to learn from others and to minimize duplication and gaps in response o Designing interventions on the basis of valid information o Committing to evaluation, openness to scrutiny and external review o Developing cultural sensitivity and competence in the areas in which they intervene/work; o Staying updated on the evidence base regarding effective practices; and o Developing an understanding of, and consistently reflecting on, universal human rights, power relations between outsiders and emergency-affected people, and the value of participatory approaches. (Anderson, 1999).

Principle 3: Build on available resources and capacities All affected groups have assets or resources that support mental health and psychosocial well-being. A key principle – even in the early stages of an emergency – is building local capacities, supporting self-help and strengthening the resources already present.

Principle 4: Use Integrated support systems Activities and programming should be integrated as far as possible. The proliferation of stand-alone services, such as those dealing only with rape survivors or only with people with a specific diagnosis, such as PTSD, can create a highly fragmented care system.

Principle 5: Provide multilayered support in emergencies, people are affected in different ways and require different kinds of supports. A key to organizing mental health and psychosocial support is to develop a layered system of complementary supports that meets the needs of different groups. All layers are important and should ideally be implemented concurrently, such as in the IASC pyramid: o Basic services and security.

Principle 6: Anticipation, planning, preparation and advice the services, including the psychosocial and mental health services that are required following disasters and major incidents, are much more likely to work effectively if the need for them has been anticipated and defined. This requires understanding of the dynamic shifts that occur with the passage of time and of the clarity about how these services are to collaborate with other services that offer humanitarian aid and responses to people’s welfare and psychosocial needs after disasters and major incidents. Knowledge about how people may react psychosocially to disasters and major incidents is likely to assist responsible people in making effective decisions prior to events and when they are making decisions while under strain during events.

Principle 7: Needs-oriented planning for families and communities All aspects of psychosocial and mental health care should only be provided with full consideration of people’s wider social environments, the cultures within which they live, and, particularly, their families and the communities in which they live, work and move. The service responses provided from within societies and, in the case of disasters and major incidents that cause greater devastation, the actions taken by external countries and organizations should be proportionate to the needs of the people who have been affected. This requires a strategic stepped model of care to underpin a variety of levels of planning and preparation before events and the multi-layered support that is provided afterwards.

Principle 8: Developing, sustaining and restoring psychosocial resilience This principle means that actions taken, including those that determine how services respond to the needs of communities and people regarding their psychosocial and mental health care, should actively maximize participation of local, affected populations whatever the degree of devastation in each area. Restoring, first, the functioning, and second, the social fabric of communities is extremely important in how societies, communities and services respond effectively to the psychosocial and mental health effects of disasters and major incidents. If communities are to receive comprehensive responses to their psychosocial and mental health needs after disasters and major incidents, the following types of service are required: (a) humanitarian aid; (b) welfare services; (c) services that are able to assist people and communities to develop and sustain their resilience; and (d) timely and responsive mental health services.

Principle 9: Integrating psychosocial and mental healthcare responses into policy and into humanitarian aid, welfare, social care and health care agencies’ work Achieving comprehensive psychosocial care and mental health services for moderate and large-scale emergencies requires that lessons learned through research and experience are translated into integrated, ethical policy and plans at four levels. They are: o governance policies o strategic policies for service design o service delivery policies o policies for good clinical practice. Governance policies relate to how countries, regions and counties are governed. Governance policies require the responsible authorities to develop strategic policies. Strategy should be developed by bringing together evidence from research, past experience, knowledge of the nature of areas of the country for which they are responsible and of their populations, and the profile of risks, to design services. Policies for good clinical practice concern how clinical staff take account of the needs and preferences of patients, deploy their clinical skills, and work with patients to agree how guidelines, care pathways and protocols are interpreted in individual cases. Policy at each of the four levels should be informed by culture and values as well as by evidence and experience gleaned from practice.

Principle 10: All planners, incident commanders, practitioners, volunteers, researchers and evaluators should agree to work to a common set of standards In certain circumstances, especially those in which there is widespread devastation, high standards may not be achievable until there has been restoration of basic community functioning and resources, including clean water and food supplies, shelter and protection, communications, and healthcare. Situations of this kind should be anticipated and covered by planning. Planning should consider the minimum standards required in a range of different circumstances. The standards adopted have substantial implications for training, research, evaluation and information gathering because all of these capabilities should be core parts of all disaster and major incident response plans. This means that the requirement for them is anticipated and standards for research, evaluation and information-gathering should be developed and planned before disasters occur. Research and evaluation should identify the factors that contribute to either the success or failure of particular types of service, their organization and delivery, and particular interventions. Research and evaluation should include follow-up studies that are designed to identify long-term effects that may be associated with psychosocial intervention programs.

So, this are the core principles of MHPSS however, other aspect like the ethical, cultural aspect are key including the ongoing MHPSS response,

  • Immediate MHPSS response,
  • MHPSS actions before interventions begin,
  • MHPSS recommendation for preparedness,
  • Social media preparedness phase etc.

Thanks for joining us

Check the attached documents for MHPSS intervention Pyramid, The MHPSS program including the myths and facts about MHPSS

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Covid19 Uncategorized

Lesson 2: Core Mental Health Issues.

Lesson 2; Core Mental Health Issues.

Dr. Garba

Introduction

Mental health is recently enjoying increased public awareness especially due to cluster of events hitting the newsstands and the social media. Frequently reported suicides especially by use of sniper or jumping off the bridge on 3rd mainland bridge are still fresh in our memories. Similarly, the outcry over the use of psychoactive substances especially codeine became quite worrisome. Besides the above sensational scenarios, a lot mental health issues are quite common and very frequently missed.

The stigma associated with mental health problems is also worthy of consideration as it determines to a large extent whether persons will seek help promptly or not.

Overview

Mental health encompasses all areas of psychological well-being. It involves the maintenance of a stable emotion, social, psychological and mood states while facing daily living challenges. This entails an ability to cope with the challenges of life without breaking down. One is able to be happy when the need arises, show sadness appropriately as well as other emotional tones like anger, jealousy, excitement, disappointment at the appropriate times and for the appropriate duration of time.

It also important to note that mental well-being is incorporated by the WHO in the comprehensive definition of what constitutes HEALTH. So, there’s no good health without MENTAL HEALTH

Misconceptions about mental illness

Let’s briefly take a look at common Misconceptions about mental illness

A lot of misconceptions exist around mental health. Many believe that they are due to spiritual or demonic afflictions. Many also believe they are due to individual weaknesses or deficiencies in personality and character. Some others often think that they are a result of drug abuse only. However, the truth is far from any of the above beliefs.

Mainly, there are multiple factors that can lead to the development of mental health problems. These are currently summarized as biological, psychological and social factors or simply BIOPSYCHOSOCIAL causes. These factors are also to be considered in therapy for mental health illnesses.

Biological factors include those that are constitutional or due to biological influences

These biological factors may be inherited predispositions like have close relatives like parents or siblings have a mental health challenge which will also imply that one is having the genes. This does not however mean that everyone carrying the genetic predisposition will develop an illness as environmental factors also play important roles

Psychological factors include those factors like personality type, the kind of love and care persons experience while growing up, and psychological impact of other experiences. Example may be witnessing a horrifying event like ghastly road accidents, being the victim or witness of rape, torture or murder.

Social factors can include poverty, poor living conditions, being an immigrant or a refugee, or even the solitude from the current COVID 19 lockdown

Let’s take a look at common mental health issues of note next

Common mental health issues worthy of note include but are not limited to the ones listed below

  • Anxiety
  • Mood disorders
  • Psychotic disorders
  • Substance use disorders
  • Organic mental disorders
  • Eating disorders
  • Personality disorders

Anxiety disorders- these are by far the commonest group of mental health challenges that are encountered in general medical practice and are usually missed by practitioners. This is because many of the symptoms and vague and non-specific to any particular organ system of the body.

Mood disorders are characterized by changes in mood states of which the commonest is Depression. Actually, mood problems can encompass any condition from depression where the person experiences persistent low mood/feelings of sadness, low energy, and lack of interest in pleasurable activities on the one hand, and MANIA which is almost the exact opposite of depression as it is characterized by elation, excessive energy, feelings of grandiosity and beliefs and many more

There are many shades of mood problems in between the 2 described above.

Psychotic disorders include those in which persons experience distortion in thinking, perceptions, experiences, beliefs, and where hallucinations may be present. Here, the individuals are not in touch with reality and they are often said to have lost their EGO BOUNDARIES as they often cannot tell the difference between personal experience and what is perceived externally from the environment.

Substance use disorders are all the various mental health issues that can arise from the use of psychoactive substances. These can range from Drug misuse or harmful use to Dependence or Addiction as the case may be.

Organic mental disorders arise from mainly other health conditions but manifesting with mental disorder symptoms. These includes Seizure disorders (convulsions), degenerative brain diseases like Alzheimer’s and other forms of dementia, head injuries and their sequelae, effects of uncontrolled diabetes, hypertension, kidney failure, liver failure, severe anemia and many others

Eating disorders anorexia and bulimia, pica and other abnormalities associated with eating

Personally disorders are generally a pattern of behavior and thinking that is often unusual and cause problems with how the person relates to himself and other members of the society

There are other disorders that are specific to children, or that are gender specific

Thank you all for your time

It was a nice time during this session, from the above explanation by Doc Garba it seems all of us a vulnerable to different types of mental challenges and that makes it imperative for proper self care so we dont slide into serious mental health challenges.

We can practice below these Ten Things  for Your Mental Health, Try these tips to keep your balance, or re-balance yourself.

1. Value yourself:

Treat yourself with kindness and respect, and avoid self-criticism. Make time for your hobbies and favorite projects, or broaden your horizons. Do a daily crossword puzzle, plant a garden, take dance lessons, learn to play an instrument or become fluent in another language.

2. Take care of your body:

  • Taking care of yourself physically can improve your mental health. Be sure to:
  • Eat nutritious meals
  • Avoid cigarettes
  • Drink plenty of water
  • Exercise, which helps decrease depression and anxiety and improve moods
  • Get enough sleep. Researchers believe that lack of sleep contributes to a high rate of depression in college students. 

3. Surround yourself with good people: People with strong family or social connections are generally healthier than those who lack a support network. Make plans with supportive family members and friends, or seek out activities where you can meet new people, such as a club, class or support group.

4. Give yourself: Volunteer your time and energy to help someone else. You’ll feel good about doing something tangible to help someone in need — and it’s a great way to meet new people.

5. Learn how to deal with stress: Like it or not, stress is a part of life. Practice good coping skills: Try One-Minute Stress Strategies, do Tai Chi, exercise, take a nature walk, play with your pet or try journal writing as a stress reducer. Also, remember to smile and see the humor in life. Research shows that laughter can boost your immune system, ease pain, relax your body and reduce stress.

6. Quiet your mind: Try meditating, Mindfulness and/or prayer. Relaxation exercises and prayer can improve your state of mind and outlook on life. In fact, research shows that meditation may help you feel calm and enhance the effects of therapy.

7. Set realistic goals: Decide what you want to achieve academically, professionally and personally, and write down the steps you need to realize your goals. Aim high, but be realistic and don’t over-schedule. You’ll enjoy a tremendous sense of accomplishment and self-worth as you progress toward your goal. 

8. Break up the monotony: Although our routines make us more efficient and enhance our feelings of security and safety, a little change of pace can perk up a tedious schedule. Alter your jogging route, plan a road-trip, take a walk in a different park, hang some new pictures or try a new restaurant.

9. Avoid alcohol and other drugs: Keep alcohol use to a minimum and avoid other drugs. Sometimes people use alcohol and other drugs to “self-medicate” but in reality, alcohol and other drugs only aggravate problems.

10. Get help when you need it: Seeking help is a sign of strength — not a weakness. And it is important to remember that treatment is effective. People who get appropriate care can recover from mental illness and addiction and lead full, rewarding lives.

But, I’ve just tried to scratch the surface of what is MENTAL HEALTH but I hope the questions arising will enable me shed more as required.

THANK YOU.

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Covid19 Uncategorized

Lesson 1: MENTAL HEALTH SUPPORT TRAINING

DAY 1: MENTAL HEALTH SUPPORT TRAINING; Introduction to Covid-19 and its impact on Mental Health

Welcome to today’s training, How to offer Mental Health Psychosocial Support in the face of COVID-19 and stay without depression. Trainer: Mr. Ogoenyi Isaac Agbo, a Clinical Psychologist.

In any epidemic, it is common for individuals to feel stressed and worried.

Common responses of people affected (both directly and indirectly) might include:

  • Fear of falling ill and dying.
  • Avoiding approaching health facilities due to fear of becoming infected while in care.
  • Fear of losing livelihoods, not being able to work during isolation, and of being dismissed from work.
  • Fear of being socially excluded/placed in quarantine because of being associated with the disease (e.g. stimatization against persons who are from, or perceived to be from, affected areas)
  • Feeling powerless in protecting loved ones and fear of losing loved ones because of the virus
  • Fear of being separated from loved ones and caregivers due to quarantine regime.
  • Refusal to care for unaccompanied or separated minors, people with disabilities or the elderly due to fear of infection, because parents or caregivers have been taken into quarantine.
  • Feelings of helplessness, boredom, loneliness and depression due to being isolated
  • Fear of reliving the experience of a previous epidemic.

Emergencies are always stressful, but specific stressors particular to COVID-19 outbreak affect the population. Stressors include:

  • Risk of being infected and infecting others, especially if the transmission mode of COVID-19 is not 100% clear
  • Common symptoms of other health problems (e.g. a fever) can be mistaken for COVID-19 and lead to fear of being infected.
  • Caregivers may feel increasingly worried for their children being at home alone (due to school closures) without appropriate care and support.
  • Risk deterioration of physical and mental health of vulnerable individuals, for example older adults (Intervention 1) and people with disabilities (Intervention 2), if caregivers are placed in quarantine if other care and support is not in place. Furthermore, frontline workers (including nurses, doctors, ambulance drivers, case identifiers, and others) may experience additional stressors during the COVID-19 outbreak:

Stigmatization towards those working with COVID-19 patients and their remains Strict bio-security measures:

– Physical strain of protective equipment

– Physical isolation making it difficult to provide comfort to someone who is sick or in distress

– Constant awareness and vigilance

– Strict procedures to follow preventing spontaneity and autonomy

– Higher demands in the work setting, including long work hours, increased patient numbers and keeping up-to-date with best practices as information about COVID-19 develops

– Reduced capacity to use social support due to intense work schedules and stigma within the community towards frontline workers

– Insufficient personal or energy capacity to implement basic self-care. Insufficient information about the long-term exposure to individuals infected by COVID-19

– Fear that frontline workers will pass COVID-19 onto their friends and family as a result of their work. The constant fear, worry and stressors in the population during the COVID-19 outbreak can lead to long-term consequences within communities and families:

– Deterioration of social networks, local dynamics and economies

– Stigma towards surviving patients resulting in rejection by communities

– Possible anger and aggression against government and frontline workers.

– Possible mistrust of information provided by government and other authorities.

– People with developing or existing mental health and substance use disorders experiencing relapses and other negative outcomes because they are avoiding health facilities or unable to access their care providers. Some of these fears and reactions spring from realistic dangers, but many reactions and behaviors are also borne out of lack of knowledge, rumors and misinformation.

Common rumors regarding COVID-19 include:

  • The virus only attacks old people and spares young people and children.
  • The virus can be transmitted through pets and people should abandon their pets.
  • The use of mouthwash, antibiotics, cigarettes, and liquor with high alcohol can kill COVID-19.
  • The disease is premeditated and COVID-19 is a bioweapon designed to target a specific population.
  • Food items are contaminated and will spread the virus.
  • Only members of specific cultural or ethnic groups can spread the virus.

Social stigma and discrimination can be associated with COVID-19, including towards persons who have been infected, their family members and health care and other frontline workers. Steps must be taken to address stigma and discrimination at all phases of the COVID-19 emergency response. Care should be taken to promote the integration of people who have been affected by COVID-19 without over-targeting. On a more positive note, some people may have positive experiences, such as pride about finding ways of coping and resilience. Faced with disaster, community members often show great altruism and cooperation, and people may experience great satisfaction from helping others.

 Examples of MHPSS community activities during a COVID-19 outbreak might include:

  • Maintaining social contact with people who might be isolated using phone calls or text messages.
  • Sharing key factual messages within the community, especially with individuals who don’t use social media.
  • Providing care and support to people who have been separated from their families and caregiver. Some of these fears and reactions spring from realistic dangers, but many reactions and behaviors are also borne out of lack of knowledge, rumors and misinformation.

 ACTIVITIES THAT WILL SUPPORT ADULTS’ WELLBEING DURING HOME ISOLATION/QUARANTINE

  • Physical exercise (e.g. yoga, tai chi, stretching)
  • Cognitive exercises
  • Relaxation exercises (e.g. breathing, meditation, mindfulness)
  • Reading books and magazines.
  • Reduce the time spent looking at fearful images on TV.
  • Reduce time listening to rumours.
  • Search information from reliable sources.
  • Reduce time looking for information (1-2 times per day, rather than every hour).

The messages below focus on promoting mental health and wellbeing in communities affected by COVID-19. MESSAGES FOR THE GENERAL PUBLIC FOR DEALING WITH STRESS DURING THE COVID-19 OUTBREAK:

  • It is normal to feel sad, distressed, worried, confused, scared or angry during a crisis.
  • Talk to people you trust. Contact your friends and family.
  • If you must stay at home, maintain a healthy lifestyle (including a proper diet, sleep, exercise and social contact with loved ones at home). Keep in touch with family and friends through email, phone calls and making use of social media platforms.
  • Don’t use tobacco, alcohol or other drugs to cope with your emotions.
  • If you feel overwhelmed, talk to a health worker, social worker, similar professional, or another trusted person in your community (e.g., religious leader or community elder).
  • Have a plan where to go and seek help for physical and mental health and psychosocial needs, if required.
  • Get the facts about your risk and how to take precautions. Use credible sources to get information, such as WHO website or, a local or NCDC.
  • Decrease the time you and your family spend watching or listening to upsetting media coverage.
  • Draw on skills that you have used in the past during difficult times to manage your emotions during this outbreak.
  • Be optimistic and hopeful.
  • Spiritual connection to feel supernaturally protected.