For over a month now, COVID-19 has created an unprecedented crisis for health systems across the globe. While we’ve been bombarded with images of intensive care units, primary care clinics and emergency rooms, the pandemic has reached its tendrils into mental healthcare, too. As the uncertainty of the pandemic’s global trajectory continues, mental health issues like anxiety and depression have markedly increased for many—especially health workers and those they care for.
Mental Healthcare Goes Virtual
In the Dominican Republic, the Mental Health Project, run by Society for Family Health (SFH)—PSI’s local network member—have seen direct messages to its “Miente Bien” social media profiles increase from by 25%, and the amount of inquiries for mental health counseling through these channels has also increased. Client requests have focused on anxiety and stress management due to self-isolation and uncertainty around the pandemic.
In the Dominican Republic, up to 40% of the population needs mental healthcare, but only 1% of the national healthcare budget goes to mental health services. Widespread misconceptions about the nature and cause of mental health conditions compound with stigma and discrimination to prevent people from accessing the services they need.
These mental health realities hit close to home for Lindsay Abrams, who funds the project as a member of Maverick Collective. The collective is an initiative of PSI that brings together strategic philanthropists and informed advocates not only to fund projects that inspire them, but also to build and participate in them first-hand. Lindsay’s dedication to improving access for and knowledge of mental health has deep roots—her family’s foundation was created in honor of her father, Bruce Abrams, who committed suicide in 1999.
In 2019, Lindsay worked with PSI’s experts and teams on the ground to develop and build the framework for the Mental Health Project, which conducts its activities digitally, in communities and at clinics. A first-of-its-kind project for SFH and PSI, the project partnered with the Dominican Ministry of Health to train health workers on providing mental health services in a primary care setting.
“Each individual that went through the training program was grateful for the opportunity to gain new skills,” Lindsay recalls from one of her recent visits to the program. “They exuded pride in that they are now able to use these skills to help patients recognize when they are experiencing mental health issues and direct them to the essential services that they need and deserve.”
A special emphasis was placed on providing digital healthcare—one-third of all suicides in the Dominican Republic occur among young people ages 15 to 29. As a member of this age group herself, it was no secret to Lindsay that social media and other digital communications are an essential way to reach millennials. By the end of last year, 658,211 people were reached through social media awareness campaigns for awareness around mental health issues in the country.
Ready for the Challenge
On March 17, the Dominican Republic began implementing social distancing measures to curb the spread of the virus. Although social interventions for mental health became more challenging than ever, SFH developed a plan to rise to the occasion. The Mental Health Project began fielding more requests for mental healthcare through social media (specifically Facebook and Instagram), and also provided the same emotional support and counseling on WhatsApp. On all three platforms, these services were provided free of cost.
The Mental Health Project also follows up with current clients by phone to ensure continuation of care and provide resources to manage crisis situations. In addition, the project uses those connection points to provide information on COVID-19 prevention, symptoms and access to care. The majority of their clients live in low-income communities and because of pre-existing conditions and closer living quarters are more at-risk of becoming infected.
Health Providers Need Mental Healthcare, Too
During its first phase, the Mental Health Project saw that those providing health services needed these services just as much as their clients. As part of its COVID-19 response, the project is preparing information and education materials on mental/emotional care for health providers in primary care centers that are on the frontlines of responding to the pandemic. The team is also providing tools and resources for mental health providers to monitor their patients virtually.
“There is so much uncertainty as it relates to when and if our society will return to life as it was before COVID-19,” Lindsay says of her own experience with the coronavirus pandemic. “I can only imagine what Sara [PSI’s archetypal consumer] in the Dominican Republic is facing; but I know that now, more than ever, she needs our help to make it through the anxiety and depression she may be feeling.”
This is a time of high stress for everyone—health workers, their patients and the communities we serve. Our work in mental health has never been as timely and critical as it is now.