While contracting the virus was a serious fear she had, months of forced isolation with limited physical contact was becoming a source of distress.

Recently, I received a text from a friend living on the outskirts of Rome, Italy. She reached out to me to ask for advice on what I thought were the best ways to resume social interaction without exposing herself or her parents to COVID-19.

While contracting the virus was a serious fear she had, months of forced isolation with limited physical contact was becoming a source of distress.

As one of the worst COVID-19 hit countries, residents of Italy have been under severe lockdown for months. It was not until two weeks ago that the government started to cautiously ease the restrictions it had in place to contain the spread of the virus.

Governments across the board have taken similar measures in the face of this pandemic. Yet, the consequent months-long physical isolation coupled with economic turmoil, constant information on death and disease, and general uncertainty have led to serious mental distress in millions of people globally.

In essence, as the UN states, while “the COVID-19 crisis is, in the first instance, a physical health crisis, it has the seeds of a major mental health crisis as well”.

For countries like Italy, the national response to COVID-19 includes some form of mental health component. From moving psychological services online to creating systems that protect high-risk individuals, some governments have taken steps to minimiSe the mental health consequences of this pandemic.

However, these nations have had an already in-built mental health service pre-COVID-19. For nations such as Ethiopia, “where mental health and psychosocial support services (MHPSS) are already limited” at best, the mental health toll of COVID-19 “can be devastating - especially for children and young people,” notes UNICEF Ethiopia.

Although there have been some governmental efforts in the past to create a mental health strategy, conversations around mental health in Ethiopia have been anything but mainstream. The stigma attached to mental illnesses and the dismissal of them as a ‘western or a privileged problem" has meant that few people get the dire services they desperately need.

In the context of COVID-19, it is imperative to rethink the psychosocial damages this pandemic can have on fellow Ethiopians. Distress during a crisis like this one is understandable. However, the impact of COVID-19 alongside pre-existing root problems like impoverishment, high rateS of domestic violence and inadequate access to alternative ways of schooling, have and will continue to contribute towards widespread psychological distress.

The loss of livelihood is one of the primary sources of worry for people. The economic impact of COVID-19 on Ethiopia’s job market is estimated to result in over one million job losses.

In Addis Abeba for instance, where the hospitality industry plays a big role, “the sector is facing an almost complete loss of customers” due to the pandemic and the resulting lockdown measures taken by the Ethiopian government.

Consequently, tens of thousands could potentially lose their jobs. With a frail welfare system, the loss of economic prospects is a serious source of angst and fear for many across the city and the nation.

The economic turmoil then trickles down into home life.

Schools and universities remain closed with no notice as to when they may reopen “meaning that huge numbers of children and young people [in Addis Abeba] ... are stuck in cramped and overcrowded family homes with little to do. And a sharp uptick in poverty will exert even more strain on already stretched households, increasing the risks of domestic violence, abuse and neglect,” writes UNICEF Ethiopia.

For many children, schools are a sort of refuge from toxic households. The abrupt change to their routine, with a possibility of increased abuse and social isolation comes at a pivotal point in their emotional developmental phase. Additionally, extremely few students in the capital have the financial and parental support to continue their schooling from home using online correspondence with their schools or through hired tutors. Hence, the lack of learning environments and lessened intellectual stimulation could also then adversely affect brain development of children.

Domestic violence has also increased globally during this pandemic. There could be as many as 31 million additional cases of gender-based violence if restrictions continue for at least six months, according to the UN. With a culture that largely deems conversations about domestic violence a taboo, it should be expected that women in Ethiopia, unfortunately, face increased abuse and violence during this lockdown period.

Like women and children, there are also at-risk populations whose mental health needs are overlooked. Those with disabilities, older adults with no families and internally displaced individuals are some of them. They are prone to multiple stressors, which then lead to substance abuse and mental health conditions such as anxiety and depression.

In the past couple of days, the number of COVID-19 cases has risen rapidly in Ethiopia. Despite the low death count, the upsurge has caused psychological distress across the city and the nation. As numbers keep increasing, so does deep uncertainty about the future. With the rising cases, the healthcare system in the city is bound to primarily focus on dealing with COVID-19 infections. This means that actions addressing mental health will be unable to get the attention it deserves.

The multiple factors causing distress and mental health conditions will have a long-term impact on our society as a whole. On a governmental level, we need to reassess mental health and MHPSS in the Ethiopian context. While that will take time, it is also important to highlight the emerging community sources of psychosocial support. Given the closure of religious institutions’ public spaces, last month's televised national prayer was a source of comfort for many. As a deeply conservative country, the chance for members of the different denominations to take part in a month-long prayer service served as a place to access resilience and empathy.

Moving-forward, work needs to be done in including mental health as part of the national health strategy. Doing such is no way an act of privilege. A mentally healthy society is absolutely essential for it to function well.

PUBLISHED ON May 31,2020 [ VOL 21 , NO 1049]

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