Mental Health – April 17 2020

Q&A on mental health during COVID-19 pandemic

Teresa Ngigi, a mental health expert for SOS Children’s Villages and an author in the field of childhood trauma, talks about the mental health impact of the coronavirus crisis on children in alternative care and in at-risk families needing support.

In this crisis, what are the particular challenges facing children and young people who live separated from their families in alternative care?

There has been a disruption of daily life routines and this is bound to affect children remarkably. Children need predictability, structure and consistency, and the measures to contain COVID-19 do not guarantee this. Children and youth thrive in interacting with others, and this has also been curtailed in a significant way.

The possibility of physically seeing their biological relatives is no longer there, and this creates fear and anxiety about them and their well-being. 

Total reorganization of life is another factor which gives rise to uncertainty, and this is bound to affect the children’s mental health and consequently behavior.

How can these challenges be addressed?

It is important for caregivers to be well so that they can convey wellness to the children. It is important to practice creative adaptation – making the best use of the current situation. Support programs for caregivers are key at this crucial stage.

Children need to feel safe in order to thrive, so creating a safe environment and involving them to be active participants in keeping themselves safe is important. Daily routines, structures and organized activities are helpful, but we need to watch against overdoing it. Children and young people also need their own time and space.

It is important to provide opportunities for them to keep in touch with their loved ones. This can be through phone/Skype/video calls, messaging or even the old-fashioned letter writing, etc. It has a therapeutic component.

Children need to feel in control of situations, and so caregivers could help them understand what they can control and what they cannot.

Meetings and other forms of contact with birth families might be limited due to isolation measures. Why is it so important to find ways to maintain contact (e.g. via online tools)?

Children living in alternative care may already feel a sense of separation from their families. Everyone needs to have a sense of belonging, and as much as they are at home in alternative care, their biological families play an important role in their sense of belonging and fulfilment. Maintaining contact reinforces this sense of belonging. When they leave care, this is where they return, hence the importance of keeping very close ties with their biological family. This experience helps to mitigate stigma.

Families needing support presumably are feeling high levels of strain right now. What are the implications of this on children and their emotional well-being?

High levels of stress in the family cause challenges in the family unit. When people are highly stressed, their brain goes into fight or flight mode, therefore all other faculties are suspended because the brain has to deal with the emergency at hand. This can lead to irrational decision-making, high level of reactivity, and uncontrolled emotions. Consequently, this can lead to violence in the home.

Most people in families are living in fear right now – fear of the unknown: Will I or someone close to me be infected? How long will this lockdown last? What will happen if I don’t go back to work? Shall I be able to have my basic needs fulfilled?

These and other questions can have a negative impact on everyone in the family, especially children. When children see their caregivers out of control, their world is shattered because they are dependent on these caregivers, and so they are likely to experience threat to their well-being, hence triggering a trauma mechanism that could lead to serious challenges.

Proximity is also a challenge in families. It can reinforce union and at the same time expose each person’s vulnerability. This is likely to trigger irrational reactions and hence result in violence.

Being confined can be risky for vulnerable families. The risk of not having any external physical support could lead to child abuse cases since no one is witnessing this and reporting becomes difficult in that the abuser could constantly be present. Owing to the fact that it is physically difficult to see what is happening in the family environment, such cases may go unreported, and could escalate into violence and abuse.

What can be done to mitigate against violence and abuse?

It is important to do the following in such situations:

  • There are helplines that have been instituted to support families through phone, Skype, and video calls
  • People in this situation need to find a way to reach out and call for help
  • Families need to be sensitized about the above dangers and how to spot early warning signs and what to do about it
  • Professionals need to have organized support systems which will reach out to all, especially the most vulnerable
  • Care professionals would need basic mental health interventions in order to know how to deal with situations in case they arise
  • Involve the entire family in setting up a plan to mitigate these challenges
  • Networking with other stakeholders could go a long way, as each could contribute to the well-being of families and especially vulnerable children

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