Carers Worldwide: Mental health support for carers in India, Nepal and Bangladesh during COVID-19

Victoria Nicholson is the Fundraising and Communications Officer at Carers Worldwide. Carers Worldwide works with local partner organisations in India, Nepal and Bangladesh to support and address the needs of unpaid family carers of persons who are sick, living with mental health conditions or living with disabilities. In this post, she addresses challenges and adaptations in supporting carers during the COVID-19 pandemic.

Key messages: Innovations:
Carers and front-line workers have reported increased anxiety and depression Online emotional support for carers                                      
Supply of medication to treat mental illness has been impacted        Working with local health services to source and distribute medication 
Service providers need to consider response but also act fast Facilitating carer self-help groups over the phone

It is common for carers themselves to have their own mental health concerns, which often develop or are heightened as a result of their caring responsibilities. We have found that on average, 79% of the carers we work with report feelings of anxiety and/or depression prior to our intervention.

Although COVID-19 is incredibly new, we have already noticed immediate negative impacts on the mental health of our service users and sector workers.

Carers are experiencing increased anxiety concerning their health and the health of their loved ones, and about immediate events and the future. These anxieties are particularly heightened for the people we work with as they are caring for highly vulnerable individuals, many of whom are at increased risk of being seriously affected by the virus if they catch it. Carers are reporting increased feelings of depression, despair and hopelessness – feelings that “bad things” are inevitable and that they will not be able to access the support that they need.

Amongst our front-line workers (partner staff in India, Nepal and Bangladesh), there has been increased anxiety as they are putting themselves at risk by going out into the community, for example, to distribute emergency food packages. They also have feelings of despair related to the overwhelming magnitude of need. However, front-line staff are also reporting feelings of positivity as they are able to make a contribution to help people in difficult situations.

Staff and service users are both experiencing mental exhaustion. 

Delivering mental health care at a time like this can be very challenging. We are unable to meet face-to-face with carers, which is the best way to support people. The people we work with are less comfortable with remote support. Our carers self-help groups are unable to meet, which means carers are no longer receiving face-to-face socialising opportunities and the emotional support that they are accustomed to. There have also been problems with the supply and distribution of medicines to treat existing mental health conditions. Staff and service users are both experiencing mental exhaustion. 

Like many organisations, Carers Worldwide is trying to introduce innovative activities to address mental health needs and provide support during the outbreak. These include:

  • Staff making regular phone calls to carers to provide emotional support
  • Staff performing triage during phone calls and referring onto phone/video-based specialist counselling if needed
  • Facilitating carer self-help groups via phone and video calls

Our carers self-help groups are village-level groups that bring together 10-12 local carers who usually meet face-to-face once a month to socialise and offer each other emotional support. To maintain these bonds, we are now introducing group calls so carers can keep in contact with their established groups.

To support people with existing mental health conditions, we are working with local health services to source and distribute medication whilst complying with the limitations of each country’s movement restrictions during lockdown.

Our recommendation to other mental health and social care providers during the COVID-19 outbreak is to take time to consider your response - but don’t take too long or try to make this the ‘perfect’ response.

Our recommendations to other mental health and social care providers during the COVID-19 outbreak are to take time to consider your response - but don’t take too long or try to make this the ‘perfect’ response. It is important for people to know you are there at first instance. Be prepared for responses not to work and for the need to make adaptations. Work through things together and be open to different ways of responding. Circumstances are fast-changing, and we need to respond accordingly. Lastly, listen to the people you are supporting. They are likely to have ideas that you do not. Empower them and yourselves too.

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Key Resources:

  • 8 ways to deal with social stigma associated with COVID-19 (Carers Worldwide and NIHMANS) [Link]
  • Quality time with the family during lockdown/quarantine (Carers Worldwide and NIHMANS) [Link]
  • Emotional wellbeing during a COVID-19 outbreak (White Swan Foundation) [Link]
  • Mental Health and Psychosocial Support for Staff, Volunteers and Communities in an Outbreak of Novel Coronavirus (IFRC) [Link]
  • Basic psychological support for staff health doctors and nurses (ICRC) [Link]

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Families and carers
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