Much like other LMICS, Pakistan has also been hit by a large and rapidly rising caseload of Covid-19 cases, overwhelming the country’s already fragile health system. Provincial governments adopted a lockdown lasting two months starting March during which outpatient departments in hospitals and private practitioner clinics remained closed. The pandemic has also been accompanied by an economic downturn and rise in financial shocks, particularly for households relying on daily wages. Moreover, Pakistan already has a high burden of mental illness. According to the most recent data provided by WHO, approximately 24 million (12 percent) of the population of Pakistan has mental health conditions and there is a large treatment gap with only 0.19 psychiatrists available per 100,000 people.
The overarching goal of the intervention is to improve pandemic preparedness and response by providing integrated Covid-19 and mental healthcare through three main approaches:
- Proactive calls: This is aimed towards patients who have been tested for Covid-19 at a large tertiary care hospital and primary care providers. Lay counsellors call patients who tested negative or positive. They also provide updated Covid-19 information, advise on isolation discontinuation, contact tracing services and mental health screening and counselling. In case of worsened Covid-19 symptoms, they refer patients to the nearest healthcare facility. Patients exhibiting symptoms of mild to moderate anxiety and/or depression are referred for further assessment and one-on-one counselling with a trained lay counsellor.
- Mental health helpline: People experiencing anxiety can call in on a toll-free number and immediately reach a trained mental health counsellor for free-of-cost crisis counselling. The counsellor listens attentively to the caller’s concerns, and offers screening for depression and anxiety followed by enrolment in one on one counselling or consultation with a clinical psychologist for severe cases of mental illness. Counsellors are trained to provide updated information and safety recommendations related to COVID-19.
- Mental Health Support for Frontline Practitioners: This is aimed towards all healthcare practitioners working on the frontlines. The component offers interactive webinars designed to provide a safe space to share their experiences, talk about fears and concerns in an open and informal manner as well as provide information about mental health, coping strategies and additional resources. It also offers tailored mental health support to anyone who requires it; current services include support groups, one on one counselling sessions and mental health check-ins (brief one on one sessions with Psychologists).