Employees and mental health: Carrying forward Covid-19 activities in mental health to present normalcy

The silent retreat of Covid-19 in early 2022 also marked the fading of elevated health concerns globally. But it is argued that Covid-19 multiplied vulnerabilities in psychological distress, and their implications are far more stretching. The pandemic also disrupted access to mental health services, which were generally ignored in the global efforts to prevent the spread of the virus. It exposed the weakness in pre-Covid-19 mental health system which now should be strengthened for the post-pandemic world. The mental health preparedness was hit by surprise due to the limited understanding of the Covid-19 virus and the lack of clarity of the associated mental health requirements. Mindful of self-care, re-socialising and coming back to the workforce constituted some of the changes for employees in the post-Covid new normalcy. After having worked online and in isolation, returning to office for work carries a tremendous burden to the mental well-being of the employees.

As of 19 July 2023, 768.24 million confirmed cases and 6.95 million deaths globally were registered, as per the WHO, due to Covid-19 which was declared a pandemic by the WHO in March 2020. In a WHO survey, 121 of 130 participating countries “reported disruptions in one or more services for mental, neurological and substance use disorders, while the demand for mental health services is increasing”. Also, in another survey in 2021, 90% of participating Member States considered mental health and psychosocial support in Covid-19 response plans significant. This came in because the pandemic wrecked the global mental health of the general population due to several preventive health measures that were enforced in the forms of mandatory masks, lockdowns, quarantines, ‘social’ distancing, inadequate health care facilities, and economic and social implications. These preventive measures affected public mental health since they produced psychosocial distress in terms of isolation and loneliness, fear of losing jobs, and financial insecurity—which got worsened by the lack of adequate mental healthcare services. In the process, the prevalence rates of depression and anxiety in general population increased globally.

Looking at the group level, the mental health of employees is also related to the dropping productivity levels. In November 2021, the white paper Modern Work released by Australia’s Black Dog Institute argues that “the severity and complexity of workplace mental health conditions has increased, with early recovery and returning to work becoming less likely”.

Well, the pandemic is over and people have been re-adjusting to living in the new normalcy of the post-pandemic world beginning in early 2022.

But the white paper also highlights significant improvements in the protection of the mental health of workers in terms of increasing number of workplaces proactively engaging in mental health in Australia. Others include fewer people working on the weekend, no increase in short-term job insecurity and workers reporting increased choice over when they work. It became useful to various stakeholders including businesses, government agencies, and healthcare professionals.

We need to re-visit the conditions of healthcare workers during the pandemic in order to strengthen the present preparedness. In a WHO study published in March 2022, medical workers faced high rates of physical and mental exhaustion, loneliness and Covid-19 contraction increased the risk for suicidal thoughts and behaviours in healthcare workers. It got further complicated as the findings indicated a high risk of severe illness and death among those with mental disorders. The pandemic impacted the decline of outpatient appointments, emergency facilities were limited to mental patients, and limited face-to-face mental health service delivery during 2020-2021. However, e-mental healthcare partly mitigated these challenges. The study further highlighted inadequate infrastructure, pre-existing inequalities and low levels of technological literacy reported e-health barriers.

These studies reveal the prevalence of depression and anxiety among employees which require continuous efforts to strengthen the post-Covid-19 mental health system. Mental health care should focus on the growing delivery of mental health services to the workforce, in particular and the overall population, in general. In The Lancet publication in 2021, wellbeing-centred policymaking is critical for future mental health of the population. We have seen how depression and anxiety resulted in a phenomenon of “quite quitting”, a condition in which employees reject to work above and beyond the working hours indicating increasing demands of workers to find flexible job conditions and an inclination towards finding better alternatives in doing something that they love. It led to the “Great Resignation” in 2021. It is argued that this has led to a decline in labour productivity.

It is pointed out that inadequacy in the mental health workforce created a problem in accessing mental health treatment in the U.S. In the U.S., 90% of adults in the U.S. considers there is a mental health crisis in the country and that the pandemic exacerbated the symptoms of anxiety and depression among different populations, according to a KFF/CNN survey in July-Aug 2022. There the Covid-19 health emergency scheme ended in May 2023. The country has initiated a health crisis hotline, 388 for landline and mobile users. Medical experts have emphasised addressing negative mental health impacts which continue to pose challenges to labour productivity and global health. They suggest preparation for long-term mental needs beyond the Covid-19 pandemic. Mental health preparation could be aligned with telehealth services by including the private sector and strengthening the implementation of government initiatives in this direction is very crucial.

In India, the government carried out online trained health workers online by NIMHANS through iGOT-Diksha platform. National Tele Mental Health Programme was announced by the Government of India in the 2022-2023 Budget to provide quality access to mental health services. Given her large workforce, the increase of about 35% prevalence of anxiety and depression in India during the pandemic indicates that the government, private sector, and civil society groups need to align their mental health activities to facilitate the mental health of the employees in both formal and informal sectors. Thus, taking forward the recommendations in The Lancet publication, mental health care should be participatory of all social and policy stakeholders. They should also be decentralised by expanding from specialists to common people in terms of the adoption of skills, prevention, and promotion.

A Forbes article argues that Singapore represents a model for mental health care management. It prioritised mental health during the pandemic and continued to strengthen the pre-pandemic mental health system. The Covid-19 Mental Wellness Taskforce which was set up to address the needs of mental health in the country transformed into an inter-agency platform to formulate a national strategy for mental health in the post-pandemic future. Its Report, 2020 proposed to develop a One-Stop online portal for national mental health resources, basically providing self-help tools; and, developing a national mental health competency training framework. The government set up an online self-administered psychosocial assessment tool called iWorkHealth for the workplace to identify and manage workplace stressors. Business Inc. in Singapore is way ahead in showing leadership in implementing measures to improve mental health during and after the pandemic and prioritising the healthy relationship between employers and workers at the workplace. It is, thus, possible in a conducive policy environment that emphasises on people-oriented perspective.

Workers’ mental engagement in work should be facilitated by investing in their socio-emotional health which is a key to higher productivity and social well-being. Removal of stigmatisation, for example in India, surrounding mental disorders/illnesses constitutes a step towards the removal of hurdles in developing mental health. Apart from the national-level preparation, international organisations can come in to prepare countries for capacity building in health emergencies or normal mental health requirements. The World Health Assembly has recently updated the Comprehensive Mental Health Action Plan 2013-2030 in its implementation strategies. It, thus, can become useful for improving the mental health of workers in different sectors and preventing their mental and physical burnout in the present normalcy.

This article is authored by Mehdi Hussain, doctoral candidate, Centre for South Asian Studies, Jawaharlal Nehru University, New Delhi.