The COVID-19 pandemic has introduced much transition in all of our lives globally. The education landscape for students of all ages has changed. With this increased isolation, stress, and uncertainty, students, teachers, and families have been impacted in a number of ways that could increase the risk of depression, anxiety, post-traumatic stress, and suicidal thoughts.
A key word to consider when we think of the impact of the COVID-19 pandemic on our children is “LOSS”. The sudden and drastic change experienced as of the 27th of March this year has brought about unprecedented losses and stressors for our children and our families.
A trauma is defined as, “an incident or event that is sudden, unexpected and life-changing”. The pandemic can be described as traumatic in that suddenly and unexpectedly we lost our “way of being” – schooling moved online for many; sport, music, drama and dance activities were cancelled; tours and camps postponed; a fear of contracting the virus developed; physical connection with friends and family members were stopped; social isolation called for; financial and economic stressors affected families; some experienced the death of someone close, to the virus; the possibility of not having a Matric Farewell, Awards Evenings or a Valedictory Service became real and so the losses have accumulated in the last 5 months and continue to accrue.
As a result, the impact of these losses have resulted in calls to mental health call-centres having almost tripled; workplaces have retrenched many employees; violence in the home has increased; social isolation and loneliness increased suicide risk; many people have been unable to access basic necessities; many of those struggling with anxiety and depression prior to the pandemic have experienced a relapse; COVID fatigue has set in; negative health issues increased due to a lack of exercise, boredom and complacency, and increased suicide attempts and deaths have been reported.
Innovative approaches to addressing mental health and suicide risk are necessary and possible. The first step in doing so is to acknowledge that NO ONE is immune to the onset of depression, anxiety, or suicidal thoughts and risk during this period of change. How then can we identify the warning signs that my child, partner, friend, student, or colleague is not doing okay and may be at risk?
Those who study suicidology tell us that the primary underlying features that can contribute to suicide deaths is:
- A lack of a sense of belonging
- A sense of being a burden
- Hopelessness and shame
- A desire to end the emotional pain experienced
- No sense of purpose or meaning
The impact of the COVID pandemic as detailed above can result in each of these contributory factors, thus increasing the risk for suicide. In fact, individuals who have been suicidal before could have a spike in suicidal risk under the current circumstances. So how do we identify if someone may be mentally unwell, struggling or a suicide risk:
First, we want to observe and become aware of:
- The actions that we see
- The words and phrases we hear
- The feelings being expressed and sensed and
- The life circumstances being experienced.
What do I see?
- Change in usual behaviour
- Withdrawal / Isolation
- Lack of personal hygiene
- Extreme mood swings
- No appetite / Eating too much
- Insomnia / Sleeping a lot
- Interest in celebrity suicide deaths
- Use of substances or increase in
- Loss of interest in hobbies / interests
- Risky or reckless behaviours
- Talking or writing about suicide on social media
- Giving away prized possessions
- Researching / Googling “How to suicide”
- Low mood but then a sense of relief
- Self-harm – cutting, burning, creating pain
What do I hear?
- You will be better off without me
- I do not belong
- I am a burden
- No one will notice if I am not here
- I am so tired
- There is no purpose or meaning to my life
- You will see….
- No one can help me
- Why must I be just so others can be okay?
- I am a worthless failure
- I can no longer provide for my family
- I am useless
What Feelings Do I Sense?
- Immense sadness
- Fear / anxious / agitated
- Anger / rage
- Desire to seek revenge
Life Events Experienced
- Effects of a pandemic
- Break-up of a relationship
- Conflict or violence in the home
- Abuse / neglect
- Work overload
- Adjustment to change in learning
- Loss / death of a loved one
- Illness or health issues
- Financial stressors
- Change is academic results
- Inability to play sport or exercise
An acronym that I use to help me remember the warning signs that may indicate a high suicide risk is: “IS PATH WARM”
So, what do you do if you identify a number of the warning signs presented in a child, family member or a friend? It is of life and death importance that we now engage with this person and ASK them if they are having suicidal thoughts. The burden to engage rests with us as the suicidal person has been subtly indicating through their actions, words, feelings, and life events, that they are not well. Now that we have identified and heard these invitations, because we now know what we are listening and looking for, can we act.
Mental health issues and suicidality will only be treated and prevented when we begin to talk about the issues. If we avoid talking to a person in crisis then we continue to emphasise that they cannot be helped, that we are afraid of their pain and we continue to highlight the stigma that accompanies these issues.
We can engage in a conversation in the following way:
“I have been noticing that you have been very sad and tearful lately, you get angry quickly, you have been isolating yourself, posting messages about death on social media, sleeping more than usual, not eating very much and I have heard you repeatedly say that there is no purpose to your life and that you are a failure. I also know that you have recently broken up with your boy/girlfriend. People who present in a similar manner often experience suicidal thoughts, could you be thinking of suicide?“
They could acknowledge that they are feeling suicidal or express that they are not having thoughts of suicide but move on to explain what they may be struggling with. It is important to remember that by asking them if they are having thoughts of suicide, you do not have the power to give them such thoughts. Rather they will be so relieved to be heard and understood by someone that they genuinely will open up and want to talk about their pain and their thoughts and plans.
The goal is to open the door to talk about what may be bringing suicide into this person’s life. It is not to try and fix all their issues, convince them that what they are feeling is not okay or will pass or discuss the impact of their suicide death on those left behind. But it is to sit with that person in their pain and empathically talk through their pain. You feel …. because … is a good tool to express empathic understanding.
However, you cannot assist your child, family member, friend on your own. Now that you have identified that they are at potential risk of suicide, it is of vital importance to negotiate with them that you will need to involve a professional, so as to ensure that they get the best help moving forward. You can say something along the lines of, “I cannot run the risk of losing you, we need to get someone else to help.”
Therapeutic support, risk assessment and suicide prevention counselling for learners and their family members who may be struggling mentally and emotionally during this period can be found at THRIVE – it’s a lifestyle at Xavier Boulevard, Winchester Hills, Johannesburg South. This brand-new Wellness Hub offers a warm, safe, and comfortable counselling space and has been created with this purpose in mind, amongst others.
If you, or a family member, are experiencing signs of depression and / or anxiety, suicidal thoughts or you just need to talk through the impact of the pandemic on you and your struggle with the adjustment to the drastic change, then please contact Lorraine Mitchell at 0845601003 or Lorraine@perception-sa.co.za.
Should you or someone close to you not be requiring counselling or therapeutic intervention but acknowledge that the adjustment to the numerous changes being experienced are taking its toll emotionally, physically, spiritually, mentally and psychologically, then here are a few practical and creative ideas to consider to assist us develop the resilience we need to journey through this time:
- Stay connected, physical distance does not mean social isolation.
- If you know persons that are feeling disconnected, alone and a limited sense of belonging – connect with them, show compassion and care, send messages and texts.
- If not addressed, experiences of overwhelming loneliness, sadness or lack of meaning may continue long after the lockdown has ended. Individuals who experience depression and loneliness after the lockdown should reach out to others, try to eat healthy foods, do fun things and exercise more.
- As a community, possibly try to assist to restore some of what they have lost due to the pandemic and lockdown – Offer a meal, a food parcel, a job that they can do for you.
- Value persons around us, highlight that no one is a burden.
- Mobilise the school to organise a Zoom / mini Matric farewell and graduation.
- Be creative – think out of the box in our “new normal” existence.
- It is equally important for organisations to include mental health as a critical factor in their business planning and strategies going forward.
- Most importantly, do something every day to help build resilience and implement strategies to look after your own mental health so that you can prevent any crises or escalation. Remember – No one is immune!
- Limit reading or listening to the news to a few accurate, reliable sources. Do not overload your thoughts with negative information.
- For people with pre-existing mental health conditions, now is not the time to stop or wean off your psychiatric medicines. Speak to your Doctor before changing your medical care.
- If you are in a difficult, conflictual, or unsafe environment – remove yourself. Go to a family member or friend. Do not remain in toxic and dangerous spaces.
- We need to act now to address the mental health needs associated with the pandemic, to reduce the enormous long-term consequences for families, communities, and societies.
There may be optimistic considerations, a silver lining to the current situation. One hypothesis is the so-called pulling together effect, whereby individuals undergoing a shared experience might support one another, thus strengthening social connectedness. The recent advancements in technology (for example, video conferencing and telehealth options) might facilitate pulling together. Pandemics may also alter one’s views on health and mortality, making life more precious, death more fearsome, and suicide hopefully, less likely.
The key to our well-being during this time is to be aware of what we need to ensure connectedness, holistic health and stability and actively seek this out for ourselves and those around us.