MENTAL HEALTH – 21st Century

COVID 19 and its mental health consequences

Anant Kumar and K. Rajasekharan Nayar
Published on: April 27, 2020
https://www.tandfonline.com/doi/full/10.1080/09638237.2020.1757052?
fbclid=IwAR3VPm_ZZR3BLUrLbjuef4lt5ed5SJl4If-NSaXOT9RohBbzwkg8It3GjNc
The global community is concerned about Coronavirus disease 2019 (COVID-19) and its long-term
consequences. It is going to impact various spheres of life such as the economy, industries, global
market, agriculture, human health, health care, etc. At present, the focus of States and the World
bodies such as the World Health Organization (WHO) is on controlling and mitigating the impact of
this pandemic by identifying, testing, treating infected people, developing drugs, vaccines and
treatment protocols. However, despite such efforts to defeat this pandemic, we are not very sure
what direction the pandemic will take in the coming days.
The WHO has also expressed its concern over the pandemic’s mental health and psycho-social
consequences (World Health Organization, 2020d). It speculates that new measures such as self-
isolation and quarantine have affected usual activities, routines, and livelihoods of people that may
lead to an increase in loneliness, anxiety, depression, insomnia, harmful alcohol, and drug use, and
self-harm or suicidal behavior (World Health Organization, 2020c). The lockdowns around the
world have led to an increase in cases of domestic violence where women and children who live
with domestic violence have no escape from their abusers during quarantine (Abramson,  2020;
Chandra, 2020; Graham-Harrison et al., 2020; World Health Organization, 2020a). The recent
survey by the Indian Psychiatric Society shows a twenty percent increase in mental illnesses since
the coronavirus outbreak in India (Loiwal, 2020). Psychologists and mental health professionals
speculate that the pandemic is going to impact on the mental health of the population globally with
the increase in cases of depression, suicide, and self-harm, apart from other symptoms reported
globally due to COVID 2019 (Li et al., 2020; Moukaddam & Shah, 2020; Yao et al., 2020). Closing of
outlets selling alcohol has also led to withdrawal symptoms and suicides by alcohol addicts,
reported in states like Kerala in India (Jayakumar, 2020). They speculate about the chances of
developing neurotic disorders such as generalized anxiety disorder and obsessive-compulsive
disorders (OCD) in large population groups. Overemphasis on consistent handwashing (for twenty
seconds) may affect a significant population group globally considering people are not aware of
when and how many times to wash. In such a scenario, many people are washing their hands on a
regular interval (Times of India, 2020). It is a sanitary fight against an invisible virus and sources of
infection. In such a scenario, OCD and related maladaptive behaviors particularly due to consistent
promotion of handwashing to mitigate the coronavirus infection and its spread is a serious concern.
Besides mood-related and emotional outbursts especially panic, fear, avoidance and fear in meeting
other people, fear of death (Thanatophobia), fear of getting isolated, stigmatization, fear of even not
getting essential items, food, etc., may have its psychological manifestations. In many states, due to
anxieties, people have been hoarding essential items which has led to shortages. Millions of People
have lost their jobs. People employed in the informal and unorganized sectors are worst hit as they
are struggling for, food, shelter and their livelihoods which created uncertainty leading to
depression, suicide, self-harm etc. The lockdown may be an important strategy to break the chain of
transmission. But it has also created boredom and monotony among office goers and children. In
many households, children who end up staying indoors become restless and, in some cases, violent.
MENTAL HEALTH – 21st Century

Many households have even closed windows and doors due to wrong notions regarding the
infection.
Interestingly the Coronavirus pandemic has another feature in this age of social media, where
people are getting overloaded with rumors and misinformation which are not authentic and
verified. Such rumors and unauthenticated information create fear, anxiety, and stress with a
sudden and near-constant stream of news reports about an outbreak. In India, many people got
exposed to positive people or to those traveled abroad and who are at risk. However, they are not
coming forward for testing due to social stigma and social isolation. They are scared and fearful that
they will be blamed, isolated and taken away from their family members. It is important that these
people receive counselling from psychologists and other mental health professionals that they have
not done anything wrong, and this is just a protocol to mitigate and control the pandemic. Their
doubts need to be clarified; they deserve social and psychological support, counseling, compassion
and kindness in such a distressful situation. Such stigma and social isolation have negatively
impacted HIV prevention in the past and we need to learn from that. The stigma associated with
mental health problems may cause reluctance to seek support.
To date, over one hundred thousand people have died worldwide, and we do not know how many
more will die due to this pandemic. In such a scenario, providing psycho-social support and helping
bereaved family members is important. Children may respond to stress in different ways such as
being more clingy, anxious, withdrawing, angry or agitated, bedwetting, etc. Children need adults’
love and attention during difficult times. They need extra time and attention. It is important to keep
children close to their parents and family and avoid separating children and their caregivers to the
extent possible. If separation occurs (e.g. hospitalization) regular contact (e.g. via phone) and re-
assurance are required (World Health Organization, 2020b). Particularly young children who have
lost their parents are more vulnerable. Every child experiencing such loss needs a safe and
supportive environment, guidance and help to express their feelings such as fear and sadness.
The mental and psychological wellbeing of healthcare providers is another concern. Healthcare
providers are continuously working in fearful, stressful, resource constrained settings where they
are under the continuous threat of getting exposed and infected. In such a condition the healthcare
providers’ mental health and psychosocial well-being are as important as managing the health of
the infected population. The WHO has issued a thirty-one-point guidance for mitigating these
problems. These include guidelines to safeguard the mental health of the population of different age
groups affected with COVID-19 with a special focus on children, women and service providers,
suggesting measures to mitigate anxiety, depression, and stigma, etc.
There are various resources available online which can be helpful in managing and coping with the
stress arising out of the pandemic. It is important for people to take care of themself, their family
members and friends. Helping others to cope with their stress makes the community stronger.
Nevertheless, the biggest challenge in mitigating mental health consequences of the COVID 19
pandemic is the lack of mental health professionals, practitioners, counselors, and health facilities
where one can approach for such help. It is going to be a real challenge for a country like India
where only 0.29 Psychiatrists, 0.07 Psychologists, and 0.36 other paid mental health workers are
available per 100,000 people (World Health Organization, 2018). In such a situation, it is important
to evolve a simple counseling package that can be delivered by givers at home or in the hospital.
The package should contain a number of dimensions, such as being empathetic and supportive to
all those who are affected. They need to be listened with compassion and kindness. Establishing
MENTAL HEALTH – 21st Century

online mental health and counseling services at hospitals, community health care centres, and at
university departments of psychology could be an opportunity to address such a crisis (Liu
et al., 2020).
China has been implementing emergency psychological crisis interventions to reduce the negative
psychosocial impact on public mental health. However, challenges exist (Dong & Bouey, 2020). One
can hope that States will learn a lesson from this pandemic and recognize public mental health as
an important priority area that needs to be formally integrated into public health preparedness and
emergency response plans.
MENTAL HEALTH – 21st Century

Student involvement, mental health and quality of life of college students in a selected
university in Manila, Philippines
Jerome Visperas Cleofas
Published online: September 26, 2019
https://www.tandfonline.com/doi/full/10.1080/02673843.2019.1670683?
fbclid=IwAR3OessIpCf2p_0q-soHxr2N8b8yNfBs9LfUJXnfrCSZTpHSFnnVIiPaDo0
This study was conceived within the context of increasing incidence of mental health challenges
observed among college adolescents in the Philippines. Being an important social institution, the
school must be able to create a social environment in order to foster better mental wellbeing and
quality of life among its students. This research sought to examine the relationship among student
involvement, mental health and quality of life among college students in a Philippine university.
This study utilized a quantitative cross-sectional, descriptive, correlational design. Survey was
administered to 249 students in a private university. Results suggest that involvement in school
organizations was correlated to depression levels, general positive affect and life satisfaction. Social
interactions with entities in school was also related with quality of life. All subscales of mental
health were associated with quality of life among the student respondents.
MENTAL HEALTH – 21st Century

An Educational Study on Gadget Addiction and Mental Health among Gen Z

Shahlan Surat1*,  Yamuna Devi Govindaraj2, Shalinawati Ramli3,  Yusni Mohamad Yusop4

1
Fakulti Pendidikan,Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia.
2
Kolej Sains Kesihatan Bersekutu Kementerian Kesihatan Malaysia, Sungai Buloh,
Selangor, Malaysia.
3
Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Negeri
Sembilan, Malaysia.
4
Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.

Published on: July 2021

https://www.scirp.org/journal/paperinformation.aspx?paperid=110418&fbclid=IwAR3YKR-Vtd-
jbD3-66uIEeGxehQqoo-gj7eNunBL8KZUgF2M1VO_CD81WIU
The acceleration of modern technology in the techno gadget era has led to the transformation of
modern media highlighted by Generation Z. The aim of this study is to explore how gadget addiction
influences the level of depression, anxiety, stress and sleep quality among the samples from the
Ministry of Health Training Institution Sungai Buloh, Malaysia. Using the stratified sampling
method, a total of 316 college students from various field are surveyed on the Smartphone
Problematic Use Questionnaire, Depression Anxiety Stress Scale and Pittsburg Sleeping Quality
Index. The Pearson correlation analysis and linear regression are adopted to find the relationship
among the variables. Results show that gadget addiction is a predictor of depression, anxiety, stress
and sleep disturbances. The findings of descriptive analysis show that the level of addiction,
depression, anxiety and stress among the trainers is high. Positive correlations are found between
the gadget addiction and levels of depression, anxiety, stress and sleep quality. Levels of depression,
anxiety, stress and sleep quality among trainers are significant, with 13%, 10.7%, 12.5% and 3.4%
experiencing symptoms of depression, anxiety, stress and sleeping disturbance respectively.
Therefore, it is generally possible to know that the problem of gadget addiction can interfere with
mental health of the users if the use of gadgets is not well controlled. The implications of this study
are useful to academics and heavy gadget users and those who are hooked with their gadgets in
their everyday life. Further studies in this area are needed to delve deeper into other issues related
to each element of gadget addiction in order to reinforce the research framework which will in turn
develop a standard guide for controlling gadget use in Malaysia.
MENTAL HEALTH – 21st Century

An investigation into the relationship between climate change anxiety and mental health among Gen
Z Filipinos

Marc Eric S. Reyes; Bianca Patricia B. Carmen; Moses Emmanuel P. Luminarias; Soleil Anne Nichole
Mangulabnan  &  Charles A. Ogunbode 

Published on: July 15, 2021

https://link.springer.com/article/10.1007/s12144-021-02099-3?
fbclid=IwAR2GC6qvMPltHFdMpAHgwxAJgsUlYdVW2NMxiDhCN4Mcr-rZV6WiOyccBZs

Climate change and mental health concerns are both defining issues of the generation of today. It
has been established that the worsening climate causes many environmental disasters and physical
health problems. However, its psychological impacts are still not well understood. Climate change
has brought about an emerging psychological phenomenon termed ‘climate anxiety’ or ‘eco-
anxiety,’ which has been described as a "chronic fear of environmental doom" (Clayton et al., 2017,
p. 68) due to the impact of climate change. This predictive cross-sectional study investigated the
link between climate change anxiety and mental health among 433 Filipinos. A total of 145 males
and 288 females aged 18 to 26 completed the Climate Change Anxiety Scale and the Mental Health
Inventory (MHI-38). Results show a significant relationship between climate change anxiety and
mental health, with climate change anxiety predicting 13.5% of the overall Mental Health Index
variance. Significantly, climate change anxiety was associated with the MHI-38’s global scale of
Psychological Distress but not with the global scale of Psychological Well-being. The findings are
discussed concerning the broader context of research on the mental health impacts of climate
change.
The consequences of a rapidly changing climate have become a significant source of concern for
many people worldwide. Many evidence-based documents show how climate change impacts the
planet and the attendant consequences for human physical health (Hathaway & Maibach, 2018). In
comparison, knowledge of how climate change affects mental or psychological health is minimal.
According to Hayes et al. (2018), climate change’s planetary effects and disastrous events can
trigger mental health problems. This argument is based on findings from studies linking climate-
related events such as extreme temperatures, increased air pollution, flooding, seasonal haze, and
rising sea levels with various mental health problems, including post-traumatic stress disorder
(PTSD), anxiety, depression, grief, survivor guilt, hopelessness, difficulties in social relationships,
and suicidal ideation (Buoli et al., 2018; Cianconi et al., 2020; Hayes et al., 2019; Ho et al., 2014;
Lieberman-Cribbin et al., 2017; Xue et al., 2019).
Further, seasonal haze is a phenomenon influenced by climate change, which affects a majority of
Southeast Asian Nations, especially during periods with minimal rainfall. This is prone to form due
to forest fires or the 'slash-and-burn' technique of farmers, where "burning of carbon-rich peatland
would send off acrid smoke, dust and dry particles (2.5 micrometers or smaller) into the
atmosphere" (Ho et. al, 2014, p. 1). It was found that healthy individuals are physically and
psychologically affected by haze (Ho et. al, 2014). Additionally, diastolic blood pressure and heart
rate are both affected after haze exposure. It was found that haze affects cerebral hemodynamics,
therefore causing the emergence of new psychosomatic symptoms (Tan et. al, 2019).  Climate
change can also affect people in subtle and indirect ways. For example, Ogunbode et al. ( 2021)
found that negative emotional responses to climate change correlate negatively with mental health
MENTAL HEALTH – 21st Century

and positively with insomnia symptoms. Similarly, Kabir (2018) found that people whose
livelihoods are affected by climate change experience psychological stress because work is essential
to their wellbeing. This study showed that the psychological impacts of climate change could
increase substance usage, increased family stress, suicide ideation, and amplification of past
trauma. Further, awareness of ongoing climate change and projected future adverse consequences
heightened by growing media coverage underlie an emerging and potentially widespread
psychological phenomenon termed eco-anxiety (Hayes et al., 2018). Pihkala (2018) describes eco-
anxiety as the different distressing emotions and mental states evoked by knowledge of
deteriorating environmental conditions. The terms ‘climate anxiety’ and ‘eco-anxiety’ are often
used interchangeably in the literature. While anxiety is certainly not the only negative emotion
people feel in response to environmental problems, Clayton (2020) suggests that anxiety is
particularly significant for capturing the sense of worry and concern people have about climate
change.
Climate anxiety is an important phenomenon to study because its effects are not limited to people
experiencing first-hand biophysical impacts from climate change. Instead, anyone with access to
climate change information through modern communications technology is potentially susceptible
to experiencing this anxiety response (Pihkala, 2019; Whitmarsh & Capstick, 2018). In the present
study, climate change anxiety is about climate/eco-anxiety, which refers to fear, frustration, and
concern over environmental and ecological issues, which stems from the awareness of the
increasing life threats from climate change.
Research suggests that climate change anxiety is a very relevant issue in many parts of the world.
For example, a study conducted by Mercado (2016) found that climate change awareness is
positively related to distress, concern, and perceived risk from climate change. Searle and Gow
(2010) also found that concern about climate change was positively associated with symptoms of
depression, anxiety, and stress among a sample of Australians. Further, a study of US adults by
Helms et al. (2018) showed that concern about adverse environmental impacts on nature, plants,
and animals—otherwise termed biospheric crisis—was related to ecological stress related to
depressive symptoms.
Moreover, the increasing global awareness of climate change and its life-threatening impacts have
reminded humans of their inevitable death, which causes changes in their behavior. Terror
Management Theory (TMT) explains such changes in behavior and attitude. For example, Fitri et al.
(2020) stated that “death anxiety stimulates intolerance of uncertainty” (p. 3). Humans are
uncomfortable with uncertainty, which causes them to worry and stress, which drives them to
overcome death anxiety. Furthermore, Terror Management Theory suggests that climate change
threats and mortality defenses influence the attitudes and behavior of humans, which could
produce both negative and positive outcomes (Fritsche et al., 2010; Fritsche et al., 2012; Fritsche &
Hä fner, 2012).
According to Routledge and Vess (2019), “fear drives people to avoid situations that pose threats to
their life” (p. 304), which includes both external and internal challenges. It was also stated that
although humans can adapt and survive different environmental challenges, humans experience
internal challenges when there is a need to adapt to external changes. With that said, psychological
buffers help people overcome internal challenges. For example, death awareness causes anxiety,
but psychological protectors prevent this from negatively affecting psychological wellbeing (Juhl &
Routledge, 2016).
MENTAL HEALTH – 21st Century

As exemplified by the study of Routledge and Vess (2019), they argued that “humans need a
properly functioning anxiety buffer system that provides a sense of self-worth and meaning in life”
(p. 303); otherwise, it would lead to feelings of anxiety and affect psychological well-being. For
instance, to avoid the awareness of death, humans identify themselves with cultural belief systems,
which enables them to believe that they are essential members of society, increasing their self-
esteem and sense of self-worth (Arndt & Goldenberg, 2017).
In an article by Major et al. (2016), they explored the relationship of Terror Management Theory to
mental health. Terror mismanagement or being unable to regulate death anxiety can result in a
wide range of psychopathology. For example, anxiety disorders, mood disorders, maladaptive
eating, and neuroticism can stem from the lack of anxiety buffering mechanisms. This study was
supported in another article by Yetzer and Pyszczynski (2019), in which they stated that “TMT
suggests that psychopathology occurs when one is unable to use one’s cultural worldview, self-
esteem effectively, and close relationships to manage existential terror” (p. 421). Thus, the three are
essential parts of a person’s anxiety-buffering system.
Furthermore, Routledge and Vess (2019) suggest that humans need a coherent and structured
world because this gives them comfort amidst death concerns. However, because of the changing
climate, today’s generations are forced to endure it along with its risks (Hansen et al.,  2017). People
who are vulnerable to experiencing anxiety from this are those with a high need for structure.
Lastly, it was found that generous and compassionate acts on behalf of others make individuals feel
that they are essential members of society. Therefore, death-related anxiety is lessened when
considering the needs of future generations and by engaging in prosocial behaviors (Wade-Benzoni
& Tost, 2009; Hirschberger et al., 2008).
In the Philippines, various accounts of ecological calamities have been reported throughout the
years. In 2012, Sapir et al. (2012) discussed that the Philippines was among the top five most
frequently hit by natural disasters over the past 10 years. Typhoon Bopha (known as typhoon
Pablo) was said to be one of the deadliest disasters to have occurred, with a death toll of 1901
Filipinos. It was also reported that there are 2.5 deaths per 100,000 Filipinos due to meteorological
and hydrological disasters. Also, a magnitude 7.2 earthquake struck the central Philippines in 2013,
which caused hundreds of injuries and 93 deaths. The said earthquake also affected several
infrastructures—destroying the Church of San Pedro built in 1602 and 10 other historic churches
(Whaley, 2013). Further, the Philippines was one of the countries reported to have experienced
several typhoons in 2018. A total of 6,490,216 Filipinos suffered from the impact, making the
Philippines rank 2nd in the top 10 countries by the number of people affected (Sapir, 2018).
In 2020, the Taal volcano erupted and damaged citizens’ houses and livestock. Regan and Jorgio
(2020) reported that the volcano has been emitting ash in the air that reached about 9 miles
(14 km). The surrounding areas within the range experienced a shortage of power and fresh water
supply. This calamity resulted in 300 evacuation centers serving as temporary shelters for over
70,000 Filipinos. With the Taal volcano being in the Pacific Ring of Fire, the report states, “a series
of deadly earthquakes between October and December rattled the southern Philippines, leaving
600,000 people in need of assistance. Two typhoons in December killed at least 26 people and
caused millions of dollars of damage” (para. 56) as well. With that said, plus the damage in
agriculture costing 74,549,300 Philippine pesos due to the ash fall, the economy and people are
negatively affected (Regan & Jorgio, 2020).
MENTAL HEALTH – 21st Century

In a study conducted by Hugelius et al. (2017) on the health effects of disasters in the Philippines,
mental health impacts are significantly higher and more enduring than physical problems after an
environmental catastrophe. Thus, Hugelius and colleagues emphasized the importance of assessing
health’s psychological and social aspects to provide proper interventions. Furthermore, the
American Psychological Association (2018) reported that 68% of Generation Z (Gen Z), individuals
ages 10–26 (Schawbel, 2016), feel a significant amount of stress about the future, which includes
the problem of climate change. Gen Z is more likely than the older generations to report their
mental health concerns. As future primary caretakers of the planet, the current study’s participants
involved Filipinos who belong to Gen Z. This generation of Filipinos will benefit the most from
exploring how climate change anxiety relates to mental health’s vulnerability to adverse impacts
from climatic and environmental change.
Studies on climate change anxiety still have many gaps, and the prevalence of the phenomenon is
difficult to investigate because of these gaps. Furthermore, its clinical definition and measurement
method are not well established; as such, it must be explored more intently (Manning &
Clayton, 2018). Thus, the present study intends to establish an evidence-based connection between
climate change anxiety and mental health. Our results will provide a more in-depth understanding
of these psychological constructs and fill a critical knowledge gap. Since climate change anxiety is
still a relatively new concept, more focus is given to this emerging phenomenon by verifying its
presence, particularly in the Philippine setting.
It is important to note that this study was conducted during the COVID-19 pandemic. According to
Tee, Salido, et al. (2020a), Filipinos reported moderate-to-severe feelings of anxiety, stress, and
depression during the early phase of the pandemic. Another study supported this result, which
concluded that Filipinos experience increased stress, anxiety, and depression than Chinese people
(Tee et al., 2021). Various factors such as gender, age, marital status, occupation, experiencing
physical symptoms (such as headache, coughs, and chills), quarantine, staying at home, negative
cognitions about personal health and COVID-19, concern for relatives, and feeling discrimination
from other countries influence stress and anxiety (Tee, Salido, et al., 2020a). The COVID-19
pandemic is also a challenge to vulnerable groups, specifically Filipinos with rheumatoid arthritis
and systemic lupus erythematosus. Being labeled as weak may cause their experience of moderate
to severe stress, anxiety, and depression (Tee, Tee, et al., 2020b).
MENTAL HEALTH – 21st Century

College Students: Mental Health Problems and Treatment Considerations

Paola Pedrelli,  Maren Nyer, Albert Yeung, Courtney Zulauf, and Timothy Wilens
Published online on: August 21, 2014
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4527955/
Attending college can be a stressful time for many students. In addition to coping with academic
pressure, some students have to deal with the stressful tasks of separation and individuation from
their family of origin while some may have to attend to numerous work and family responsibilities.
In this context, many college students experience the first onset of mental health and substance use
problems or an exacerbation of their symptoms. Given the uniqueness of college students, there is a
need to outline critical issues to consider when working with this population. In this commentary,
first, the prevalence of psychiatric and substance use problems in college students and the
significance of assessing age of onset of current psychopathology are described. Then, the
concerning persistent nature of mental health problems among college students and its
implications are summarized. Finally, important aspects of treatment to consider when treating
college students with mental health problems are outlined, such as the importance of including
parents in the treatment, communicating with other providers, and employing of technology to
increase adherence. It is concluded that, by becoming familiar with the unique problems
characteristic of the developmental stage and environment college students are in, practitioners
will be able to better serve them.