Talk therapy groups provide mental health support during the Covid-19 lock down

Etheldreda Nakimuli-Mpungu

Emerging reports into Covid-19 from China and the UK suggest that the pandemic could have profound and potentially long-term impacts on mental health.

In Uganda, as in most countries, the pandemic has placed communities under lock-down leading to social, emotional and economic challenges.

The social isolation, excessive anxiety, uncertainty about the future, financial losses, unemployment are some potent risk factors for mental health problems including depression and anxiety.

Unfortunately, communities across Africa are challenged by limited access to mental healthcare in the context of wider structural problems of access to healthcare.

Given that the cooperation of community members is crucial to the uptake of prevention strategies of the spread of Covid-19, it’s important that African governments establish effective approaches to combat high levels of stress among socioeconomically-disadvantaged populations in sub-Saharan Africa.

Covid-19 emergency response teams should have a strategy to promote and support mental wellbeing particularly in vulnerable groups.

The Innovative strategy a team of African and International researchers has provided evidence that through talk therapy groups, multiple mental health problems, social and economic challenges can be mitigated with task shifting approaches.

A recent study into the effectiveness of talk therapy groups published in the Lancet Global Health in March 2020 has shown that nearly all participants in the groups achieve remission of stress symptoms and remain stress free one year later.

Talk therapy groups are based on the theory that the way we think affects the way we feel and subsequently the way we behave.

For example, when you think that “I can never be successful in any business because of the Covid pandemic”, then you are going to feel demoralized, this negative feeling is associated with negative energy which will make you feel weak.

This will cause you to have less interactions with people so your chances of learning about promising viable options are greatly reduced. Consequently, you are unable to engage in any other income generating activity, hence unable to regain your income.

Subsequently, you will feel more demoralized and this will confirm your negative thoughts that your business will never recover. So the negative cycle goes on and on and you spiral down into depression.

The talk therapy groups focus on reversing this negative cycle by teaching participants skills required to always maintain a positive outlook.

To add some icing on the cake, participants learn income generating skills. Unlike other therapies, these talk therapy groups attract both men and women and have been proven to be a very cost-effective way of dealing with high levels of stress.

All types of health cadres and lay people have been trained to lead these therapy groups which can be a valuable tool in curbing the mental health effects of the Covid-19 lockdown.

Integrating talk therapy groups into other COVID-19 prevention strategies taking place across vulnerable communities will not only improve awareness about Covid-19 in rural communities but will also reduce levels of social, emotional and economic stress.

For communities with access to smartphones, talk therapy can take place online.

For example, the telehealth service run by The Medical Concierge Group (TMCG); a leading telemedicine and digital health company in Uganda can create a tele-mental health platform.

Individuals struggling with depression symptoms, anxieties, loneliness, excessive anger and those coping with problems by using excessive alcohol or drugs can engage in talk therapy sessions individually or in a group through voice calls, SMS and social media with a trained counsellor.

Mental health issues that cannot be resolved through first-line talk therapy can be addressed through coordinating and facilitating referrals to the existing mental health facilities.

Evidence of the feasibility and optimal value of tele-talk therapy has been reported in studies from other parts of the world.

Given the Covid-19 pandemic, an online talk therapy platform run by mental health professionals is urgently needed to support the mental health of the general population.

The author is a senior lecturer & Psychiatric Epidemiologist Department of Psychiatry, School of Medicine Makerere University College of Health Sciences.