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Providing Much Needed Mental Healthcare to Frontline Healthcare Workers in India

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Health worker Monica Ben tying her mask to go to a self-help group meeting hosted by Anganwadi (rural childcare center) worker in Kanthapura, Gujarat, India

Frontline health workers usually have higher than normal levels of stress while providing healthcare in communities. They are facing tremendous stress now in providing care and services, sometimes managing acute cases, through the difficult times of the COVID-19 pandemic. UNICEF has committed to addressing the mental health and psychosocial needs of frontline health workers across all of their work.

With India facing alarming rates of COVID-19 infections, the need to support health workers is critically important. The UNICEF India team has been working tirelessly with the states to respond. They have trained over 2.2 million frontline health workers in infection prevention and control practices, provided critical hygiene supplies to 2.3 million people, and supported maintaining essential health services to over 34 million women and children. The scale of care and services provided by the frontline health worker is deeply impressive, but it also means that they are being stretched thin.

In light of this, UNICEF India, with support from the Johnson & Johnson Foundation, is launching a program that will in part provide psychosocial support to nurses and doctors working on the front line. Collaborating closely with key stakeholders, including the National Institute of Mental Health and Neurosciences (NIMHANS) and professional psychiatry associations, this program aims to build the capacity of state and district level mental health teams and program managers in supporting health workers.

In turn, health workers will be trained in safety and wellbeing practices, specifically tailored to health workers operating in the medical context today. “Now more than ever, healthcare providers prove to be the core asset of every health system in the world,” explains Luigi D’Aquino, Chief of Health for UNICEF India. “Every day, at homes, at outreach sessions and at healthcare facilities, healthcare providers put their lives at risk and face tremendous pressure and challenges to protect the right to life and health for women and children, and for communities at large. This effort in India serves as a first engagement through our partnership with Johnson & Johnson Foundation to provide psychosocial and mental health support for health workers.”

This new program in collaboration with the Johnson & Johnson Center for Health Worker Innovation will provide healthcare workers on the front line and facilities access to dedicated mental and psychosocial services and support. By mid-2021, UNICEF, through government systems, aims to reach 45,000 healthcare workers across 7,500 COVID-19 hospitals and healthcare centers across the country. The program is designed to reach more than 200,000 doctors, nurses and community health workers with this essential support by the end of three years.

The need is immense: mental health conditions affect one in four people over a lifetime and are responsible for more than 10% of the global burden of disease.[1]

“At the Center, we believe that the key to ensuring high-quality access to healthcare for everyone, everywhere, is a strong health system with well-trained and well-equipped frontline health workers,” says Katsura Tsuno, Director of Global Community Impact in the Asia Pacific region. “In India, like many countries around the world, the COVID-19 pandemic is placing a high burden on frontline health workers and they are experiencing high levels of physical and mental exhaustion. These health workers face overwhelming workloads, medical supply shortages, depletion of personal protective equipment and the reality of losing patients and colleagues amid the pandemic. This is why we are partnering with UNICEF to provide psychosocial support for frontline health workers and improve health care workforce resilience.”

Mental health is a global issue, yet it remains stigmatized and underfunded in almost every country, whether rich or poor. This World Mental Health Day, UNICEF calls on governments to invest in mental health and psychosocial support services, including for frontline health workers.

“The Center works with partners such as UNICEF to address the most pressing challenges faced by frontline health workers,” adds Tsuno. “Because if we solve the challenges facing frontline health workers, we will improve healthcare for everyone.”

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Self Help Group meeting hosted by Anganwadi worker, Laxmi Parmar to discuss preventive measures for COVID 19

[1] Erskine, R. (2015). Psychology, Mental Health and Distress. Mental Health Practice, 19(2), 10–10. doi:10.7748/mhp.19.2.10.s9