Social stigma threatens COVID-19 response but patients heal faster with support, says WHO

*Experts alert to rise in mental health cases as less than 10% of vulnerable people access care in Nigeria
Experts are concerned that the rising stigmatisation of persons with Coronavirus disease (COVID-19) and those who have survived the virus is fueling the spread of the disease and worsening the mental health of the infected and affected population.

However, they say raising public awareness on stories of people who have recovered from COVID19 is a good approach to curb stigma associated with the disease.

As part of efforts to address the situation, the World Health Organisation (WHO) Nigeria is supporting government by championing the “hero campaign”, which aims to disseminate stories of people who tested positive and recovered from COVID19.

More so, WHO said it will continue supporting risk communication activities in form of motorised van campaigns, radio programmes and community engagement across the country.

Anecdotal evidence indicate that stigma associated with the COVID-19 can make people hide when they are sick and can also make people delay in seeking treatment. Individuals can contribute to the reduction of stigma associated with COVID-19, especially those who work at the frontlines and also share information.

A test case, given by the WHO, is that of Fatima Mustapha, a 25-year-old student from Kano state, who recently recovered from COVID-19 in Abuja, the Federal Capital Territory (FCT), who is facing serious challenges of stigma amongst her friends and even family. The emotional turmoil of this experience has made her become withdrawn, keeping to herself in her family house. She had looked forward to uniting with her friends and family members after her 14-day stay in the isolation center but alas, that was not to be.

“Last week, my aunt came to visit and she specifically told my mum to make sure I stay in my room until she leaves as she doesn’t want to contract the virus. Even though my mum tried explaining to her that I was no longer infectious, all her pleas fell on deaf ears,” she added.

In his observation dealing with COVID-19 survivors, a Stress Counsellor with the WHO from the Faculty of Clinical Psychology and Psychotherapy at the Baze University Abuja, Dr. David Igbokwe, shared some advice. “Firstly, the choice of words matter and all are encouraged to use inclusive language and less stigmatizing terminologies. Phrases such as ‘people who have COVID-19’ or ‘people who are being treated for COVID-19’ instead of ‘victims’. Secondly, share information based on latest scientific data and avoid sharing rumours.

Thirdly, talk positively and include encouraging words such as ‘overcome’, ‘prevail’ etc. and avoid use of negative words or messages.”

There are many people like Fatima who, after successfully winning the fight against COVID 19, face stigma in their communities and work places.

Just like her, Mr. Innocent Omoaka of Benin City, Edo state mentioned that most people do not go to testing centres for fear of stigmatization. They are afraid to go there and someone sees them and automatically labels them as COVID-19 patients and people get to distance themselves from them.

“A few weeks ago, some sample collection centers were commissioned and I decided to go get tested even though I did not have any symptoms. To my surprise, the information circulated within minutes in my community and people were scared to come close to me. I was clearly discriminated against because most of them believed I had the virus and was not being open about it; some even wished me quick recovery. No amount of explanation could make them believe I was not positive.”

WHO Nigeria Mental Health officer, Mr. Samuel Tarfa, said: “Stigma affects emotional or mental health of stigmatized persons or groups and the communities they live in. Stopping stigma is immensely important to making communities and community members resilient.

“Stigma robs individuals of opportunities that define quality life ranging from satisfactory health care to affiliation with a diverse group of people. It also hurts those who are trying to battle their challenge, it hurts those who lost loved ones due to the condition or are trying to support their loved ones as they cope with the condition.”

Meanwhile, medical experts have raised concerns over the increased mental health ailments in the country.

They stated that workplace stress, unemployment, depression, anxiety predisposes one to mental health issues.

However, Nigeria, a country of about 200 million, boasts of less than 150 psychiatrists, consists of the highest caseload of depression in the continent, ranks 15th in the frequency of suicide globally.

Also, the WHO estimates that fewer than 10 per cent of mentally ill Nigerians have access to the care they need.

Furthermore, a recent WHO-led study estimates that depression and anxiety disorders cost the global economy US$ 1 trillion each year in lost productivity.

To proffer solutions, WellNewMe, a health technology company, partnered with Dennis Ashley Medical Clinic (DAMC), a health service provider, to study the risks of workers developing mental health issues in the Nigerian workplace.

Principal Clinician, DAMC, Dr. Oge Ilegbune, said the strong relationship between physical and mental wellbeing was often overlooked, stated that the individual is in good health only when there is a balance between the different elements of well-being.

She explained that four in five employees in Nigeria are at risk for mental health issues.

Ilegbunne said: “In 2019, over 6,800 employees, between the ages of 20 and 60, from across Nigeria were surveyed on a wide variety of mental health issues, and it was found that 79per cent were at an increased risk of developing mental health issues.

“Studies have shown that at least one in four persons will suffer from mental health issues in their lifetime. Also, a negative working environment may lead to physical and mental health problems, harmful use of substances or alcohol, absenteeism and lost productivity.

“Workplaces that promote mental health and support people with mental disorders are more likely to reduce absenteeism, increase productivity and benefit from associated economic gains.”

Ilegbunne added that healthcare practitioners have a lot of work to do in educating individuals and organisations that a much-needed balance is required to achieve complete good health.

Co-founder, WellNewMe, Dr. Obi Igbokwe, noted that the survey reveals that a third of all the employees were exposed to workplace stress.

Igbokwe explained that the study also showed that eight per cent of Nigerian employees had an increased risk for developing depression, which is double the actual incidence rate currently recorded and making Nigeria the country with the highest caseload of depression in Africa, according to WHO.

He highlighted that stress is often one of those conditions when left unchecked, can have a significant impact on an individual physical and mental state, and sometimes render them incapable of performing an optimal level at work.

Consultant psychiatrist and founder, Green Oaks, Dr. Chinwe Obinwa, cited that the result of the survey should be of concern to all organisations including small businesses to optimise employee mental wellbeing.

She stated that studies have indicated that tailored mental health programmes would have significant improvement in absenteeism and productivity in the workplace.