Latin America’s mental health impacted during the pandemic

RIO DE JANEIRO, BRAZIL – Of the countless costs that the novel coronavirus pandemic is exacting on humanity’s well-being, one of the least visible but potentially most costly in the long run is on minds and emotions.

At a first glance, disruption to mental health can be seen in the number of people who reported feeling worried, anxious and depressed during any one week in the past year and a half.

But this is only the tip of an iceberg with deeper roots in one of the regions most affected by the virus, and simultaneously with poorer starting conditions to cope with all the consequences it has produced.

The waves of infection have produced peaks (and valleys) of anxiety. In Latin America’s large countries, the surge in cases were mostly accompanied by an increase in the percentage of people that during those days reported having experienced this feeling.

Furthermore, in most countries, April and May 2020 showed much higher levels of anxiety than expected because of the still low spread of the virus at the time. The anticipation of what was to come (one of the defining features of anxiety patterns) presumably triggered the numbers, which would later normalize.

In Brazil, Peru and Chile this combination is remarkable. But another phenomenon emerges with particular intensity in Colombia and Mexico: after a sharp spike in contagions, reports of feelings of anxiety remain high for a while, without fully subsiding, suggesting a more permanent kind of vigilance over time, a reflection of the anticipation observed 18 months ago.

While reports of anxiety followed these varying dynamics, the percentage of people reporting depression-like feelings increased noticeably and more consistently in virtually all countries during the period.

In some, such as Brazil and Colombia, the trend appears to have begun to taper off in recent months, but with a much milder downward slope than the upward climb, suggesting that the return to mental and emotional normality will be slower than its breakdown, probably in tandem with an emergence from the pandemic and all that surrounds it that does not appear easy or quick.

These reports of feelings of anxiety, depression, and simply concern in no case correspond to diagnoses of anxiety disorders and depression. That is: a person with such a diagnosis will have the corresponding feelings, but their occasional presence does not point to a structural pathology.

So, when comparing the pandemic reports with the prevalence of clinical diagnoses in each country before the pandemic, two relationships become relatively clear. The higher the prevalence of anxiety and depression in 2017, the higher the percentage of people reporting feelings of anxiety and depression in 2020 and 2021, respectively.

This connection opens the door to a two-way feedback loop. People with a previous pathology see how it deepens, or simply subsists, due to the pandemic context. And in others, the problem can be triggered to the point of becoming constant.

In the United States, for example, a significant increase in symptoms related to anxiety disorders has been noted, particularly among young adults (18-24 years old), who are more sensitive to a disruption in their daily lives caused by the pandemic at a time that is critical to their maturity, both socially and emotionally.

Moreover, mental health services are overwhelmed, which like for other pathologies, were unable to operate regularly during the pandemic, something that the World Health Organization (WHO) warned about in October.

In Latin America, the starting point was less solid in itself: a 2017 Pan American Health Organization report measured coverage for mental health problems in countries across the American continent, based on expert opinions from each country. The consensus: the lower the income, the lower the coverage. Regionally, this is particularly true in Central America and the Latin Caribbean.

In addition to the deficiency in supply, there is a challenge in ensuring that it meets the demand. For some time now, campaigns to raise awareness and end stigmatization such as the Colombian #NoEsDeLocos have been trying to build these bridges.

Likewise, the visibility that sports references, like gymnast Simone Biles, and cultural references, like musician J Balvin, have given to this range of disorders through their own testimonies can contribute to consolidating a more homogeneous, informed, and stable demand for clinical support.

But just as the path to receiving treatment differs between and within countries by socioeconomic bracket, so do the deeper factors that not only condition effective access, but the likelihood that certain pathologies will emerge and take root in a pandemic context.

Structural factors

Mental health issues are by definition the product of an interaction between individual and environment. In detailed data from the U.S. during the pandemic it is noted that while 17% of people in households with an income above US$90,000 per year expected the Covid-19 crisis to have a “major impact” on their mental health, the percentage doubled (35%, one-third) among households earning less than US$40,000 a year.

Based on these data it would be possible to state that living conditions that produce a lower safety margin, less room to complete personal goals, and definitely more uncertainty, can favor the emergence of symptomatic pictures related to depression and anxiety.

And indeed, basic concerns, such as covering financial and food needs, were particularly high during the pandemic. So was the attempt to prevent human contacts, raw material for meeting socio-emotional needs. All of these were noted primarily in Bolivia, Venezuela, and Guatemala.

In fact, there is an apparent relationship between the level of initial income in the country and the degree of material concerns during the pandemic.

This same relationship also occurs with the availability of mental health coverage, producing a kind of vicious circle, a poverty trap, that may be deepening in the pandemic context.

It will take a few years for incidence data of clinically diagnosed disorders to confirm and rule out these assumptions, assessing this particular price to be paid by minds and emotions.

Source: El Pais