YouBelong conducts rapid Covid-19 Phone Survey
May 14, 2020
From 8th to 18th April 2020, YBU conducted a phone survey of individuals (and their families) within the Kampala and Wakiso Districts recovering from severe mental illness, who have been interacting regularly with the YBU Team as part of enrolment in the YouBelong Home programme between November 2017 to April 2020. Attempts were made to contact 150 persons. Phone access was achieved with 113 persons.
The phone survey addressed two main areas: 1. The level of accurate evidence-based information about COVID-19 held by families contacted in the survey. 2. The impact of COVID-19 and the national lockdown on the physical and mental health of individuals (and their families) recovering from severe mental illness.
Three broad themes emerged concerning the current and impending impact of COVID-19.
Firstly, the survey results indicated that the Ugandan Government’s information sharing strategy about COVID-19 was having an adequate level of impact in the survey group in imparting knowledge about the causes, symptoms, precautions and where to seek health support. Commensurate with the Ugandan Government’s dissemination of official evidence-based information, 67% of participants displayed an adequate level of knowledge of COVID- 19.
At the heart of responders’ comments, however, were expressions of fear and anxiety at the impending COVID-19 crisis. Further survey questions explored this emotional response and provided more detail indicating, amongst family members (including children), high levels of fear, anxiety, a sense of hopelessness and helplessness regarding the level of impact of impending COVID-19, as well as the lockdown. In Ugandan culture, it is not uncommon for people to place catastrophic events or diseases in a context of spiritual/cultural belief that is beyond human intervention or control, and for some in this survey, this framing was evident.
As well, the survey identified a sense of loss of control over one’s life and a need for a sense of personal and family-centred security. Besides knowledge about COVID-19, families were seeking practical guidance and leadership about what to do and not to do if/when high levels of infection rates occur in communities.
Secondly, while those surveyed recognized the extent of their psychological stress, their attention (seemingly at the expense of their psychological needs) was more geared towards prioritizing basic living needs, such as food for survival during the lockdown period. A large number of contacted families were only eating one meal a day during lockdown. Money was reported to be scarce due to stopping of primary income generating activities, leading to food rationing in the family home and inability to pay essential utilities bills. As one family member said ‘we will die of hunger before coronavirus’. The need for daily food for families had been prioritized over other physical and mental health needs, including the need for medications.
Thirdly, and following on from the above, compromised health care has occurred during lockdown. Survey participants with health needs indicated anxiety at not being able to access health centres that, for most surveyed, were many kilometres away. Individuals recovering in the family home from severe mental illness indicated experiencing additional stress, resulting in a relapse of symptoms for some. Health care was compromised through lack of money due to the suspension of income generating activity and the suspension of public transport leading to major challenges in traveling to health facilities to obtain medication refills. These factors have exacerbated the deterioration of physical and mental health conditions, including the difficulty to manage behaviour of some family members with severe mental health conditions. Concerns about access to health services for physical health problems, particularly reproductive health emergencies, has added to individual and family distress.
At the conclusion of the phone survey calls, participants were asked what they thought the Ugandan Government could do to help them during the COVID-19 crisis. The overwhelming majority of responses were related to addressing concerns about the basics of life, particularly the provision of food, and followed by concerns regarding access to medications, public transport and the ability to engage again in income generating activity.
The survey brings out some key insights about the mental health impact caused by the serious threat to life and wellbeing of COVID-19, as well as the mental health consequences of social distancing and national-level lockdowns, consequences that, by their nature, will have long lasting mental health effects on sections of the population following the COVID-19 crisis. This potential risk raises the question of how planning for recovery can be inserted into public health policy planning and implementation during the crisis response phase for COVID-19 in Uganda?