Mental health wise, all of us have been affected: Harvard's Shekhar Saxena

Speaking to Anjuli Bhargava from his residence in Geneva, Saxena says the severest toll of the Covid-19 pandemic may be on the mental health of large sections of the human population

When it comes to mental health, we are all developing countries, says Shekhar Saxena, professor of the Practice of Global Mental Health, Harvard T H Chan School of Public Health. Speaking to Anjuli Bhargava from his residence in Geneva, Saxena, whose career of 43 years includes stints at the All India Institute of Medical Sciences (AIIMS) and World Health Organization (WHO), says the severest toll of the Covid-19 pandemic may be on the mental health of large sections of the human population. The world, he thinks, may have to grapple with a generation that suffers from the ill effects of this catastrophe for decades to come. Edited excerpts:

Man is supposed to be a social animal, but a lot of people have now developed an aversion to or even fear of meeting others. How will it change going forward?

Yes, this is happening everywhere. Some people have reached a new normal and may revert to the old ways of doing things or socialising. Through the pandemic, many have adapted to this new reality where active socialising has been discouraged.

There are two factors for this. One is the anxiety playing on everybody’s mind as we are still not out of the woods. More waves, more variants and the consequent fear of uncertainty remains with everyone. What will tomorrow bring? This had earlier been quite certain. Now, it isn’t.

Second, change is difficult for most people. Adjusting to new realities and finding ways of satisfying one’s needs in a changed environment has already happened once in the last year-and-a-half. This way of working, this way of deriving pleasure and this new way of socialising. Now, it is difficult to change back yet again as many are deriving enough gratification in what they are now doing. They have found an equilibrium, which they don’t want to disturb again.

One can understand this for those who seem happier, but not everyone is. What does this mean for society when physical activity, too, has been restricted?

In terms of decreased physical activity, we will begin to see the manifestation of this new behaviour. Many who have settled too well will never come back to the old ways of living, socialising and moving around freely.

Take the instance of working from home. A very large number will never go back to everyday office; and companies are having to adjust as their employees simply don’t want to revert to the old ways. I’d say this is a generational shift we are seeing in our lifetime. I can’t remember any single episode in my lifetime that is changing the way we live and work as dramatically as this.

Some of the things that happen may be good in the short term but maybe not so over a longer period of time. I do think the mental effects may be very bad for society as a whole. If people hardly meet each other, what will be the impact on our social fabric, family ties and consequently, their mental well-being and resilience as individuals, as families and as a society? Many of these are unanswered questions.

Mental health has to be seen as a dimension or a spectrum rather than as a binary between people who are well and those who are not. When I was studying psychiatry, we were told that there are people who have a mental disorder — just like physical diseases — and there are people who are okay. Over the years, I have realised that we are all on a spectrum between excellent mental health and very bad mental health, and we move from one end to the other in time. There is no fixed state as such. So somebody in excellent mental health today may be in poor shape tomorrow, or a few years later. In the pandemic, I would say all of us have moved.

What can the government do to help with this silent pandemic?

It will be very expensive and harmful to ignore mental health as a society. One that I can suggest right away is that the new health and wellness centres being set up by this government — there are 50,000-odd — need to incorporate and provide trained medical staff that can focus on the mental health of citizens. What is worse is that the mental health of healthcare professionals is in a very precarious position currently. Take the word “wellness” seriously. Wellness is not just physical; it is also mental. In fact, it can be more mental than physical.