Despite the Covid-19 pandemic resulting in a global upsurge of mental health challenges, it has also had a “silver lining”; that of reducing the stigma around mental illness, leading psychiatrist, Anton Grech told The Malta Independent on Sunday.

“What happened was that before, psychiatry was always stigmatised, but now that anxiety is affecting more people and there is more awareness because of the impact of Covid, we are noticing that people are becoming more accepting of the need to increase help for mental conditions. So at least there is a positive aspect to it,” said Grech.

“In every cloud there is a silver lining,” he remarked.

Grech noted that, for a long time, many people didn’t understand that “people, who have mental health challenges, would be suffering from an illness like any other physical condition”, which he noted has become evident through science.

He explained that a person suffering from a mental illness would similarly be experiencing a malfunctioning (differing in severity), of one of the body’s organs: the brain.

“The brain is an organ in our body just like the heart and the kidneys, a marvellous organ but it can also go wrong like any other organ,” stated Grech.

Preventative measures

Grech, interviewed on the occasion of World Mental Health Day which is celebrated today, told this newsroom that stress is one of the leading triggers for mental conditions and that therefore, resilience to stress is paramount to maintaining a healthy state of mind.

Thus, he noted that besides increasing education about mental illnesses, mental health education and awareness is paramount.

He said that physical health is an integral part to maintaining mental health resilience since, as he put it: the physical part and the mental part of the body are “the same system”.

For example, he noted that the circulation of blood is essential for maintaining mental wellness, since the brain, like any other organ in the body needs enough blood flow to function properly.

“There is no health without mental health,” he remarked.

Furthermore, Grech noted the importance of our close networks in preventing mental illnesses.

“One of the main factors which prevent mental illness is having a close social network,” said Grech.

He informed that the earlier one picks up on signs of mental health struggles, the better the outcome of treatment will be, and thus will improve the changes of that person recovering.

Moreover, he spoke about the need for more education about mental health in schools, as a crucial part of preventing mental illness was “learning how to live within society”.

Furthermore, when asked about preventative measures for suicide, Grech said: “Research has shown that the best way to prevent suicide is to provide care to mental conditions. By far, nearly all the people who have committed suicide are because they had been passing through a psychiatric condition.”

Thus, he noted that though increased amenities for suicide prevention are important, the most important thing is to provide enough psychiatric care that is accessible, so that people can get the treatment they need as soon as possible so as to prevent getting to that stage.

Treatment: Which to go for?

Grech noted how each mental illness requires a different method of treatment and that in some cases medication is a very important part while in other times it’s a minor part. He also noted how different conditions need different amounts and types of therapy.

He informed that in treating someone experiencing a mental health condition, one needs to take into consideration three aspects: the physical/biological aspect, the psychological aspect (how a person feels) and the social aspect (how one acts), which altogether make up the bio-psychosocial model.

Some conditions, which are more biological like bipolar disorder, often require more treatment with medication, but in other instances, like for example if someone is passing through bereavement, psychotherapy is more important, he said.

Where to go for treatment?

When it comes to acute, urgent cases, wherein one feels like they need immediate help, Grech said that these people should seek help at the emergency department at Mater Dei hospital, where they will find a psychiatrist, who will offer immediate assistance.

On the other hand, he noted that if one is not requiring emergent care for their mental state, then the best way to seek help would be to go to a general practitioner (GP), who will be able to refer that person to one of the free mental health centres around Malta and Gozo.

Grech remarked how psychiatrists try as much as possible to prevent admission to hospital and to reduce people’s stay therein. But, when certain conditions are “acute” and the person can no longer take care of himself/herself (especially if the person becomes a danger to himself or others), Grech said that one would need a “place of safety” where they can be monitored by nurses on a 24/7 basis. In these cases they will be referred to Mount Carmel hospital.

 

Covid-19 transformations on mental health services

Grech noted that the World Health Organisation’s (WHO) Europe branch has set up a Covid-19 technical advisory group, of which he is a member.

It consists of various experts in mental and public health who report on the impacts that the Covid-19 pandemic has had on mental health in their respective countries so as to develop and implement newfound strategies across Europe as a whole.

He said that statistics have shown that women and children were the most affected by the mental health challenges that are resulting from the pandemic.

He said that one of the main factors for an increase in mental health struggles, since the onset of the pandemic, was the breakdown of people’s social networks along with financial anxieties and the looming fear of themselves or someone close to them passing away suddenly from the virus.

Moreover, he spoke of the increased uptake of “unhelpful coping mechanisms” like the consumption of alcohol − that many people adopted to cope with the increase or onset of anxiety − which in itself could enable depression among other mental health conditions.

When asked for his views on cannabis, Grech advised that legal or not, people should avoid it since research has “repeatedly” shown that cannabis itself can cause mental illness.

Moreover, Grech noted that besides the pandemic having reduced some of the stigma on mental illness, the newfound WHO psychiatry Covid-19 technical advisory group is enabling an increase of mental health services across Europe.

Thus, Grech noted that new projects aiming to harbour mental wellbeing in Malta are “in the pipeline”.