Anxiety in times of COVID-19, domestic violence and cyber crime: Helplines in Assam haven't stopped ringing since lockdown
COVID-19 outbreak: The team of over a 100 callers — made up of health advisory officers, counselors and medical officers, have reached out to 20,656 people quarantined in Assam and attended to over 132,690 calls as of 10 March, with over 80 percent of these calls related to COVID-19 cases.
Guwahati, Assam: By 23 March, when the countrywide lockdown began, not a single person in Assam had tested positive for the Sars-Cov-2 virus even as the Coronavirus cases in India climbed to 469, with 9 turning fatal. But with several businesses and services pulling its shutters down for 21 days, a new set of frontline workers have entered the battlefield in Assam — tele callers and counsellors.
The 104 Sarathi helpline launched by the Piramal Swasthya Management and Research Institute in collaboration with National Health Mission and the Assam government has been running as a COVID-19 helpline since the lockdown. Apart from disseminating information under the guidelines of the World Health Organisation and Ministry of Health and Family Welfare, the tele callers have doubled up as tele-counsellors now.
The team of over a 100 callers — made up of health advisory officers, counselors and medical officers, have reached out to 20,656 people quarantined in Assam and attended to over 132,690 calls as of 10 March, with over 80 percent of these calls related to COVID-19 cases. Apart from Assam, Piramal Swasthya has been supporting beneficiaries through 104 Health Helpline in 6 other states — Himachal Pradesh, Sikkim, Jharkhand, Chattisgarh, Karnataka and Bihar — in partnership with the state governments.
Although Piramal Swasthya says that they have been providing counselling in addition to medical or health related advise, experts caution that many of their tele counsellors are not formally trained as psychologists. Dr Sangeeta Goswami, a clinical psychologist and founder of Guwahati based Mind India Foundation, recently took a 15-minute stress management for the tele-callers.
"With the COVID-19, everyone has been pushed to the frontline. They have suddenly started getting more calls on anxiety issues, which they are not equipped to handle," said Dr Goswami. "But somehow they have been managing but by talking about the facts rather than feelings"
Addressing mental health issues, she added, also comes with the emotional investment from the tele-callers, which wasn't the case earlier. "One of the tele-callers told me that while listening to the fears of the people, she herself started feeling very vulnerable," she told Firstpost. "This has been quite overwhelming for them"
Since the lockdown, the 104 helpline registered a 250 percent increase in the number of both outbound and incoming calls. So far, 30 cases have been found positive in Assam with 28 connected to the Tablighi Jamaat Markaz cluster in Nizamuddin in New Delhi. As per a statement released by Piramal Swasthya, the helpline has become 'a nodal point for contact tracing to help curb the spread of infection', which has been credited with tracing many of the Jamaat returnees in Assam. The demise of a 65 year old returnee from Hailakandi district on 10 April was the first recorded death in the state from complications caused by the COVID-19 infection.
Dr Goswami said that with the pressure of handling the increasing number of calls, very limited time was allocated for the stress management session, in which she shared some self management tips and group relaxation exercises. "I also gave them tips on employing empathy while speaking to the public, since they are otherwise used to sharing information in a more mechanical manner to dozens of callers"
However, Pomi Baruah, the Deputy Secretary in the Health Department and the Nodal Officer for the 104 Helpline, said that there hadn't been any major surge of calls related to mental health issues. "We have strengthened the counselling services by appointing 3 psychiatrists at the helpline and more are being recruited," she said.
Moreover, Baruah said, mental health professionals from GMCH have started training tele-callers, especially those who are speaking to quarantined patients, over Zoom. "They are being trained on soft skills so that they can speak to them from a very humanitarian point of view," she added.
The tele-callers have also been counselling the quarantined on the stigma that has come to be attached to those tested positive for the virus, she added.
New helplines to address COVID-19 stress
On 7 April, the Psychiatry Department of Guwahati Medical College and Hospital in collaboration with the Assam State Police launched six helpline numbers for tele-counselling, operational from 9 am to 9 pm. Dr Mythili Hazarika, an Associate Professor of Clinical Psychology at GMCH, trained five other clinical psychologists and psychiatric social workers attending to the calls.
"While these mental health professionals had been trained in short modules of support during pandemics but it was face to face. So I had to make guidelines of tele psychological counseling from scratch," she told Firstpost. Meant to address issues of anxiety, fear, uncertainty as well as domestic abuse, anger and children, especially those with special needs, Dr Hazarika said that the counselors had already logged about 40-50 calls in a matter of 2 days. On average, she said, the tele-counsellors are spending about 15-20 minutes per call.
Clinical psychologist, Dr Sandamita Chowdhury said that they had been receiving around 8-10 calls per consultant, which were related to practical challenges during the lockdown and psychological issues. Clocking a 12 hour shift everyday, Dr Chowdhury continues to attend to cases at the Army Hospital in the morning and volunteers from 3pm to 9pm on one of the six helpline numbers.
"On the very first day, I got calls from migrant workers stuck outside Assam who were very anxious about coming home. Then, the father of a patient with Obsessive Compulsive Disorder had called to report that due to the shortage of psychiatric medicines, his daughter's symptoms were resurfacing," she further added.
However, Dr Chowhury said, since this is tele counseling, the psychologists are required to keep it solution focused since they are working in the absence of knowledge of a person's case history and other details. "We also have a line of psychiatrists who we are referring to in case they need urgent help"
Spike in number of domestic violence and cyber crime cases
Meanwhile, the women's helpline number 181 registered a clear spike in the number of domestic violence cases since the lockdown, as has been reported countywide and in other countries, like the United States and France.
Curiously, 181 in Assam had also seen a sudden increase in cyber crimes, with 11 cases related to internet blackmailing out of the 65 complaints they had logged so far, as per Nilakshi Sharma, who manages the helpline in Guwahati.
"It's basically to defame a woman. Many of these men in the age group of 22-26 years don't have anything to occupy them, so they start pressuring their girlfriends to oblige them. If she protests, he'll blackmail her by threatening to post obscene pictures of her," she said.
Per the screenshots they have received from the complainants, Sharma said the accused have sent messages, where the accused threaten to go to the survivor's home and rape/kidnap them and show those videos to their parents.
Whatever the nature of the complaint, helpline managers said they're only effective if the administration is prompt in their response. "The brother of a domestic violence survivor had called us from South Salmara district at 11.30 pm saying that his sister had been thrown out of the house and could not go anywhere because of the lockdown," said Sharma.
When they tried to contact the local police station, the Officer in Charge was very callous in his response and was only sorted out after the Superintendent of Police stepped in. "The OC actually told the survivor that if she had a bike she could come down, or else, it's better she stays at home," she said.
In another case, a woman in Karimganj district was hiding from her husband in the neighbour's house and it took three hours to rescue her. "We had to hire a vehicle and pay for it, which is fine, because we know the police and the administration are already very stressed with the viral outbreak," Sharma added. "They see this as an additional burden"
Dr Hazarika said the data from the calls would be compiled in a research paper as a learning document from the pandemic period. However, Dr Goswami also noted that mental health should not be considered only retrospectively in any crisis situation, as is the norm. "We don't have any psychological preparation in disaster management irrespective of what the disaster is, which is something I've been trying to impress upon the government that this needs to be made a priority," she said. "We really need to have psychological aid for those working in the frontline as well as community workers, particularly the youth, to curb panic among the public"
Regarding the cyber crime cases, Sharma said that the women's helpline tele-callers have had to personally counsel the perpetrators by threatening to book them under relevant sections of the law. "In such cases, women desist from filing a first information report because the accused is known to them," she said.
Since the lockdown, the Assam Police has taken on a massive campaign online in all the districts to curb fake news on social media. As per information shared by the Director of the Information and Public Relations, 8 cases of 'Fake news/misinformation' and 59 cases of 'Rumours and Objectionable comment' had been registered as of 9 April.
Sharma, however, added that she is yet to see more serious action in crimes against women. "We see the police advertising a lot about cyber crime activities. But in reality they are doing nothing"
The author is a journalist based in Guwahati, Assam.
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