Celebrated every year on October 10th, World Mental Health Day raises awareness on mental health issues and helps prevent the stigma attached with it.
This year, World Mental Health Day developed a deeper meaning, as our daily lives have significantly changed because of the Covid-19 pandemic. In the last few months, the pandemic has brought new challenges: to doctors who provide care under difficult circumstances, to students who adjust to studying from home, to workers who have lost their jobs or whose income has significantly decreased, and to a huge number of people who find themselves in poverty or in unstable humanitarian situations.
Experience taught us that the need for psychiatric and psychosocial support substantially increases in times of emergencies: it is expected to increase in the coming months and years. Mental health programs have chronically been underfunded for many years, at both national and international levels. They are today more important than ever. The goal for this year’s World Mental Health Day campaign is to increase the investment in mental health.
But is it also possible for you to protect yourself from depression and anxiety on your own? Head of the psychological assistance program at the NGO Proliska, Olga Klimovskaya, shares her insight with us.
Olga Klimovskaya is confident that having basic psychological self-help skills will help maintain mental health in the face of the Covid-19 pandemic.
Question: Olga, thank you for agreeing to this interview. According to WHO, pandemics are characterized by an increase in anxiety and depression. Have you observed this?
Olga Klimovskaya: Indeed, we observe that many people experience anxiety and suffer from depressive conditions. This is natural when the situation is uncertain or threatening, when you do not know what to expect. But if people possess skills that help them to cope with difficult situations, it is much easier for them to go through this difficult time.
Question: How can such skills be acquired? Are there first steps to take when you start to feel bad?
Olga Klimovskaya: In general, the main task of a psychologist is to give people effective tools and skills to help them cope with the situation on their own. There are five steps you can and should take yourself.
Step 1 – Normalize your daily routine. It is very important to get enough sleep, eat regularly and maintain good hygiene. Yet, often people in a state of stress forget to do basic things and this further exacerbates the situation. They think: “the main thing for me now is to survive, and then I will return to a normal regime.” But actually, it is these basic actions that help you survive. Wake up in the morning, wash your face, brush your teeth and focus on these simple steps.
Step 2 – Treat yourself to something nice every day. Listen to your favorite song, watch your favorite movie, talk to the person who makes you happy. Even in difficult situations, you can find 15 minutes to please yourself with something you like.
Step 3 – Communication. It is necessary to find a way to communicate, even if it is a simple phone conversation. It is very important to hear the voice of another person. It doesn’t matter what you talk about. Even a simple “Good afternoon, how are you?” can help relieve stress associated with a lack of communication. Also, avoid people who are a source of stress.
Step 4 – Filter the news you read. Anxiety can be caused by over-reading the news and winding yourself up. Get back to things that are simple and stable. Take a walk, breathe fresh air, consume less information and use trusted sources of information.
Step 5 – Seek help if needed. It is worth remembering that stress responses are different from an individual to another: your response is the normal response of a normal person to abnormal circumstances. Be attentive to yourself, take care of yourself. If, despite following the previous recommendations, your condition does not improve, if it is difficult for you to fall asleep, to concentrate, if your mood does not improve and especially if you have thoughts of harming yourself or others, you should contact a psychologist and ask for help. Sometimes a few consultations are enough for your condition to improve significantly.
Question: If one has made the decision to seek help, how can they find a psychologist?
Olga Klimovskaya: There is several organizations and hot lines you can contact. Psychologists at the NGO Proliska help the most vulnerable – people who live near the contact line – by providing them with personalized assistance.
Question: How does State-sponsored psychological assistance work? What kind of support does it provide?
Olga Klimovskaya: There is medicine, or you can turn to a hospital for help. There are school psychologists. There also are centers that provide social services. Although, they unfortunately are underfunded and understaffed, you can still find specialists who can provide basic support. Moreover, a program is being introduced, which trains family doctors to provide basic psychological support and prescribe basic medication. This is a good initiative. Often people may not reach a psychologist based somewhere far away. It is easier for them to share their problems with the family doctor. This program, Mental Health Gap Action Programme (mhGAP), works very well all around the world.
One central question is now being discussed: is mental health support a medical service or a social service? If it is a social service, then communities should fund it. But it is difficult for them to find resources, especially so for communities without land tax due to mine contamination. There is a revenue problem so it is not clear how to find funds. There are often no specialists either. It is very good that international organizations are funding this work, training specialists and preparing to transfer programs to communities and perhaps to governmental organizations that will help communities that do not have the necessary resources.
Many communities are now learning how to plan social services: what services are needed and how much they cost, how to find specialists and much more. With State help, communities will gradually assume all of these functions. They will have to because international organizations will not be able to provide funding all the time.
Question: What are the needs for psychological assistance now? Do Proliska and UNHCR have information on the needs of people who live close to the contact line?
Olga Klimovskaya: The expert opinion is that the structure of needs is the same here as where an emergency occurs. If a person’s basic needs are not met, they begin to feel psychological discomfort. That is, if we can ensure a decent life for a person, their psychological state also improves. This is a very important principle of UNHCR’s work. The agency primarily strives to uphold human dignity.
More often than not, there is also a need to create a space where a person feels comfortable to communicate. Due to quarantine, this is not always possible. But you can still talk on the phone. Recently, UNHCR and Proliska collaborated with Vodaphone Ukraine to provide free mobile credit to more than 2,500 people. Connecting with other people solves some of the problems.
We are also talking about more focused work: for example, providing first psychological aid to a person who cannot cope with difficult events.
We do work a lot with people living near the contact line and teach them self-help skills. Recently, in a village of the region, I witnessed a very sweet scene: an elderly woman was showing another how to calm down, using our technique for this. I was very glad to see our methods being passed around from person to person.
However, it often happens that basic techniques alone are not enough to help. In this case, it is necessary to conduct deeper individual work. I am very grateful to the Johns Hopkins University in the United States of America for developing the CETA method (Common Elements Treatment Approach). CETA specifically focuses on working with people living in crises area. I am also grateful to the Kyiv-Mohyla Academy for adapting the method to our country’s context. We use this method very effectively with people who live close to the contact line.
Question: Psychologists constantly train and study. How is psychology developing now?
Olga Klimovskaya: I graduated from the Faculty of Psychology at Karazin Kharkiv University. We learned the theory, how to conduct diagnostics, but were not given any practical skills on counseling. Now there are more and more new methods of working with people. I really like the CBT method (Cognitive Behavioral Therapy) as it is based on results of practical work. It contains many simple tools that school psychologists and paramedics can also use. All over the world, training in specialized intervention methods takes place in special courses and programs. One more very important point: psychologists work with their soul. They face someone else’s pain and help them to cope with it. Therefore, it is very important for psychologists not only to study theory and methods, but also to receive support from colleagues. Regularly having their work reviewed also helps checking whether they are correctly applying methods they were taught.
Question: Is it important for people to know about neurotransmitters and other physiological aspects that affect a person’s mental state?
Olga Klimovskaya: It is important people learn effective self-help methods. For some, it is enough to know the practical steps that can balance neurotransmitters, such as getting enough sleep, eating right, thinking “good” thoughts. Other people seek to delve deeper to understand how this works at the level of physiology. This is very individual.
Question: What are the most difficult situations?
Olga Klimovskaya: They are the one where people experience states of despair, shame and fear, when it seems to them the situation is hopeless. But when they start to feel better, there is a way out. There are very positive stories of people finding strength and healing an inner wound; their life then becomes better. These are very complex traumas such as torture, sexual assault, or other traumatic events. They are many people who overcame such traumatic experiences and found the strength to live a full life.
Question: Children born in the last 6 years have always lived in the conflict zone. How can this affect their condition now and in the long term?
Olga Klimovskaya: The condition of children is very dependent on the condition of their parents. If parents cope, then children also feel more confident. Therefore, psychologists pay a lot of attention to working with parents. Undoubtedly, trauma associated with the conflict will remain in society for a long time. Some psychologists say that still today, we see consequences of the trauma of World War II. This is still affecting society, yet it was so long ago. Wars, conflicts, pandemics are very scary. We understand this will require a lot of work. The main thing is to be able to get support. Our psyche is very flexible and can recover from any injury. It just takes time and support.
Question: Over the past 6 years, what has been the happiest day in your professional life?
Olga Klimovskaya: It is every day: when I see a person is coping and finds hope again, when they understand that they are good and that there also are many good things in the world. This is a holiday for me every time.
Olga Klimovskaya has been working for 2 years at the Proliska humanitarian mission, which is implementing a UNHCR project to provide assistance to people living near the contact line. Psychosocial work is an important aspect of the project. Proliska employs 11 professional psychologists who constantly improve their skills and apply innovative methods. For 2 years, more than 5,500 people received support and returned to a normal life.
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