By Tara Gibson - October 14, 2020
In jurisdictions where lockdown restrictions have been gradually relaxed, communities have had the opportunity to ease into the “new normal” stage-by-stage. That's not the case for at-risk individuals who have remained in self-isolation, and who now may be suffering from extreme return anxiety.
Since the relaxing of lockdown restrictions, many people have expressed anxiety about returning to day-to-day activities such as commuting to work, shopping in crowded supermarkets, or sending kids to school. These fears are completely justified. The relaxing of lockdown restrictions was not prompted by the virus going away; the motive was to restart economies once healthcare systems had sufficient capacity to cope with new outbreaks.
For some, the relaxing of lockdown restrictions couldn’t happen soon enough. For others, economies opened too quickly without safeguards in place to mitigate the risk of further infection. For a third group, their lockdown experience continues - albeit self-imposed - due to the extreme risk to their physical health of contracting even the smallest dose of COVID-19. This group also is at extreme risk of developing mental health issues once they have no option but to re-enter society.
At-risk individuals are people with pre-existing conditions that make them more vulnerable to the consequences of COVID-19. Some at-risk individuals have pre-existing conditions due to living an unhealthy lifestyle, but many more are at-risk due to having compromised immune systems. This may be - for example - because they are undergoing treatment for cancer or due to taking immunosuppressant medications that prevents their bodies fighting the virus.
As a rule, it is hard to identify at-risk individuals with compromised immune systems just by looking at them. They are not necessarily overweight, they do not pause for breath after modest exertion, and other than the fact they are taking immunosuppressant medications, they led normal, active lifestyles - until the start of the COVID-19 pandemic. At the start of the pandemic, at-risk individuals were advised to shield themselves from society by staying home - where many of them still are.
As individuals, we all cope differently with situations such as lockdowns. Many people will identify with the subconscious implications of long term lockdowns on their mental health - a loss of concentration, the avoidance of certain situations (which can also be a conscious decision), disturbed sleep, and emotional agitation. While we may not understand why - for example - we find it harder to concentrate at times, these are all symptoms of anxiety.
For those of us who were able to take advantage of the relaxation of lockdown restrictions as they happened, the transition to the new normal has been a gradual process - enabling us to cope with each symptom of return anxiety as it manifested. However, for at-risk individuals who have been shielding, but who now have to commute, shop, or send kids to school, all the symptoms of return anxiety - plus the symptom of hypervigilance - are hitting them all at once. It's a very scary place to be.
The normal course of action for individuals suffering from severe anxiety is to seek counselling; but for many at-risk individuals, face-to-face counselling is out of the question, and not all at-risk individuals have access to technology that would enable them to participate in remote counselling sessions. Furthermore, many at-risk individuals do not have the funds or healthcare coverage to afford the mental health services they need.
An inexpensive solution for public health departments is to develop an “at-risk database” that can be used to check-in on individuals by SMS text to see how they are coping and offer support when it is needed. The database would differ from a vulnerable needs registry inasmuch as at-risk individuals may not identify themselves as qualifying for special attention under the CMIST definition of vulnerability, and would not take advantage of the service.
The simplest way to set up an at-risk database is to invite at-risk individuals to text a keyword to a short code number (i.e. “HEALTH” to 123456) to be included in the database. Thereafter, at-risk individuals could be sent periodic text messages in a question and answer format to enquire about their levels of anxiety and whether or not they require help with day-to-day activities. An example of a question and answer text could be:
Q: How are you feeling today?
A1: I'm fine and getting on with stuff.
A2: I could do with talking to somebody.
A3: I am unable to cope with going out.
At-risk individuals respond to the text messages by pressing the corresponding number on their mobile phones. The responses are collated by the database's software so that public health departments can prioritize resources to where they are most needed and identify non-respondents for follow-up calls. Ultimately, a system of this nature could significantly reduce individual mental health issues, the societal cost of return anxiety, and the potential for an increase in suicide.
Tara is a Marketing Coordinator on the Rave Mobile Safety marketing team. She loves writing about all things K-12, State & Local, Higher Ed, Corporate, and Healthcare, and manages the Rave social media channels. When she's not working, she's taking care of her smiley, shoe eating, Instagram-famous fur baby, Enzo!
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