5 ways CARE is keeping mental health at the heart of our coronavirus response

People queuing for food parcels at a CARE distribution in Honduras

Around the world, we are all facing the uncertainty and anxiety of the coronavirus pandemic.

But imagine having to choose between buying soap or food, or to social distance in an overcrowded camp, or to fear violence while you are supposed to be safe at home. Now more than ever, being mindful of our own – and others’ – mental health is fundamental to our ability to get through this together.

Here are five ways CARE is responding to mental health during the COVID-19 pandemic:

1. Telephone hotlines

I left Venezuela with my husband and two daughters, two years ago. We had to sell our house and a motorcycle. With the quarantine, my husband lost his job and all of us are starving. My husband was thinking of returning to Venezuela but the situation there is so dangerous, we don’t have any kind of protection. I want a future for my children, a place where they can study.
– A caller to CARE Ecuador’s telephone helpline

As stress levels have risen due to COVID-19 globally, so has the number of hotline calls. With 500,000 Venezuelan refugees in Ecuador facing uncertainties about their migration, CARE Ecuador’s telephone hotlines provide legal support as well psychosocial counselling.

With some of the world’s strictest lockdown measures, CARE Jordan activated hotlines staffed by teams of case managers and counsellors to respond to inquiries, provide referrals and offer counselling to cope with the challenges and new circumstances across the country.

In Palestine, only 8% of women – compared to 67% of men – can access mental health services. According to CARE Palestine’s partner SAWA, hotline calls regarding mental health support and abuse/violence reports increased by 20%, since the pandemic started. The majority of these calls came from young men and adolescent boys that experienced abuse at home. Once the hotline extended its hours, there was a 38% increase in women’s calls regarding abuse and domestic violence from partners.

2. Counselling and advice on gender-based violence

I am the victim of several acts of violence on the part of my husband. Before, he did nothing to contribute. I used to fight to feed the children. Now it's hard. I ask him for money to feed the family and it's all the time arguments and fights. He also rapes me for sex – he wants to insist. The kids are fighting all the time in the house too.
– Response from a women’s group participant in Cameroon when asked about the impact of the pandemic

The impact of COVID-19 on mental health is also closely linked to rising cases of domestic and gender-based violence. If COVID-19 related restrictions extend for  six more months, this could result in 31 million additional cases of gender-based violence worldwide. In a recent CARE report on West Africa, women reported high levels of fear of going outside, due to the risk of catching coronavirus, but also from staying inside the home, due to an increased risk of domestic violence. 92 of the 100 countries CARE is working in are focusing on tackling gender-based violence – for example, by setting up online or telephone services for gender-based violence survivors in places like Ecuador, Timor Leste and Egypt, or by creating national gender-based violence awareness campaigns social media, radio or TV.

In March 2020, 35% more cases of domestic abuse were reported across Kosovo than in March 2019. CARE Balkans partners with the SIT Centre, the only NGO providing mental health counselling for men and adolescent boys in Kosovo. Kadri Gashi, founder of SIT, says:

When the lockdown started, we needed to find solutions, so we started lectures on mental health, yoga, mediation sessions and information on gender-based violence, all online.

promo flyer for podcast
Promo for ‘Podcast Youth’, started by Center E8 in Serbia to help young people coping with the challenges of the pandemic

3. Online safe spaces for youth

We are a team of young people that are working for young people. So, we decided to think outside of the box and invent some ways to be there for them. We saw the crisis as an opportunity to expand and we just had to make it happen. So now we have recorded 12 podcast episodes and they're about mental health.
–Jan a ŠARIĆ, Coordinator at Centar E8, a CARE partner working on the Young Men Initiative in Serbia

With interruptions in the school calendar and social life, the COVID-19 pandemic is predicted to have serious long-term consequences for young people’s mental health. Even before the pandemic, more than one in five people living in conflict settings had mental health conditions, many of which started in the adolescent years, by the age of 14. In the Balkans, a post-conflict region dominated by patriarchal gender norms, young people reported three stress factors to CARE and its 16 partner organisations: being overwhelmed with e-learning sessions, missing their “freedom” to be with friends, and uncertainty about their futures.

CARE Balkans’ partners mobilised quickly and developed activities for young people, including Zoom group calls, yoga sessions, live lectures with psychologists, Instagram contests, mobile counselling and even a new Youth Podcast. “Partners are expanding having 20-30 calls a week to talk to young people about their issues,” says Emilija Milenković, Project Manager of CARE’s Young Men Initiative (YMI) in the Balkans. Staff not only provide advice but also offer support through role models and giving a sense of belonging to nearly 30,000 students and young adults. Rubin, 18 years old, a YMI participant at his high school in Albania, says:

We’ll talk about our feelings, our experiences. We have talked at least one time a week. And sharing our feelings makes us discharge the negativity. We are happy we have such great support.

emojis in phone chat (mock-up)
Emojis are being used to communicate safety with GBV survivors in Ecuador (replicated conversation)

4. WhatsApp support groups

For the women who do get through to us, or who contacted us before the lockdown, we know many of them risk using their aggressor’s phone to reach out for help.  It is extremely challenging to support women under these circumstances, but we have found ways to do it. We have created a coded system of emojis so the women can communicate with us undetected, via WhatsApp.
– Amparo Peñaherrera, who works for a CARE partner organisation which runs a shelter for women survivors of gender-based violence in Ecuador

CARE staff have had to adapt quickly due to the new COVID-related challenges, turning to technology to communicate with participants and conduct programming. In Ecuador, partners carefully communicate with gender-based violence survivors trapped in their homes through coded emojis. For example, a mouse might mean “I need to hide” or a cat “I need help to escape”.

Even before the coronavirus pandemic, mental health services were limited in West Africa and, psychologists were rarely consulted due to strong public prejudices. For emotional, social and economic support, Village Savings and Loan Associations (VSLAs) have created a safety net and safe space for the women during times of stress such as the current pandemic. VSLAs are central to CARE’s programmes in West Africa and have played a critical role in community disease prevention and response. For example, WhatsApp’s accessibility and voice note option for illiterate populations makes it a preferred tool. It helps members stay connected and reinforces an atmosphere of solidarity.

5. Peer-to-peer psychosocial support training

We select volunteers from the (internally displaced) camp, who are living in each area. Because they are living there in the camp it is easy for them to monitor patients, people at risk of non-communicable diseases, because they are neighbours. They are trained for communication skills and counselling skills. So, in this situation, while we are not there, we can ask them to provide care for their patients.
– Aimee I. Mateo, Health in Emergencies Project Coordinator for CARE Philippines

Empowering local people with tools and training to overcome challenges is fundamental to CARE’s work. When intense COVID-19 measures banned travel within the Philippines, staff were prevented from going to certain isolated communities, such as the internally displaced people in Marawi City. However, they found a way around this by equipping communities and neighbours with psychosocial and health support, through a series of family trainings on gender-based violence, family planning and conflict resolution. Janerah Abdulmoin, CARE Philippines’ Partnership and Advocacy Officer in Mindanao, says:

I think this is a domino effect, like if mental health is not addressed it will affect them physically and there will be more problems.

When she can finally go back to Marawi City, she will meet with the community volunteers to have a ‘kumstahan’ to hear about house visits and provide psychosocial support to volunteers.

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News and stories are provided by CARE staff working to support our emergency responses and long-term development programmes.