KARACHI: Mental health professionals in Pakistan have turned to digital counselling amid the Covid-19 pandemic that has made access to face-to-face psychotherapy difficult as millions remain confined at homes.
Experts fear that social isolation, a lack of routine and sudden changes in plans can be ideal breeding grounds for anxiety and depression and tough measures taken to restrict movements and social gatherings can limit access to help.
“Online counselling is coming as a saviour for millions during the lockdown. The hospitals and medical centres should be avoided as they are most contagious in this dire situation which makes therapy from home far safer,” says psychologist and expert in cognitive behavioural therapy Tipu Pervaiz while speaking to The Express Tribune on why remote help is coming across as a “better option”.
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“People are deprived of face-to-face counselling and therapy and being in isolation is going to make the situation even worse for those vulnerable to mental illnesses. Many are going to have symptoms like stress and anxiety,” Pervaiz maintains, adding that this is where psychologists and therapists can become the front line of defence for those battling a range of emotions.
Calling online counselling the need of the hour, Pervaiz says it is a more practical and a realistic approach to lending a helping hand when the person needs it the most.
“If a person is having a panic attack or feels depressed, he/she needs help right away, not tomorrow or a week later,” he says, noting that visits to therapists require appointments in advance which could mean help may not be provided at the required time.
Meanwhile, ReliveNow, a mental health advocacy group, has launched free, 15-minute counselling sessions to help individuals deal with psychological problems and traumas in times of a global pandemic.
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Put in practice from March 19, the initiative particularly caters to the people with several mental illnesses that are also at risk of exacerbating due to the uncertainty created by the Covid-19 and the steps enforced in the wake of it, such as social distancing and lockdown, demanding significant changes in people’s lifestyles.
“One of the major things to come out of this [virus outbreak] was mental health and significant stress among people,” says Amna Asif, Founder and CEO of ReliveNow. “We have conducted over 200 sessions up to now and want to help people in whatever way we can within their premises.”
Asif pointed out that most of the clients availing services from them were women as there had been cases of domestic violence and abuse too, which is one of major outcomes from the current situation.
On digital counselling, she says she came up with the idea to have a more “accessible and affordable” platform for mental health in 2018.
“There was a stigma attached to it [mental health] and many victims would just not go to clinics to seek help, afraid of being termed crazy,” Asif recalls as she points out a “wee bit” improvement in people’s perception towards mental health now compared to when she started.
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“The millennials are more accepting of the new changes and open to discussions on mental health,” she remarks with a whiff of relief.
Asif says she wanted to create a digital platform for mental health in Pakistan which was “specifically bilingual and culturally apt” and where people could be heard and given professional support easily. However, she bemoans that there were really few qualified mental health experts for the country’s total population.
Future of digital counselling
According to researchers, the results achieved from face-to-face counselling can be attained through digital means as well. Studies published in the Journal of Affective Disorders and Cyberpsychology and Networking showed texting a therapist to be just as effective as meeting them in real life.
The study at the University of Zurich found out that depression in patients treated online decreased compared to a “minimal decline” in those who were treated conventionally. “No more depression could be detected in 57 percent of patients from online therapy compared to 42 percent with conventional therapy,” it said, also concluding that degree of satisfaction with the treatment and therapists was “more or less equally high”.
But despite the switch to online mediums and their effectiveness in providing counselling, there are also concerns over privacy and qualifications of therapists.
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Speaking to The Express Tribune, 26-year-old Maryam Ali* said that she thinks her communication is a lot more interactive and productive with her therapist when it is face-to-face as she feels “more secure.”
“I don’t always feel comfortable online or on video calls to discuss issues that are so complex. Real connection tends to take a back seat when we start relying on technology so much,” she says. “A proper treatment requires frequent visits and not just one session so it is greatly affected now due to the lockdown and physical distancing,” she continues.
Patients who prefer face-to-face counselling also say networking issues and lack of proper technical facilities have been some of the hindrances faced during online counselling sessions.
*(Name has been changed to protect privacy)