COVID-19: Mental Healthcare without Social Justice?

Mental health is not just about absence of mental illness. It is critical that the government takes long-term economic and mental health policy measures to ensure employment, basic amenities and public health, without which mental healthcare cannot address the debilitating effects of ongoing structural violence on a majority of citizens.

The general view of professionals within mainstream psychiatry and medicine as well as social media-dependent masses is that a pandemic, such as COVID-19, creates trauma-triggering mental disorders, of which post-traumatic stress disorder (PTSD)¹ is the predominant one (Taylor 2020). This conception is based on the premise that it is primarily the traumatic event (for example, the outbreak of a life-threatening pandemic) rather than the adverse sociopolitical conditions preceding and succeeding (poverty and migration of labourers) that inflicts the mental health of the person. Is one of the worst affected sections during the pandemic—migrant labourers, whose life, health or mental health has always been at risk (Yadav 2018) even before this pandemic—really concerned about diagnosis and treatment for PTSD or other disorders? No, they are not. In most of the developing societies of the world, the less privileged have feelings of being further dehumanised when exposed to political violence or other massive traumatic events like COVID-19, irrespective of developing PTSD² following the traumatic events. For them, the causes for concern and distress are the questions of survival by finding employment or resuming one’s work, safeguarding social identity and individual voice that are under threat, and ensuring education for their children (Bracken et al 1995; Priya 2015, 2018; Summerfield 1999; Viswambharan and Priya 2016; Weiss et al 2003).

As Summerfield (1999) has pointed out, even the psychosocial intervention towards mental health does not appear meaningful to them if the structurally induced injustice is not acknowledged by the interventionist. Given that, in today’s world marked by neo-liberal push towards decreasing allocation of funds for health and education by the government, insecure employment and commodification of labour or human capital—all of which propagate denial of equity and equality, thereby creating injustice for the less-privileged—how can one imagine mental healthcare without social justice? More specifically, we would analyse how the unjust neo-liberal context may threaten mental health and related care for citizens during this pandemic.