key: cord-0780248-oijegmps
authors: Iqbal, Yeshim; Jahan, Rubina; Yesmin, Sakila; Selim, Ashique; Siddique, Shaheen Nafisa
title: COVID‐19‐related issues on tele‐counseling helpline in Bangladesh
date: 2020-08-18
journal: Asia Pac Psychiatry
DOI: 10.1111/appy.12407
sha: 676cad6dbae20808d6b14a85f8b08657be15250f
doc_id: 780248
cord_uid: oijegmps

OBJECTIVE: To provide a brief description of COVID‐19‐related issues presented by callers to a tele‐counseling helpline in Bangladesh. METHOD: Counselors who receive calls write brief descriptions of each call. These descriptions were coded and analyzed. RESULTS: Eighty‐six percent of callers displayed anxiety and/or sleeplessness; these callers also displayed a range of issues including family/interpersonal problems, financial difficulties, physical health concerns, mental illness, and difficulty managing quarantine. CONCLUSION: These findings indicate the mental health challenges faced in Bangladesh due to lockdown and can inform future interventions.

COVID-19 is an unprecedented global crisis, with researchers and healthcare professionals urgently organizing to meet the demands it has caused. There is a pressing need for mental health research (Holmes et al., 2020) and evidence on different countries' populationlevel mental health concerns (Rajkumar, 2020) in relation to COVID-19 to inform ongoing policy and intervention decisions. 

Counselors fill out an online call checklist recording demographics (age, gender, location of caller, reason for calling) and basic descriptive characteristics of the calls, including a brief qualitative written description of each call.

The first two authors of this article conducted close readings of the written descriptions of the calls, and each individually developed a set of categories, consisting of subcategories, of the issues presented by callers. A final set of categories was decided upon through discussion and is as follows: psychological symptoms, mental illness, family/ relational issues, managing quarantine, financial/livelihood concerns, health-related concerns, and frontline worker concerns (described in further detail in the Section 3). The second author coded all the calls and categorizing each call into one or more of these categories. The first author coded a random subset of 40 calls and inter-rater reliability was calculated between the first and second authors on this subset (Kappa = 1). The categories developed here are thus entirely data-driven.

In the following section, we provide basic demographics of the callers, followed by a description of how callers fall into the above categories.

The 201 callers were 71% male and 29% female; with a mean age of 39.3 (SD = 12.26, minimum = 17, maximum = 78). Thirty-two percent of callers report from being inside Dhaka (the urban capital of Bangladesh); the rest report calling from various locations outside of Dhaka, mostly rural and subrural.

Of the 201 calls examined here, counselors completed written descriptions for 193 calls. Of these 193, 19 called for information about the service or with an immediate referral request and did not share any personal mental health challenges. The remaining 174 calls were coded.

One hundred and fifty-two (87%) callers described psychological symptoms, which were almost exclusively anxiety and/or sleeplessness about the present situation. Because almost all of the calls display these symptoms, all calls were also coded to include the categories below. The percentages listed below are out of these 152 calls. Thirty-one callers listed more than one of the below categories; for purposes of succinctness, this is not further elaborated here.

Fourteen (9.2%) callers had a diagnosed mental illness (including clinical depression, schizophrenia, obsessive-compulsive disorder, panic disorder. Note that calls that actively displayed suicidal ideation were referred to a different hotline; they therefore do not occur in this data set).

3.2.3 | Family/relational concerns >Sixteen (10.5%) callers were in this category, which included interpersonal problems arising within family members due to lockdown, such as fighting, managing children in lockdown, and an increase in household chores and caretaking.

Forty-four (28.9%) callers were in this category, which included difficulties managing time in lockdown, boredom or restlessness, and problems working from home/balancing personal and professional life 3.2.5 | Financial/livelihood concerns Twenty-eight (18.4%) callers were in this category, which included forced unemployment, needing immediate financial support, or related livelihood concerns.

Sixty-four (42.1%) callers were in this category, which included physical health symptoms or concerns around access to treatment or testing for COVID-19.

Seven (4.6%) callers were frontline (health) workers with concerns about infecting family members/fear for their own health.

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lead to an underrepresentation of family issues. Financial and livelihood concerns also seem underrepresented at 16%, given the economic crisis due to lockdown; however, this may be explained by the existence of these sources of support for individuals. Note also that these are the issues faced during the initial stages of the lockdown, which may evolve depending on how long it continues.

We thank Dr Erum Marium and Arun Das for their assistance in preparation of this manuscript.

The authors of this article worked on the development of the helpline described in this article and currently serve as its supervisors/ advisors.

The data that support the findings of this study are available from the authors upon reasonable request, but are not publicly available due to restrictions governing its use.

https://orcid.org/0000-0002-8841-1079