“I get angry so easily. I always try to find scopes to go outside, but even if I go outside, there’s no one to meet. And it’s just, I feel really disturbed in my head, and I can’t wait for all of this to end. I feel depressed and angry. On social media, when I communicate with other people, they get angry. So our relationships are getting worse, between my friends and I.” -- Asif (24, male)
University students are already susceptible to certain mental stresses; the combination of academic pressures, living away from home, and irregular sleep patterns may exacerbate the risk of poor mental health.
Growing stress and anxiety
A study of 590 undergraduates at Jahangirnagar University used the DASS-21 to measure depression and anxiety and results showed that 52.2% of the participants suffer from moderate to extremely severe depression; 58.1% had moderate to extremely severe anxiety; and 24.9% had moderate to extremely severe stress. Considering the situation of mental health, both globally and locally of young people, it is important to consider the impact of the lockdown due to the pandemic on psychological well-being of university students.
For university students, the step toward normalcy is clear: Reopening educational institutions. University students are used to a certain level of uncertainty in their day-to-day lives. They have to maintain a balance between family life, social life, and their grades and academics. This can be a difficult balance to strike even on the best of days.
Thus, when faced with quarantining and a shutdown of educational institutions, students have found themselves in a completely unprecedented and precarious situation. Suddenly, their usual routine has been halted -- they are no longer carrying out their daily commute to complete classes or meeting friends afterwards for tea and adda.
In order to understand the mental health impacts of the pandemic, BRAC James P Grant School of Public Health undertook a rapid mix-methods study, where we interviewed 73 students from 11 public and private universities about their experiences. This rapid research assessment was funded by the Imperial College London, as part of a larger study on mental health.
A heavy toll
The results are not surprising -- the pandemic took a heavy toll on their well-being. Among the respondents of our study, a majority (59%) reported that the situation was significantly affecting their mental health and well-being. While around a third of them reported a moderate impact, further questioning revealed that many students were feeling anxious, and even depressed, due to the lockdown.
The shutdown of universities had enormous social implications on students as well. Students were most concerned about not being able to meet friends (46%) and feeling cooped up at home (37%). They reported being unable to tolerate staying at home for such long periods of time.
Many revealed that university gave them a reason to get out of the house, allowing them to have freedom, independent lives, meet their friends, and socialize. The situation was worse for those who had experienced more autonomy while living in dorms and halls.
A respondent Arifa (20, female) shared: “Our moms or aunts are used to staying in the house during their time, but for our generation, we spend most of our time outside the house, either for study or work purposes and meeting our friends. So now, staying in the house makes us feel like a prisoner.”
Ruhul (21, male) told us: “I already had anxiety, and now I feel even worse … Due to this, I have started suffering from insomnia. I also feel lonely, as I can’t meet with friends like I used to. This is also affecting my studies. This is also having an effect on my physical health.”
Growing fears and a lack of support
A large number of students shared fears around not being able to graduate on time (71.2%), and thus having limited job prospects. Graduation is directly linked to their future plans -- whether it is looking for jobs, applying for higher education, or even getting married.
Respondents such as Samia (21, female) tell us: “We know that this lockdown will last. In the beginning, we were ready for this. But day-by-day our tension is increasing. Now it seems unbearable. Now we realize we are very helpless. Nothing is in our hands.”
The pandemic has created a uniquely challenging situation for the students interviewed, and possibly their families as well. As these young students attempt to develop coping mechanisms for the new situation they find themselves in, it is apparent that they are under-equipped with the resources that could help them.
When we asked how students are managing their stress, many described support networks among friends or family (primarily their mother). However, only a handful mentioned the availability of counselling services at their university. There was no mention from the students about external centres promoting psychosocial support and care.
A need for better mental health services
This is unsurprising as mental health care currently makes up only 0.05% of Bangladesh’s health budget (WHO, 2020), and the newly drafted National Mental Health Strategic Plan 2020-2030 is yet to be implemented.
Mental health in Bangladesh is both underserved (less than 1 outpatient facility per 100,000 according to WHO) and under–researched.
There are many barriers to the uptake of mental health care in the country, including but not limited to, awareness, affordability, accessibility, and stigma.
While private and non-governmental organizations have also taken a few steps to introduce psychosocial support online or over the phone (organizations like Kaan Pete Roi, Moner Bondhu, and Moner Jotno Mobile E), they have their limitations. Awareness of such services is low, and they also have inadequate manpower and cannot cater to the needs of the whole nation.
When asked for recommendations to improve mental health and well-being, our respondents suggested spending time with family and trying to remain productive with the free time available.
However, there is no mention of the need for improved mental health care.
This speaks to the resounding silence around the need for better services.
There needs to be better messaging to raise awareness and break the stigma around mental health services.
It is also urgent for the government to increase spending and decentralize the available services so adolescents can access these services from across the country.
Overall, there is a need for targeted mental health support for students -- who are now approaching one year since the academic institutions shut down.
Schools and universities can act as a bridge to promote mechanisms and outreach programs in the form of online or over-the-phone counselling to help students.
Psychosocial well-being impacts all other aspects of our health and productivity and it is high time we make mental and emotional health care a priority.
The PI of the project is Dr Sabina Faiz Rashid, Dean & Professor, BRAC James P Grant School of Public Health, BRAC University. Selima Sara Kabir is an Assistant Research Coordinator, Sameen Nasar is a Senior Research Associate and Rituja Shome is a Senior Research Assistant at BRAC James P Grant School of Public Health, BRAC University. Names used in the article have been changed to maintain privacy.
