“We’ve got through hard times before” : acute mental distress and coping among disadvantaged groups during COVID-19 lockdown in North India - a qualitative study

Abstract

Background The COVID-19 crisis in India negatively impacted mental health due to both the disease and the harsh lockdown, yet there are almost no qualitative studies describing mental health impacts or the strategies of resilience used, and in particular, no reports from the most vulnerable groups. This study aimed to examine the acute mental health impacts of the COVID-19 crisis as well as coping strategies employed by disadvantaged community members in North India. Methods We used an intersectional lens for this qualitative study set in rural Tehri Garwhal and urban Dehradun districts of Uttarakhand, India. In-depth interviews were conducted in May 2020 during lockdown, by phone and in person using purposive selection, with people with disabilities, people living in slums with psychosocial disabilities and widows (total n = 24). We used the framework method for analysis following steps of transcription and translation, familiarisation, coding, developing and then applying a framework, charting and then interpreting data. Findings The participants with compounded disadvantage had almost no access to mobile phones, health messaging or health care and experienced extreme mental distress and despair, alongside hunger and loss of income. Under the realms of intrapersonal, interpersonal and social, six themes related to mental distress emerged: feeling overwhelmed and bewildered, feeling distressed and despairing, feeling socially isolated, increased events of othering and discrimination, and experiencing intersectional disadvantage. The six themes summarising coping strategies in the COVID-19 crisis were: finding sense and meaning, connecting with others, looking for positive ways forward, innovating with new practices, supporting others individually and collectively, and engaging with the natural world. Conclusions People intersectionally disadvantaged by their social identity experienced high levels of mental distress during the COVID-19 crisis, yet did not collapse, and instead described diverse and innovative strategies which enabled them to cope through the COVID-19 lockdown. This study illustrates that research using an intersectional lens is valuable to design equitable policy such as the need for access to digital resources, and that disaggregated data is needed to address social inequities at the intersection of poverty, disability, caste, religious discrimination and gender inherent in the COVID-19 pandemic in India.

Psychological Burden and Experiences Following Exposure to COVID-19: A Qualitative and Quantitative Study of Chinese Medical Student Volunteers

“…A teacher (LL) and two graduate students (KZ and YP) collected the data after receiving data collection training. Qualitative recordings were transcribed verbatim and analyzed using the seven steps of the framework analysis method i.e., transcription (converting recording to text version); familiarization (familiarizing ourselves with the entire interview process by recording, transcribing material and reflective notes); coding (coding all relevant things from as many different perspectives as possible); developing a framework (coding the first few records separately to form a set of codes that could be applied to all subsequent records and keeping an “other” code under each category to avoid ignoring inappropriate data); applying the framework (using the existing categories and codes for analytical application); charting and then interpreting data (coding the interview data and analyzing the links between categories to explore relationships and/or causality) [ 18 , 19 ]. Two researchers independently reviewed the interview materials, summarized and extracted meaningful statements.…”

Informal settlements in the context of COVID-19: Pandemic restrictions and the building of community resilience

“… 42 The COVID-19 crisis and blockade measures can also have an impact on the mental health of vulnerable groups. 43 In summary, for people in informal settlements, damage from virus control may outweigh the health risks of the disease. 44 The disparities between rich and poor and the unequal distribution of resources are magnified during crises like a pandemic.…”

The good, the bad, and the mixed: Experiences during COVID-19 among an online sample of adults

“…Here, we distinguish between psychological experiences during COVID-19 (e.g., feeling stressed, sad, or lonely) and COVID-19 stressful events (e.g., job loss, death). Heightened levels of mental health difficulties were commonly reported (e.g., distress, anxiety, depression) [4,5,9,10]. However, emerging longitudinal research suggests these effects may be small, and there is likely considerable variability in the psychological experiences of COVID-19 [6].…”