BETSHY

Tag: Mental Health

  • Signs, Symptoms and Indicators of Domestic Abuse

    Signs, Symptoms and Indicators of Domestic Abuse

    This blog post will educate the reader about the signs of domestic abuse , and how to identify it in every day life. It also touches on the specific symptoms and indicators of female genital mutilation, forced marriage, honour-based abuse, and digital domestic abuse; as well as who is most at risk from experiencing these.

    Physical Abuse

    Individuals affected by physical violence present with recurrent physical injuries such as black eyes, bruises, split lips, marks on the neck, or sprained wrists. Moreover, the explanations given for these injuries might be inconsistent, and might be obviously a cover-up for something else. Finally, they might also wince when making motor movements as if in pain and trying to avoid pressure on a specific part of the body. However, it must be noted that perpetrators tend to be wary of where they leave marks, so as to avoid getting caught. So in many cases, physical abuse is hidden from the public eye and the victim is manipulated into keeping things secret. Physical signs of domestic abuse might not always be visible because the perpetrator might be ensuring that they leave no evidence that could incriminate them. This might mean that they will attack the victim in specific hidden places such as the head, the stomach, or breasts, among other places. Furthermore, they might have manipulated the victim to hide the marks, or to keep silent; and the victim might actually be using clothing, make-up, and accessories to actively cover the injury. 

    Emotional & Psychological Abuse

    Individuals affected by emotional abuse present with symptoms of agitation and anxiety, chronic tiredness and insomnia, substance or alcohol use disorder, submissiveness (e.g. apologising all of the time), anhedonia, low self-esteem, low self-confidence, fear or wariness, depression, and/or suicidal ideation. Whilst these symptoms might not always be caused by domestic abuse, these are commonly experienced by people who are in abusive relationships. Therefore, it is important to take into account these indicators when safeguarding adults from potential abuse which might be hidden. Emotional signs of domestic abuse are inherently invisible and can only be detected by observation. If the victim does not have a support network who knows them well, it might be more difficult for anyone to notice any differences in behaviour. Furthermore, not everyone is equipped with the knowledge to correctly identify signs of emotional abuse. Moreover, victims might actually avoid disclosing anything, especially if the perpetrator has manipulated them to keep things to themselves through blame and/or threats. 

    Individuals affected by domestic abuse present with behavioural markers that could reveal their ordeal such as drastic behaviour or personality changes, unjustified self-isolation, being unable to attend scheduled meetings, avoidance of social gatherings, the sudden reluctance to engage in activities once enjoyed, and/or secretive behaviours. Furthermore, the individual might appear anxious and/or fearful, and their behaviour might seem extremely ‘well-behaved’ when around their perpetrator. These individuals may try to cover up the abuse they are being put through by giving excuses that are unrelated to what is actually happening. Behavioural signs of domestic abuse are difficult to pinpoint if the victim is not known to the witness very well, and therefore the witness cannot notice a change in usual behaviour. This means that unless someone notices the situation, a bystander intervention is unlikely, especially when the victim makes excuses for apparent unusual incidents which no one can recognise as an inconsistency. 

    Coercive Control

    Individuals affected by coercive control present with signs and indicators such as asking their perpetrator for permission to socialise with others, receiving numerous texts and/or calls from their perpetrator, having no money or access to it, having no car and being picked up by their perpetrator all the time, and/or needing to be home at specific times. These individuals might also keep these patterns secret, and might actually feel shame related to their ordeal. Signs of coercive control are often quite hidden from everyday life because the victim might appear to be respectful rather than fearful of her perpetrator. Others might not pick up on the abusive flood of texts and/or calls, or might not understand that all of these communications come from the perpetrator. Furthermore, victims might feel embarrassed to disclose their financial situation and/or dependencies, and might avoid answering truthfully when questioned about details. 

    Female Genital Mutilation (FGM)

    Women who have been genitally mutilated present with difficulty walking, sitting, or standing; they show signs of being in pain, and may spend longer in the toilet than usual. They might be anxious, depressed, and/or might be self-isolating without a justification. They might present with drastic changes of behaviour and personality, may engage in truancy at school/college/university, might become absent from work and/or might withdraw from social activities. Furthermore, the Home Office has a list of countries flagged as ‘risky’ when it comes to female genital mutilation. These are Somalia, Kenya, Ethiopia, Sierra Leone, Sudan, Egypt, Nigeria, Eritrea, Yemen, Kurdistan, and Indonesia. Women and girls at risk of female genital mutilation are those who speak about special ceremonies or rituals about womanhood in their culture, those who say that they are going on holiday outside the UK, those who say that a ‘special’ relative is coming to visit them, and those have family members who have been already mutilated. This means that when women and girls present with any of the above indicators, and especially when they have connections to any of the blacklisted countries, they should be safeguarded through bystander intervention.

    Forced Marriage

    Forced marriage happens here in the UK and also abroad. Sometimes only the woman is forced, and other times both parties are forced. Individuals affected by forced marriage present with truancy or absence from work, fearfulness and anxiety about holidays, failure to return to occupational life after a holiday, not being allowed to study or work, having excessive parental control,  depression or isolation, and/or attempts to escape their ordeal at home. Furthermore, those at risk of being forced into marriage include those who have connections to those who have already been forced to marry, and those whose culture promotes early marriage. Countries known to have child marriage include Nigeria, Central African Republic, Chad, Bangladesh, Mali, South Sudan, Burkina Faso, Guinea, Mozambique and India (Reid, 2018 ); as well as Pakistan (Ijaz, 2018). 

    Honour-based Abuse

    In some cultures, the family or community might attempt to protect or defend their shared values through abusive means and/or threats of abusive means such as harassment, assault, imprisonment, murder and rape. This is what is known as honour-based abuse and it is directly linked to beliefs, and attitudes. Individuals affected by this type of abuse present with drastic changes in behaviour or personality, anxiety, demotivation, poor performance, excessive control by others, self-isolation which cannot be justified, confrontational and argumentative behaviours, truancy or absence from work, attempts to escape their ordeal, self-harm, depression, substance or alcohol use disorders, suicidal ideation, and/or actual bodily harm (ABH). Furthermore, individuals at risk of honour-based abuse include those who have relatives who have been forced into early marriage, and those who come from cultures where honour-based abuse is perceived as normal. Countries flagged as risky when it comes to this type of abuse include Turkey, Kurdistan, Afghanistan, South Asia, Africa, the Middle East, South and Eastern Europe, and traveller communities. This means that people from these cultures are particularly at risk of being abused. 

    Digital Domestic Abuse

    Digital domestic abuse entails harassment, bullying, and/or stalking through an online platform, and/or the restriction of someone from  accessing technology. Individuals affected by digital domestic abuse present with an excessive number of texts/calls, appear visibly upset or distressed after texts/calls, online attacks against their integrity, and online embarrassing media involving them. Furthermore, individuals who are being coercively controlled through technology present with a monitored access to social media, emails, and/or the internet by their perpetrators,  signs that others have access to their personal digital accounts, a controlled access to technology by the perpetrators, a recurrent pattern of asking for permission from their perpetrator before connecting digitally with the people in their lives, an excessive guardedness about what is said in emails or other digital platforms, and/or a recurrent pattern of borrowing other people’s technology for access to the internet. Moreover, an individual can be both abused digitally, and also face to face, with punishments, reprimands and other negative consequences used by the perpetrator to intimidate the victim into obeying. 

    References

    Ijaz, S. (2018) ‘Time to End Child Marriage in Pakistan’, Human Rights Watch, 9 November [Online]. Available at https://www.hrw.org/news/2018/11/09/time-end-child-marriage-pakistan (accessed 14 February, 2022). 

    Reid, K. (2018) ‘Untying the knot: 10 worst places for child marriage’, World Vision, 6 July [Online]. Available at https://www.worldvision.org/child-protection-news-stories/10-worst-places-child-marriage (accessed 14th February, 2022).  

  • Women Who Are Mad

    Women Who Are Mad

    De facto and de jure social injustices are an expression of the id quo. These impulses have a detrimental effect on women’s daily lives, making it a lot more difficult for them to enjoy their human rights. This document has shared data particles of knowledge about current injustices occurring to ‘mad’ and ‘intersectional’ women in the UK, the psychological impact of these injustices (e.g. Borderline Personality Disorder), and the legal framework of international law, which the UK is subject to. De jure and de facto injustices exacerbate mental health problems, and lead to the introjection of maladaptive behaviours, and can corrupt the individual superego. Furthermore, UN Women (2016) recommends that  all countries take on board the Istanbul Convention, and the UK is a country member of the UN Security Council. The UK’s Domestic Abuse Act 2021 does not fully cover all the criteria necessary for the prevention and protection of women’s rights, as well as the prosecution of perpetrators of violence against women. Similarly, the Equality Act 2010 only protects some of the many characteristics that elicit discrimination against human beings, and the word ‘dignity’ does not appear once in the Human Rights Act 1998. This seemingly innocuous semantic exception is a malpraxis. All these technical legislative failures lead to very costly consequences for the least advantaged in the status quo. The facts and figures have shown that women in the mental health sector are the most affected group, out of which patients with BPD tend to struggle the most with daily attitudinal obstacles, intersectional discrimination, and de facto impediments.

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    Women Who are Mad (1) Download

  • Authoritarianism in Mental Health Settings

    Authoritarianism in Mental Health Settings

    When I began this journey in Forensic Psychology, I did not expect to learn as much as I have. The main tenet of this career consists in understanding psychopathy , and psychopathology.

    It does make me question authoritarianism and the ways in which it can manifest. For instance, Milgram and Adorno et al. studied the psychology of obedience under pressure, and how following orders led to the holocaust. An aspect that has been questioned little is how scarcity or the fear of scarcity has led to similar phenomena due to how people have been conditioned to see money as an enabler of everyday behaviour. For instance, when Milgram conducted his obedience experiments during the 60s, he monetarily rewarded his participants for taking part in the studies. Modern psychologists have attempted to re-examine the dynamics at Yale’s laboratory and what might have led the participants to show that they were capable of being sadistic under such conditions. An example is Gibson’s (2013) work which meticulously examines the prods given by the experimenter. In a way, Gibson seeked to understand how the orders and requests given by the authority figure contributed to the decision-making processes of the participants. However, I have not come across much research highlighting the role of the monetary incentive in everyday behaviour; or how being given a monetary incentive places a subconscious obligation on individuals to comply with requests, even if such requests at times make them feel uncomfortable.

    The c/s/x movement, also known as ‘the psychiatric survivors movement‘ (Wikipedia, n.d.) explores how a large number of individuals report feeling or having felt dehumanised by the mental health system. For the unstigmatised person, it is often more common to assume that all these people expressing dissatisfaction with the system are crazy, than to understand the nature of what it means to respect a person’s dignity and human rights. It is quite a complex situation, because it is unclear what reinforces and keeps some mental health settings from actively listening to their patients’ concerns.

    According to Turner (2015), signal detection theory (SDT) “describes processes whereby information that is important to the perceiver (known as the ‘signal’) is distinguished from other information that is unimportant and potentially distracting (known as the ‘noise’). It is my hypothesis that some of the inherently dehumanising behaviours occurring in the mental health system happen as a result of the hyper-normalisation of object-relations with patients. As I mentioned on my post ‘Investigating the neuropsychopathology of prejudice‘, people can at times perceive those with stereotyped and stigmatised characteristics as non-human objects. This would of course increase the chance of mental health settings staff processing signals coming from clients as background noise, rather than as worth-listening-to human signals. Such established conscious and unconscious behaviours leading to the dehumanisation of many clients are reinforced through monetary incentives, and through an intragroup, mob-like co-validation of such unconscious biases. Like Eichmann, many live their lives constantly affirming to themselves that they were just following procedures and orders, or just doing their job; and therefore they believe it is not their responsibility to reflect on how clients are impacted by this. But the signals coming from mental health patients often stand in stark contrast to the common belief that these dehumanising, and at times non-empathic methods are appropriate, or even de facto acceptable.

    I do think everyone deserves to be paid for their labour, and that having access to a basic form of income is an important foundation in any society; and I also think that mental health settings need to be encouraged or trained appropriately to detect clients’ signals as more than just background noise (i.e. as more than non-human objects signals) in order to reduce risk outcomes. The situation is problematic, persistent, and pervasive with these manifestations of authoritarianism in mental health settings. It would indeed be arrogant to assume that all the patients/clients expressing dissatisfaction with the service are wrong, or to culturally pathologise reasonable dissent. It would also be irresponsible and de jure unacceptable to fail to take steps towards alleviating feelings of ‘being dehumanised’ in civil society, especially if such feelings of dehumanisation have the potential to lead to never events, such as suicide.

    References

    Gibson, S. (2013) ‘Milgram’s obedience experiments: A rhetorical analysis’, British Journal of Social Psychology, vol. 52, York, The British Psychological Society/York University, pp. 290-309 [Online]. Available at https://pmt-eu.hosted.exlibrisgroup.com/permalink/f/gvehrt/TN_cdi_gale_infotracacademiconefile_A332152211 (accessed 11 October 2020).

    Turner, J. (2015) ‘Making sense of the world’, in Turner, J. and Barker, M. J. (eds) Living Psychology: From the Everyday to the Extraordinary, Milton Keynes, The Open University, pp. 7-45.

    Wikipedia (n.d.) ‘Psychiatric survivors movement’ [Online]. Available at https://en.wikipedia.org/wiki/Psychiatric_survivors_movement (accessed 11 October 2020).

  • Psychological Survival Through the Coronavirus Pandemic

    Psychological Survival Through the Coronavirus Pandemic

    This is a short video answering some questions in relation to how to cope with the intensity of the coronavirus pandemic by focusing on psychological survival and wellbeing at home.

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  • COVID-19: Situation Report, Administrative Challenges, and What Psychologists can do to Help the Crisis

    COVID-19: Situation Report, Administrative Challenges, and What Psychologists can do to Help the Crisis

    UK-specific numbers

    As of 10 April 2020:

    CONFIRMED CASES: 73,758

    PATIENTS DISCHARGED: 344

    PATIENTS WHO DIED: 8,958

    Worldometers (2020)

    Are the numbers to be trusted?

    There is a certain ‘mystery’ with the numbers. For instance, the GOV.UK’s (2020a) dashboard has not been updating the recovery section of its spreadsheet since the 22nd March. This has led to much confusion, and many people are suspicious of the numbers being provided. For instance, the media (Merrick, 2020) announced that health secretary Matt Hancock tested positive for coronavirus on the 27th March, 2020. Then on the 2nd April, 2020 he was back to work (Matt Hancock gives first coronavirus briefing since coming out of isolation, 2020) and was looking healthy. Nevertheless, the historic record spreadsheet did not register his recovery, indicating that maybe only those admitted to hospital are being registered in the records.

    Another odd discrepancy is the fact that even though Worldometers (2020) updated for the first time this month the number of recovered patients yesterday to 344, the historic record document mentioned above- which is available on the GOV.UK’s (2020a) dashboard- continues to show 135 as the number of recoveries. This is worrisome as it gives an impression of misinformation and it elicits uncertainty. No wonder many people are having a gut feeling of ‘deception’ at the hands of the GOV.

    What is the government’s plan?

    As of the date of this writing, the GOV.UK’s (2020b) coronavirus action plan is full of misinformation and inaccuracies. I wrote to the Department of Health & Social Care (GOV.UK, 2020c) on the 1st April in order to communicate my concerns in regards to their published document and to request more frequent reviews of it. Nevertheless, nothing has been done about it, and the file continues to create feelings of confusion and uncertainty. Here you can download the analysis I conducted. You will be able to understand the discrepancies better after reading it.

    Coronavirus-Action-Plan-Appraisal Download

    What is the WHO saying?

    I attended the World Health Organization’s (2020) press briefing yesterday (10th April). Dr. Tedros Adhanom Ghebreyesus, Director-General stated: “When health workers are at risk, we are all at risk”. There were many important calls to action, such as ensuring that medical staff are able to have adequate rest periods instead of long, exploitative shifts; the development of an immune response; and the clarification of the severity of the disease. For instance, so far we have heard about patients who are in mild, and critical conditions. It was mentioned in the conference that an explanation of the moderate condition would be helpful, as there are confirmed cases of pneumonia which have not required hospitalization.

    Another important point discussed was that the death of health workers has become a ‘tragic’ stimulus to action. The health environment was spoken about as a double-edged sword. It was also raised that personal protective equipment (PPE) is therefore a must have in hospitals in order to reduce the exposure of health workers to infectious hazards. This reminds us of the importance of staying at home and protecting the NHS. Furthermore, it was also suggested that psychosocial support for front-line and health workers should be made readily available, and reasonable adjustments should also be made by administrative staff in order to prevent doctors and nurses from developing fatigue as a result of extremely long shifts.

    What can psychologists do to help the coronavirus crisis?

    The coronavirus (COVID-2019) impacts on different people in different ways. Psychologically speaking, this requires an ongoing decision-making process based on the likelihood of catching the virus, and the perceived severity of the consequences.

    “The barriers component may comprise both physical limitations on performing a behaviour (e.g. expense) and psychological costs associated with its performance (e.g. distress)”.

    Abraham and Sheeran (1996, p. 33)

    The outbreak is by all means a stress-generative situation. Exploring the psychopathology of the coronavirus pandemic, such as the negative and positive symptoms it causes (e.g. confusion, neurosis, and psychosis) would help both, professionals and students to feel more efficient in their preparedness for what is to come next. For example, the concept of normal distribution and the curve as illustrated by The Visual and Data Journalism Team (2020) would help people understand what is meant by “the peak” of the outbreak that so many sources are expecting and talking about.

    Psychologists are also encouraged to help people understand the serious challenge at hand, and the levels of vulnerability in individual differences. Moreover, it would also be helpful to stimulate the GOV so they respond quicker without the need for the tragic stimulus of death explained above. Furthermore, exploring the cycle of panic and neglect that manifests as response to the threat would help soothe emotionally vulnerable human beings. Advice about how to strengthen the system is welcome. When it comes to forensic psychologists, it would be useful to elucidate how data formulates policy, and why it is important to have accurate data in order to prevent confusion at subnational levels, including criminal justice settings.

    How can I check the coronavirus numbers for myself?

    There are two ways you can check the coronavirus statistics. For global numbers go to Worldometers.info/coronavirus.

    For UK-specific numbers:

    1. Go to the GOV.UK’s (2020a) Dashboard.
    2. Click on the ‘About’ tab at the bottom of the page.
    3. Click on the ‘Access historic data from the dashboard (xlsx)’ link.
    4. Save the file on your device.
    5. Open the file with a spreadsheet software such as Google Sheets (n.d.), Microsoft Office Excel (n.d.), or LibreOffice Calc (n.d.).

    Please note that GOV staff have neglected the recovery section in the official spreadsheet since 22nd March, 2020. If you are concerned about the numbers, please contact the Department of Health & Social Care on https://contactus.dhsc.gov.uk/ and explain to them your concerns.

    References

    Abraham, C. and Sheeran, P. (1996) ‘The health belief model’, in Conner, M. and Norman, P. (eds) Predicting Health Behaviour, Buckingham, Open University Press, pp. 23-61.

    Google (n.d.) ‘Google Sheets’ [Online]. Available at https://www.google.co.uk/sheets/about/ (Accessed 11 April 2020).

    GOV.UK (2020a) ‘Total UK COVID-19 cases’, 4th April [Online]. Available at https://www.arcgis.com/apps/opsdashboard/index.html#/ae5dda8f86814ae99dde905d2a9070ae (Accessed 11 April 2020).

    GOV.UK (2020b) ‘Coronavirus action plan: a guide to what you can expect across the UK’, 3 March [Online]. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/869827/Coronavirus_action_plan_-_a_guide_to_what_you_can_expect_across_the_UK.pdf (Accessed 11 April 2020).

    GOV.UK (2020c) ‘Department of Health & Social Care’ [Online]. Available at https://www.gov.uk/government/organisations/department-of-health-and-social-care (Accessed 11 April 2020).

    LibreOffice (n.d.) ‘Calc’ [Online]. Available at https://www.libreoffice.org/discover/calc/ (Accessed 11 April 2020).

    Matt Hancock gives first coronavirus briefing since coming out of isolation (2020), Youtube video, added by The Sun [Online]. Available at https://www.youtube.com/watch?v=qrF6Z8s5dmw (Accessed 10 April 2020).

    Merrick, R. (2020) ‘Coronavirus: Health secretary Matt Hancock tests positive’, The Independent, 27 March [Online]. Available at https://www.independent.co.uk/news/uk/politics/coronavirus-matt-hancock-boris-johnson-test-positive-covid-19-symptoms-a9430031.html (Accessed 10 April 2020).

    Microsoft (n.d.) ‘Office Excel’ [Online]. Available at https://products.office.com/en-gb/excel (Accessed 11 April 2020).

    The Visual and Data Journalism Team (2020) ‘Coronavirus pandemic: tracking the global outbreak’, BBC News, 10 April [Online]. Available at https://www.bbc.co.uk/news/world-51235105 (Accessed 11 April 2020).

    World Health Organization (2020) ‘Coronavirus Disease (COVID-2019) press briefings’ [Online]. Available at  https://www.who.int/emergencies/diseases/novel-coronavirus-2019/media-resources/press-briefings (Accessed 10 April 2020).

    World Health Organization (n.d.) ‘Biography of Dr. Tedros Adhanom Ghebreyesus, Director-General’ [Online]. Available at https://www.who.int/antimicrobial-resistance/interagency-coordination-group/dg_who_bio/en/ (Accessed 11 April 2020).

    Worldometers (2020) ‘COVID-19 coronavirus pandemic’ [Online]. Available at https://www.worldometers.info/coronavirus/ (Accessed 11 April 2020).

  • Coronavirus (COVID-19): Understanding the New Status Quo, Following Governmental Advice, and Interpreting the Numbers

    Coronavirus (COVID-19): Understanding the New Status Quo, Following Governmental Advice, and Interpreting the Numbers

    We have heard the advice, but how can we interpret the information? Why follow the lockdown protocols? This article will clarify the coronavirus’ status quo.

    UK-specific numbers:

    CONFIRMED CASES: 47,806.

    PATIENTS DISCHARGED: 135.

    PATIENTS WHO DIED: 4,934.

    (GOV.UK , 2020b)

    What’s the difference between the coronavirus and COVID-19?

    The coronavirus is what people catch, and the COVID-19 is the respiratory disease that can develop. A good analogy for understanding the differences between the two terms is HIV and AIDS. Whilst not all people who test positive for HIV develop AIDS, those who do develop it become severely ill. Similarly, not everyone testing positive for the coronavirus develops COVID-19, but those who do develop it are hospitalised and become severely ill. This is why preventing catching the coronavirus is just as important as preventing catching HIV.

    What is the likelihood of catching the coronavirus?

    As of the date of this writing, and according to Worldometers (2020a), there have been 47,806 confirmed cases in the UK, which has a population of 67,802,457 (Worldometers, 2020b). This means that the total number of hospital admissions per 1 million population is approximately 704, and the number of deaths per 1 million population is 73. Furthermore, Plymouth (the city where I live) had a population of 264,200 as of February (World Population Review, 2020), and as of the date of this writing it has had a total of 102 hospital admissions (GOV.UK, 2020b), out of which 13 (approximately 12.8%) patients have died (O’Leary, 2020); which means that even though there is a low risk of catching the virus, those who do catch it and develop COVID-19 are at high risk of dying.

    Why should I stay at home?

    Because you do not know whether you are infected or not, and if you are coronavirus positive but you have not developed COVID-19; you could still pass the virus onto other people who might be more vulnerable than you and who might develop COVID-19. Alternatively, you could catch the virus and in the worst case scenario die.

    How is staying at home protecting the NHS?

    When you prevent catching the coronavirus, you also prevent spreading it around. This means that you are doing everything you can to make sure that the NHS does not become overwhelmed with patients.

    What preventive action can be taken?

    • You could self-educate on the topic in order to feel confident that you know what’s going on, and how to survive the crisis.
    • You could stay home in order to prevent becoming a patient, or spreading the virus (creating patients). This means that the NHS will have more supplies to deal with the overwhelming number of cases, and those severely ill will have a higher chance of getting the medical attention and equipment that they need.
    • You could share the information with your friends and family.

    What reliable advice is available?

    • The World Health Organization (WHO; 2020a) has a section dedicated to the coronavirus pandemic with all available scientific information.
    • The NHS.UK (2020) has a section also dedicated to the disease.
    • The GOV.UK (2020a) also has a section dedicated to the lockdown in relation to the pandemic.

    How is the virus transmitted?

    According the World Health Organization (WHO; 2020b) “COVID-19 virus is primarily transmitted between people through respiratory droplets and contact routes […] transmission of the COVID-19 virus can occur by direct contact with infected people and indirect contact with surfaces in the immediate environment or with objects used on the infected person […] Airborne transmission is different from droplet transmission […]can remain in the air for long periods of time and be transmitted to others over distances greater than 1 m”.

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    References

    GOV.UK (2020a) ‘Coronavirus (COVID-19): what you need to do’ [Online]. Available at https://www.gov.uk/coronavirus (Accessed 5 April 2020).

    GOV.UK (2020b) ‘Total UK COVID-19 cases’, 4th April [Online]. Available at https://www.arcgis.com/apps/opsdashboard/index.html#/ae5dda8f86814ae99dde905d2a9070ae (Accessed 5 April 2020).

    NHS.UK (2020) ‘Advice for everyone’, 3 April [Online]. Available at https://www.nhs.uk/conditions/coronavirus-covid-19/ (Accessed 4 April 2020).

    O’Leary, M. (2020) ‘Ten coronavirus deaths confirmed in past 24 hours across Devon and Cornwall’, Plymouth Herald, 5 April [Online]. Available at https://www.plymouthherald.co.uk/news/uk-world-news/coronavirus-death-toll-uk-risen-4021937 (Accessed 5 April 2020).

    World Health Organization (2020a) ‘Coronavirus disease (COVID-19) pandemic’ [Online]. Available at https://www.who.int/emergencies/diseases/novel-coronavirus-2019 (Accessed 5 April 2020).

    World Health Organization (2020b) ‘Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations’, 29 March [Online]. Available at https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations (Accessed 5 April 2020).

    World Population Review (2020) ‘Plymouth population 2020’, 17 February [Online]. Available at https://worldpopulationreview.com/world-cities/plymouth-population/ (Accessed 5 April 2020).

    Worldometers (2020a) ‘COVID-19 coronavirus pandemic’, 5 April [Online]. Available at https://www.worldometers.info/coronavirus/ (Accessed 5 April 2020).

    Worldometers (2020b) ‘U.K. Population’, 5 April [Online]. Available at https://www.worldometers.info/world-population/uk-population/ (Accessed 5 April 2020).

  • Coronavirus (COVID-19) Brief: Protection Motivation Theory, Outbreak Appraisal, and Understanding Collective Behaviour

    Coronavirus (COVID-19) Brief: Protection Motivation Theory, Outbreak Appraisal, and Understanding Collective Behaviour

    The world is in chaos. The coronavirus has accelerated at an unprecedented rate, leaving planet Earth feeling vulnerable and in a state of collective sorrow. Things have never been like this. Unless you are over 100 years old, you have never witnessed this level of transnosological danger in your entire life. Due to the panic-ridden headlines, many people are experiencing an aversion to potential loss or potential grief. Others seem to be in denial. Where is the balance? This article aims to explore some of the facts, figures, and dynamics determining coronavirus-associated behaviour.

    “Protection motivation theory describes adaptive and maladaptive coping with a health threat as the result of two appraisal processes: threat appraisal and coping appraisal“.

    Norman and Conner (1996, p. 11)

    Threat Appraisal

    Worldometers (2020)

    As of 28/03/2020:

    TOTAL GLOBAL CASES: +602,000

    TOTAL GLOBAL DEATHS: +27,400

    TOTAL GLOBAL RECOVERIES: +133,500

    How severe is the threat?

    The threat is perceived by the public as extremely severe and unprecedented. Here in the United Kingdom it has been set as high risk; and this is why Primer Minister Boris Johnson has enforced the draconian lockdown (Cabinet Office, 2020). The virus is very contagious, and due to the increasing death rates people are feeling very susceptible with this disease threatening their physical integrity, and potentially their life or the life of those whom they love. Nevertheless, it must be objectively said that 95% of recorded cases worldwide report mild symptoms. Yet, from mild symptoms have arisen many deaths.

    How susceptible am I to the threat?

    It seems that among the high risk groups are people over 80 years old, those with underlying health conditions, and smokers with chronic pulmonary problems. Furthermore, according to the United Nations (2020): “The risk depends on where you are – and more specifically, whether there is a COVID-19 outbreak unfolding there”. In other words, demographic variables will indicate the level of risk in specific areas. For instance, the South West area where I live in the UK is the area with the lowest risk of contamination (GOV.UK, 2020b), and my city (Plymouth) has only 26 cases so far (O’Leary, 2020). Furthermore, commenting on the safety of packages and deliveries, the UN (2020) further states: “The likelihood of an infected person contaminating commercial goods is low and the risk of catching the virus that causes COVID-19 from a package that has been moved, travelled, and exposed to different conditions and temperature is also low”. So if you are concerned about me, don’t worry, I am ready.

    I sanitise my body, my environment, and my mind. Call me mad, but I’ll survive.

    How is the virus appraised by the global government?

    The World Health Organization (WHO) has warned the world about the fact that no antibiotics, no medication, and no vaccination has proven to prevent or cure the coronavirus. Therefore, they appraise this as a serious situation.

    World Health Organization (2020).

    What are mental health experts saying?

    Mental health experts understand that this is without a doubt a stress-generative situation. The uncertainty that COVID-19 triggers is in many cases inevitable. Furthermore, the unpredictability and uncontrollability that manifest with the facts and figures are a source of anxiety for many people. Nevertheless, this does not mean that pre-emptive and preventive action cannot be taken. The GOV and the WHO have issued specific guidance which can help reduce the hazard and intensity of the situation. Sanitary action is in this case reasoned action, and this can be planned, performed, and maintained in order to cope with the threat in an adaptive way. Moreover, because this is an extraordinary situation which has disrupted the standard routines of many people, there is a certain level of confusion, fear, and worry. Remember to:

    • Wash your hands with soap as frequently as possible for 20 seconds.
    • Stay indoors unless it is absolutely necessary to go out to seek medical care.
    • Order groceries online as infrequently as possible instead of going to the shop (even though online deliveries are the least unsafe option, there is still a risk of contamination through such medium).

    Coping Appraisal

    INTERNAL LOCUS OF CONTROL: Factors which can be totally controlled by and depend solely on the individual.

    EXTERNAL LOCUS OF CONTROL: Factors which can’t be controlled by and do not depend on the individual.

    (Norman and Conner, 1996).

    I see people behaving like nothing is happening. Am I too paranoid?

    No. What you see happening is a state of collective denial. People keep going to work, doing physical exercise outdoors, and attending social gatherings because they are underestimating the severity of the threat. The kind of self-absorption that is dominant in individualistic, Western societies is an intellectual disadvantage in this case which requires an analysis of global events and behaviour. It only takes analysing what is happening in China, the US, Italy and Spain to understand that due to the incubation period of the virus (up to 2-3 weeks; Worldometers, 2020) it is quite possible that the COVID-19 is having a delayed impact in the UK. The virus does survive a long time in the air, meaning that it can be breathed quite easily. This is why a two metre distance is advised. Those behaving as if nothing was happening are not able to rationalise the threat because being able to move around gives them a false sense of being in control of the situation. In my opinion, it is an unnecessary risk they are taking. Similarly, those going to work outside the emergency system are still playing down the risk.

    According to Norman and Conner (1996), the more an individual perceives potential health susceptibility, and the more that the threat is perceived to be severe, the more fear arousal there is. This means that the way people respond to the outbreak will depend on their level of awareness about the high risk the coronavirus poses. For instance, here in the UK there are more deaths than recoveries, and the counter for recoveries has been stuck at 135 (GOV.UK, 2020b) for several days already, unlike the counters for new cases and deaths, which keep burgeoning. This is problematic and worrisome. So if you are feeling too paranoid and as if you are being too careful, rest assured that you are just being as careful and responsible as you and everyone else are expected to be.

    What can I do to calm down?

    This is a good question, as everything functions better when people remain calm. There are many variables that are within your locus of control, such as the way you interpret the situation (perception) which can be optimised by engaging in intellectually stimulating activities such as reading, watching films, or having conversations. The more you learn, the more confident you will feel in assessing risk, and the more you will engage in reasoned behaviours that promote health and prevent disease. Another variable that you can control and nourish in yourself is your emotional wellbeing, which can be enhanced by ensuring that you get enough sleep (this will also boost your immune system, and will therefore help you fight off infections; NHS.UK, 2018), that you eat well, and that you have a tidy and clean environment around you. If you have long-term conditions, it is necessary that you continue to take your prescribed medications during this time in order to keep healthy. Furthermore, remember that you have the capacity of preventing contamination by following the guidance. Successfully executing the recommended courses of action will help you feel self-efficient and safe. Engage in some yoga or pilates at home, entertain yourself, and stay in touch with your family and friends digitally. Keep the following points in mind:

    • Neither underestimate nor overestimate the magnitude of the situation. Stay tuned for the facts and figures.
    • You can sign online petitions to participate in requesting specific outcomes for the common good.
    • Plan for short to medium term supplies and associated variables of a lockdown.
    • Mental contagion can happen if you allocate too much time and attention to digital material which is sensationalist or misinformed. Be wise about the type of information you consume.
    • Double check that your beliefs about what is healthy are not based on misinformation. Here are some myth busters to keep in mind:

    What factors are not under my control?

    There are several variables that could become a source of frustration during the lockdown. Anything that is outside your mind, and outside your environment is outside your control. You are not responsible for the behaviour of others, and the best thing you can do is share the guidance with your loved ones and hope that they follow it. Moreover, you have no current participation in most of the decision-making processes of the jurisdiction (e.g. the legal measures being duly taken by the GOV in relation to this pandemic). If you are not able to work from home, and cannot make money as a result, you might feel like everything is going to collapse, and in such case all you can do is hope that the GOV will protect your welfare, as such decision is within their locus of control. If you are a key worker, you might feel that your life is being put at risk in order to save the life of others. All you can do is hope that the GOV will listen to the healthcare industry in regards to the much needed protective equipment, spaces, and ventilators. This too is within the GOV’s locus of control. For example, medical staff in Spain are being forced to sedate and asphyxiate the elderly to death in order to use their ventilators on younger patients. Because providing equipment is a decision which only the Spanish political leaders can make, doctors are having a psychological breakdown and are accusing the authorities of genocide for neglecting the welfare of vulnerable citizens. Take a look at this video:

    Play

    References

    Cabinet Office (2020) ‘Guidance: Staying at home and away from others (social distancing)’, GOV.UK, 23 March [Online]. Available at https://www.gov.uk/government/publications/full-guidance-on-staying-at-home-and-away-from-others (Accessed 27 March 2020).

    GOV.UK (2020a) ‘Coronavirus (COVID-19): what you need to know’ [Online]. Available at https://www.gov.uk/coronavirus (Accessed 27 March 2020).

    GOV.UK (2020b) ‘Total UK COVID-19 Cases” [Online]. Available at https://www.arcgis.com/apps/opsdashboard/index.html#/ae5dda8f86814ae99dde905d2a9070ae (Accessed 27 March 2020).

    Hamzelou, J. (2020) ‘How long does coronavirus stay on surfaces and can they infect you?’, New Scientist, 25 March [Online]. Available at https://www.newscientist.com/article/2238494-how-long-does-coronavirus-stay-on-surfaces-and-can-they-infect-you/ (Accessed 27 March 2020).

    Johnson, B. (n.d.) ‘About Boris’, Boris Johnson [Online]. Available at http://www.boris-johnson.com/about/ (Accessed 27 March 2020).

    NHS.UK (2018) ‘Why lack of sleep is bad for your health’ [Online]. Available at https://www.nhs.uk/live-well/sleep-and-tiredness/why-lack-of-sleep-is-bad-for-your-health/ (Accessed 27 March 2020).

    Norman, P. and Conner, M. (1996) ‘The role of social cognition in health behaviours’, in Conner, M. (ed) Predicting Health Behaviour, Buckingham, Open University Press, pp. 1-22.

    O’Leary, M. (2020) ‘Four new coronavirus cases confirmed in Plymouth’, Plymouth Herald, 26 March [Online]. Available at https://www.plymouthherald.co.uk/news/plymouth-news/four-new-coronavirus-cases-confirmed-3989498 (Accessed 27 March 2020).

    United Nations (2020) ‘Coronavirus (COVID-19): Frequently Asked Questions’ [Online]. Available at https://www.un.org/en/coronavirus/covid-19-faqs (Accessed 27 March 2020).

    World Health Organization (2020) ‘Coronavirus disease (COVID-19) advice for the public: myth busters’ [Online]. Available at https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters (Accessed 27 March 2020).

    Worldometers (2020) ‘Coronavirus Update (LIVE)’ [Online]. Available at https://www.worldometers.info/coronavirus/ (Accessed 27 March 2020).