The SA government has put in place measures focused on containing the Covid-19 outbreak, including school closures, remote working policies, and restricting domestic and international travel.

While this is a responsive step, it is important that interventions should also focus on prevention and ensuring that the healthcare system is adequately equipped to respond to the growing demand to access mental healthcare services.

The Covid-19 pandemic poses an urgent threat to both the physical welfare of individuals and the collective economic health of our communities. But there is also a looming mental-health crisis just waiting to erupt.

There are acute mental-health issues: people in addiction recovery without access to physical meetings, economic anxiety from job losses, financial instability and business closures, depression fuelled by physical seclusion, feelings of isolation, loneliness, panic and fear.

For those who suffer with anxiety disorders such as obsessive-compulsive disorder, agoraphobia and panic disorder, the virus has inadvertently validated many of the fears they have long worked to counter as irrational.

Imagine years of therapy to train your brain out of the thought that something bad will happen if you do not wash your hands seven times, only to be suddenly bombarded with messages about the critical importance of washing your hands. Then add on the realisation that you cannot find hand sanitiser anywhere.

People in quarantine may experience boredom, anger, and loneliness. Symptoms of the viral infection such as a cough and fever are also likely to cause worsening anxiety. For an example, after testing positive for Covid-19, two doctors from Limpopo followed protocol and self-isolated.

Nevertheless, on Thursday April 2 2020, a contingent of men in masks, supported by police, arrived with a court order and dragged them off to a hospital isolation ward - on the orders of the Limpopo health MEC.

This may well be an infringement on the rights of these doctors. They were also blamed for introducing the virus into the province. This action is contrary to the World Health Organisation statement that "people affected by Covid-19 have not done anything wrong, and they deserve our support, compassion and kindness".

Social distancing may leave many people feeling disconnected and lonely. Social distancing need not necessarily mean social isolation. Remain in contact with loved ones via telephonic or digital means.

Much has been said about Covid-19's effects on people with under
lying health conditions and immune suppression, but not so much about people living with mental illness. Yet those are among the most vulnerable people in society and face widespread stigma.

The direct relationship between a pandemic and rising levels of mental health problems must not be overlooked. Even for people without pre-existing mental health conditions, this is a particularly uncertain and distressing time.

There must be appropriate mental health and psychosocial support. Particular focus should be on people with the virus itself, and health workers on the frontline.

An integrated care approach, which pairs mental wellness with emergency medical responses, is needed. In the meantime, there are resources to help mental wellbeing. The SA Depression and Anxiety Group (Sadag) (0800 456 789), Lifeline (0800 150 150) and the SA Federation for Mental Health (0800 121 314) all have helplines to call.

*Dr Bila, Department of Social Work & Criminology, University of Pretoria