It was a familiar scene during the massive Ebola outbreak in West Africa that began in 2014: Elated survivors dancing as they left treatment centres free of the deadly virus.
Three years later, with another deadly outbreak wracking war-torn parts of the Democratic Republic Congo, health officials have a better understanding that being cleared of the physical symptoms of Ebola does not mean survivors are free of the disease. The mental health impacts of Ebola can be long lasting and devastating.
University of Ottawa assistant professor Dr. Jude Mary Cénat is among researchers working to ensure better psychological care for victims of Ebola to protect them from some of those severe mental health impacts.
Ebola has severe mental health consequences, he said. Many survivors — some of whom watched family members die — are left with profound guilt, depression and anxiety. Some suffer from post-traumatic stress disorder, something compounded during the current outbreak, which is taking place against a backdrop of conflict. And ongoing stigma once they have survived the disease often makes things worse.
Cénat and Elise Bourgeois-Guérin of TéLUQ, a Quebec-based distance learning university, recently travelled to a region of the Democratic Republic of the Congo that saw previous outbreaks. They were there to train psychologists and others about complex trauma. Many victims of Ebola are also victims of other trauma, including war and community and sexual violence.
“You have to be able to address all that multiple trauma,” Cénat said.
More study is needed to help governments, NGOs and communities be better equipped to offer mental health support during Ebola outbreaks, he said. Programs are needed that can be adapted to individual community’s needs. That is some of the work Cénat and his team are doing.
There also must be adequate funding to make sure the mental health needs of survivors and other community members are met.
“Mental health has to be part of the response. You can’t just address the physical health. It is one of the best ways to build more resilient individuals and communities.”
A paper by Cénat and others recently published in the British Journal of Psychiatry described the work psychologists are doing in the current outbreak in the North Kivu and Ituri regions of DRC — which is the second worst in history and remains out of control — and called for an international effort to provide more psychological support.
“In Ebola treatment centres, the ill suffer both physically and psychologically because they are plagued by the fear of death as well as hurt by the distress and rejection of others. As patients deal with the agony of physical pain caused by the disease, the psychological pain that accompanies it can be terrifying for patients who cannot be supported by their loved ones.”
Among health workers in the current outbreak are psychologist, who are at the bedsides of sick patients.
“These psychologists also risk their lives both for those who will die and those who will survive.”
At one treatment centre, psychologists see patients two or three times a day to respond to their distress and anxiety attacks, “for which medical treatments against Ebola can do nothing.”
In an outbreak in which 39 health workers have died from Ebola (and 119 have been infected), the work of psychologists is both dangerous and crucial, Cénat wrote, but work must be done to better understand the disease’s impact on individuals and communities and their coping mechanisms.
“These are global mental health and public health actions we must begin as soon as possible to help communities cope in a country that is in dire need of mental health professionals.”
Copyright Postmedia Network Inc., 2019