No normal crisis

Psychological associations across the globe have all been faced with an extraordinary challenge in the last year – how to support professionals and the public during an international health emergency, taking into account each of their country's unique circumstances. 

Albania was hit by Covid-19 in early March – just as the country was recovering from a 6.4 magnitude earthquake in late 2019. President of the Order of Psychologists of Albania (OPA) Dr Valbona Treska said that thanks to this experience in helping people to cope with the aftermath of the quake psychologists were prepared to support people through emergencies – though no-one could have predicted the sheer scale of the Covid-19 pandemic. 

'These are two experiences that have made us stronger as professionals. The Psychologist Order today has a membership of 1,100 psychologists. Our institution is still new and we haven't yet become four years old. These situations have taught us to be very connected to each other, have increased the interest of our members in providing voluntary help, and have definitely helped us strengthen our role.'

The OPA brought together teams of volunteers to support those affected by Covid and offered 50 days of free-of-charge support via an online psychology service, and psychologists took part in webinars and training from international organisations. In July and August the country also experienced two cases of suicide of people in hospital being treated for Covid-19. 

Treska and her colleagues turned to the international community to explore whether any other countries faced similar incidents, and for support on how best to psychologically support patients. 'While the unofficial information in Albania was that patients were not allowed to communicate even with their families. Up to this point psychological assistance was lacking for hospitalized patients.

'To date, there are four cases of suicide from patients being treated for Covid-19 reported in hospitals in Albania. Colleague David Murphy from the British Psychological Society came to our aid with some guidelines and references of tests that could be used by our psychologists. After getting permission from BPS to use these materials, we are working on translating and adapting them. Based on these materials we have work and made relevant proposals to the Ministry of Health.'

Based on those BPS guidelines the OPA has made recommendations to the Ministry of Health that there should be a psychologist on each Covid-19 ward with 50 patients to provide psychological support and carry out risk assessments for mental health problems for each patient. 'In November 2020, an ad hoc group was set up at the Ministry of Health to investigate the suicides of Covid-19 patients in hospitals, part of which is also OPA. This group is continuing its work.'

The OPA has also lobbied the Albanian Ministry of Education on the importance of psychologists in schools and in June it was announced that numbers of school psychologists in the country would be doubled. Given psychology is a relatively new profession in Albania, Treska said it was difficult to advocate for both the role of psychologists and the benefits of psychology – among heads of institutions and within the general population. 

'Very modestly, I think that within our human capacities and the complete lack of financial assistance, we have done our best to mitigate the consequences of this situation. It is not easy to organise a whole community of professionals on a voluntary basis. 

'Strengthening the profession remains one of our biggest challenges. With the help and support of our counterparts in Europe and USA who have been consolidating for years, we hope to be able to move forward.'

Director of Psychology Fields, Programs and Projects, and Director of the Psychological Response Team, Pedro Ochoa, and Director of the Office of International Affairs, Maria Luisa Ramirez, both work full-time within the Colombian Association of Psychologists (Colegio Colombiano de Psicólogos – Colpsic). Since the start of the pandemic Ochoa and Ramirez have also been working on projects to support the mental health and wellbeing of both the general population and healthcare staff – creating networks of psychologists, producing 34 guides on topics such as mental health during isolation and emotional management for those diagnosed with Covid-19, and carrying out independent research. 

Ramirez said there are 140,000 psychologists in Colombia with Colpsic representing the profession as a whole. 'At Colpsic we have our headquarters in Bogotá and we have 11 chapters, each with a regional president to identify local needs. So we're trying to get to all the psychologists in the country, which is a challenge… the psychologists in the Amazons, to give an example, should have the exact same opportunities as a psychologist in Bogotá.' 

Colpsic brought together more than 4,000 volunteers where 205 professional volunteers and 121 expert volunteers worked on a government helpline to disseminate information and provide psychological support throughout the country. Ramirez said the organisation had also held numerous workshops and training sessions on a vast variety of topics nationally and internationally. 

'David Murphy gave us a workshop at the end of May on how hospital psychologists were supporting the ICU units around the country. At that time in Colombia we were just starting off understanding Covid and we didn't have that experience so it was a very valuable workshop. We've also been able to exchange experience with other associations – for example the Federation of Psychologists in Venezuela (Federación de Psicólogos en Venezuela – FVP)  have had helplines for many years so when we were also starting off we had some consultancy with them.' 

Ochoa (pictured, below) said the pandemic was no normal crisis, as this one has no clear end, but he hoped the fault lines revealed by its impact would be addressed. 'I think that Colombian public policy will be reviewed. And I think it really is in constant crisis in our health system and this current situation only makes it worse. We need more work in promoting health and we need to work more in public policy to improve mental health. 

'And it's not only the virus, there are a lot of economic and social effects that could be more serious than the virus. I think that we also need to work more in scientific literacy because many people don't understand science – and maybe something truly worse is that many politicians don't understand science.' 

From a personal point of view Ochoa and Ramirez said the pandemic had revealed the importance of the term "practice what you preach". Ramirez said this wasn't a Colombian-specific issue. 'I've actually talked to colleagues from all around the world, and they report the same thing – they're teaching mental health but not applying mental health.' 

On a more positive note Ochoa has seen people begin to recognise the importance of psychology, and potential impact of psychological knowledge. 'We have a special position right now, because people need this immensely important work in mental health.' 

Ramirez added that psychologists' moment is now. 'It's our opportunity to really elevate the voice of psychology, not only nationally, but around the globe. But for me personally, as I work in International Affairs, I think these months have been a real opportunity to consolidate networks with international colleagues and collaborate more under solidarity. I think that everyone has been understanding that we can actually be one, we have one psychology and we can be a global psychological community.' 

President of the Psychological Society of Ireland (PSI) Mark Smyth (pictured, below) said during the society's response to Covid-19 he had been reminded of one of its most valuable resources – its membership. 'When we turned to our membership and divisions and asked them for their support in developing guidelines and multimedia content, they stepped up straight away and made an incredible contribution to what PSI produced this year. What I think we learned is how adaptable psychologists can be at a time of need and how willing they are to go the extra mile to help.'

Since the start of the outbreak PSI members have recorded videos offering advice and support on stress, relationships and managing chronic illness. The society also created a podcast series and made some adaptations to its supervision requirements for training courses and developed guidance for online therapy and assessment.

Smyth said one of the most challenging aspects of being PSI president during the pandemic was the fact it fell in the year of the society's 50^th anniversary. 'It is well known that Irish people love to socialise and spend time with each other and we had a full year of celebratory events planned to mark our organisations birthday including a gala screening of a movie documenting our 50 years. 

'Not being able to be with each other in the ways that we hoped was probably the biggest challenge this year.  But every challenge also brings unforeseen opportunities and moving onto Zoom for meetings and events made PSI a lot more accessible for some of our members who would have found it difficult to travel to Dublin for events and I'd like to see virtually joining for events continuing even after Covid19 has left us.' More personally, as a psychologist working in CAMHS, Smyth said it had been a challenge to support young people and families to adapt to online sessions and helping them through the losses they had experienced. 

Smyth has worked as a Garda Reserve for 11 years and was extremely aware of the pressures that Covid-19 has brought to police services. 'Working alongside them you gain an invaluable appreciation for how on a daily basis they put themselves in harm's way to keep us all safe. Prior to 2020 it was to protect us from crime and violence and this year Covid19 got added into the mix, but they still went to work every day when others had to stay at home. I feel there has been a lot of overlap between my psychology and policing roles, and I hope when Covid-19 has been contained that our police in Ireland and the UK will be recognised for the incredible role they have played this year.'