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Pakistanis’ mental health during the COVID-19 Through this correspondence, I aim to highlight the secondary crisis-in-making which is mental health and psychosocial issues which mark the need for psychological crisis intervention during COVID-19 outbreak. Mental health and wellbeing are substantial foundations of healthcare and thus identification and mitigation of these issues is vital for healthy psychosocial functioning of individuals and community. This paper identifies potential mental health issues and proposes to adopt behavior modification to adapt with the quarantine, social isolation and social distancing. Pakistan should introduce psychological crisis intervention program (see Mukhtar, 2020). Pakistan (7025 confirmed cases) contracted coronavirus (COVID-19 – Coronavirus Disease 2019) through the arrival of overseas Pakistani (students, zaireen, visitors and pilgrims) from other geographical locations to Pakistan. Pakistan’s (fifth most populous country) basic family unit is extended-consanguine family system with multiple generations living together and thus in collectivistic culture such as this practicing social distancing poses a challenge on mental health of all family members. Community-dwellers depend on social support through family interaction and cultural activities to keep feelings of loneliness, negative emotions and psychological distress at bay. People could experience fear of death, fear of getting oneself or their family infected, anxiety, anger, depressive symptoms, and other mental health concerns during this pandemic outbreak (Rana et al., 2020). Many factors are contributing in the affected mental health, psychosocial functioning, wellbeing, psychological and emotional welfare including uncertainty of this novel illness, unpredictability of the new risk including the self-isolation, social-distancing, and quarantine) impaired social functioning, interpersonal issues, perpetuating emotional and behavioral disorders, precipitating psychological problems, predisposing mental health issues, and tendency of easily getting affected from traumatic events. Healthcare conditions in Pakistan are exacerbating on daily basis and thus controlling the disease would require holistic comprehensive management on both physical and mental healthcare situation (Mukhtar, 2020). COVID-19 pandemic outbreak could have negative impact on psychological and mental health of people, for instance psychological distress, mental health issues, grief, shame, helplessness, hopelessness, posttraumatic symptoms, substance abuse, panic attacks, stress, anxiety, depression, loneliness, ambivalence, fear, anger, stigma and worry towards socioeconomic status (Mukhtar, 2020). Mental health refers to the state of wellbeing in which individuals realizes their own ability to cope with normal life stressors and productively work to contribute in their own community (WHO, 2005). Mental health constitute a six element psychological perspective which includes a) self-acceptance, b) meaning in life, c) autonomy, d) healthy relations with others, e) environmental mastery, and f) personal growth. Coronavirus pandemic outbreak which consolidated social-distancing and self-isolation has challenged all the aspects of mental health, wellbeing, emotional health, psychological and social wellness at the collective level (Mukhtar, 2020). Interpersonal issues including domestic violence, abuse, trauma, negative emotions, unhealthy relations and family environment, financial instability, poverty, poor health and other factors in addition to coronavirus has exacerbated the wellbeing of all individuals making them question their self-acceptance, meaning in life, and relationships with others. Restricted movement resulting from lockdown could make people question their autonomy and environmental mastery. And all in all challenges the personal growth and compromising mental health of general public (Lima et al., 2020; Shi and Hall, 2020). The mental health issues have become secondary major health concerns globally prevalent in individuals to variable extents. People are experiencing anxiety, anger, confusion and posttraumatic symptoms during the self-isolation and quarantine (Banerjee, 2020). Healthcare professionals are doing meticulous job in protecting the nation from this catastrophic event (Rana et al., 2020), however, for effective treatment of infected individuals and their families’ mental states should be monitored as well. Communities could adopt behavior modification to adapt with the Coronavirus’s adverse outcomes by reframing the situation to improve mental health through: mindfulness, personal growth, building resilience, coping strategies, health problem solving, cultivating positive emotions, and curbing negative emotions through behavior modification. Adopting new behaviors such as mindfulness of hand-washing, healthy diet, physical activity; practicing introspection, meditation and minimalism; learning new skills of sketching, musical instruments, dancing; acquiring new languages; procuring knowledge of books, and podcasts; accumulating influential videos, series, movies, games, and music; and expressing gratitude through introspection and mindfulness – these activities could bring resilience, coping, wellbeing, gratitude, mindfulness and adapting and adjusting with the new changes outcome of coronavirus outbreak. Psychiatrists, experienced and trained mental health practitioners, and counselling psychologists could provide empirically-evidence based perspectives on misinfodemics (rumors, conspiracy theories, myths, superstitions, misinformation, disinformation and false information), normalize communities about the mental health issues, optimize mental health availabilities through internet platforms, and empower individuals and communities through mental healthcare. Government of Pakistan should incorporate psychological interventions as part of healthcare system in the context of public health emergency. Pakistan should introduce psychological crisis intervention program (see Mukhtar, 2020) to timely, effectively and efficiently mitigate the psychosocial and mental health impact of COVID-19. There is a paucity of research on the mental health factors prevalent in Pakistan during the COVID-19 pandemic outbreak so this commentary marks the preliminary suggestion to evaluate the impact of coronavirus outbreak on mental health in Pakistan. Government of Pakistan should strengthen personnel, optimize institutional good governance and offer advanced trainings and degrees in the field of counselling psychology and mental health. Financial disclosure The author declares no financial disclosure related to the submission. Declaration of Competing Interest The author declares no conflicts of interest. Acknowledgment None.

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article-title	Pakistanis’ mental health during the COVID-19
body	Through this correspondence, I aim to highlight the secondary crisis-in-making which is mental health and psychosocial issues which mark the need for psychological crisis intervention during COVID-19 outbreak. Mental health and wellbeing are substantial foundations of healthcare and thus identification and mitigation of these issues is vital for healthy psychosocial functioning of individuals and community. This paper identifies potential mental health issues and proposes to adopt behavior modification to adapt with the quarantine, social isolation and social distancing. Pakistan should introduce psychological crisis intervention program (see Mukhtar, 2020). Pakistan (7025 confirmed cases) contracted coronavirus (COVID-19 – Coronavirus Disease 2019) through the arrival of overseas Pakistani (students, zaireen, visitors and pilgrims) from other geographical locations to Pakistan. Pakistan’s (fifth most populous country) basic family unit is extended-consanguine family system with multiple generations living together and thus in collectivistic culture such as this practicing social distancing poses a challenge on mental health of all family members. Community-dwellers depend on social support through family interaction and cultural activities to keep feelings of loneliness, negative emotions and psychological distress at bay. People could experience fear of death, fear of getting oneself or their family infected, anxiety, anger, depressive symptoms, and other mental health concerns during this pandemic outbreak (Rana et al., 2020). Many factors are contributing in the affected mental health, psychosocial functioning, wellbeing, psychological and emotional welfare including uncertainty of this novel illness, unpredictability of the new risk including the self-isolation, social-distancing, and quarantine) impaired social functioning, interpersonal issues, perpetuating emotional and behavioral disorders, precipitating psychological problems, predisposing mental health issues, and tendency of easily getting affected from traumatic events. Healthcare conditions in Pakistan are exacerbating on daily basis and thus controlling the disease would require holistic comprehensive management on both physical and mental healthcare situation (Mukhtar, 2020). COVID-19 pandemic outbreak could have negative impact on psychological and mental health of people, for instance psychological distress, mental health issues, grief, shame, helplessness, hopelessness, posttraumatic symptoms, substance abuse, panic attacks, stress, anxiety, depression, loneliness, ambivalence, fear, anger, stigma and worry towards socioeconomic status (Mukhtar, 2020). Mental health refers to the state of wellbeing in which individuals realizes their own ability to cope with normal life stressors and productively work to contribute in their own community (WHO, 2005). Mental health constitute a six element psychological perspective which includes a) self-acceptance, b) meaning in life, c) autonomy, d) healthy relations with others, e) environmental mastery, and f) personal growth. Coronavirus pandemic outbreak which consolidated social-distancing and self-isolation has challenged all the aspects of mental health, wellbeing, emotional health, psychological and social wellness at the collective level (Mukhtar, 2020). Interpersonal issues including domestic violence, abuse, trauma, negative emotions, unhealthy relations and family environment, financial instability, poverty, poor health and other factors in addition to coronavirus has exacerbated the wellbeing of all individuals making them question their self-acceptance, meaning in life, and relationships with others. Restricted movement resulting from lockdown could make people question their autonomy and environmental mastery. And all in all challenges the personal growth and compromising mental health of general public (Lima et al., 2020; Shi and Hall, 2020). The mental health issues have become secondary major health concerns globally prevalent in individuals to variable extents. People are experiencing anxiety, anger, confusion and posttraumatic symptoms during the self-isolation and quarantine (Banerjee, 2020). Healthcare professionals are doing meticulous job in protecting the nation from this catastrophic event (Rana et al., 2020), however, for effective treatment of infected individuals and their families’ mental states should be monitored as well. Communities could adopt behavior modification to adapt with the Coronavirus’s adverse outcomes by reframing the situation to improve mental health through: mindfulness, personal growth, building resilience, coping strategies, health problem solving, cultivating positive emotions, and curbing negative emotions through behavior modification. Adopting new behaviors such as mindfulness of hand-washing, healthy diet, physical activity; practicing introspection, meditation and minimalism; learning new skills of sketching, musical instruments, dancing; acquiring new languages; procuring knowledge of books, and podcasts; accumulating influential videos, series, movies, games, and music; and expressing gratitude through introspection and mindfulness – these activities could bring resilience, coping, wellbeing, gratitude, mindfulness and adapting and adjusting with the new changes outcome of coronavirus outbreak. Psychiatrists, experienced and trained mental health practitioners, and counselling psychologists could provide empirically-evidence based perspectives on misinfodemics (rumors, conspiracy theories, myths, superstitions, misinformation, disinformation and false information), normalize communities about the mental health issues, optimize mental health availabilities through internet platforms, and empower individuals and communities through mental healthcare. Government of Pakistan should incorporate psychological interventions as part of healthcare system in the context of public health emergency. Pakistan should introduce psychological crisis intervention program (see Mukhtar, 2020) to timely, effectively and efficiently mitigate the psychosocial and mental health impact of COVID-19. There is a paucity of research on the mental health factors prevalent in Pakistan during the COVID-19 pandemic outbreak so this commentary marks the preliminary suggestion to evaluate the impact of coronavirus outbreak on mental health in Pakistan. Government of Pakistan should strengthen personnel, optimize institutional good governance and offer advanced trainings and degrees in the field of counselling psychology and mental health. Financial disclosure The author declares no financial disclosure related to the submission. Declaration of Competing Interest The author declares no conflicts of interest.
p	Through this correspondence, I aim to highlight the secondary crisis-in-making which is mental health and psychosocial issues which mark the need for psychological crisis intervention during COVID-19 outbreak. Mental health and wellbeing are substantial foundations of healthcare and thus identification and mitigation of these issues is vital for healthy psychosocial functioning of individuals and community. This paper identifies potential mental health issues and proposes to adopt behavior modification to adapt with the quarantine, social isolation and social distancing. Pakistan should introduce psychological crisis intervention program (see Mukhtar, 2020). Pakistan (7025 confirmed cases) contracted coronavirus (COVID-19 – Coronavirus Disease 2019) through the arrival of overseas Pakistani (students, zaireen, visitors and pilgrims) from other geographical locations to Pakistan. Pakistan’s (fifth most populous country) basic family unit is extended-consanguine family system with multiple generations living together and thus in collectivistic culture such as this practicing social distancing poses a challenge on mental health of all family members. Community-dwellers depend on social support through family interaction and cultural activities to keep feelings of loneliness, negative emotions and psychological distress at bay. People could experience fear of death, fear of getting oneself or their family infected, anxiety, anger, depressive symptoms, and other mental health concerns during this pandemic outbreak (Rana et al., 2020).
p	Many factors are contributing in the affected mental health, psychosocial functioning, wellbeing, psychological and emotional welfare including uncertainty of this novel illness, unpredictability of the new risk including the self-isolation, social-distancing, and quarantine) impaired social functioning, interpersonal issues, perpetuating emotional and behavioral disorders, precipitating psychological problems, predisposing mental health issues, and tendency of easily getting affected from traumatic events. Healthcare conditions in Pakistan are exacerbating on daily basis and thus controlling the disease would require holistic comprehensive management on both physical and mental healthcare situation (Mukhtar, 2020). COVID-19 pandemic outbreak could have negative impact on psychological and mental health of people, for instance psychological distress, mental health issues, grief, shame, helplessness, hopelessness, posttraumatic symptoms, substance abuse, panic attacks, stress, anxiety, depression, loneliness, ambivalence, fear, anger, stigma and worry towards socioeconomic status (Mukhtar, 2020).
p	Mental health refers to the state of wellbeing in which individuals realizes their own ability to cope with normal life stressors and productively work to contribute in their own community (WHO, 2005). Mental health constitute a six element psychological perspective which includes a) self-acceptance, b) meaning in life, c) autonomy, d) healthy relations with others, e) environmental mastery, and f) personal growth.
p	Coronavirus pandemic outbreak which consolidated social-distancing and self-isolation has challenged all the aspects of mental health, wellbeing, emotional health, psychological and social wellness at the collective level (Mukhtar, 2020). Interpersonal issues including domestic violence, abuse, trauma, negative emotions, unhealthy relations and family environment, financial instability, poverty, poor health and other factors in addition to coronavirus has exacerbated the wellbeing of all individuals making them question their self-acceptance, meaning in life, and relationships with others. Restricted movement resulting from lockdown could make people question their autonomy and environmental mastery. And all in all challenges the personal growth and compromising mental health of general public (Lima et al., 2020; Shi and Hall, 2020).
p	The mental health issues have become secondary major health concerns globally prevalent in individuals to variable extents. People are experiencing anxiety, anger, confusion and posttraumatic symptoms during the self-isolation and quarantine (Banerjee, 2020). Healthcare professionals are doing meticulous job in protecting the nation from this catastrophic event (Rana et al., 2020), however, for effective treatment of infected individuals and their families’ mental states should be monitored as well.
p	Communities could adopt behavior modification to adapt with the Coronavirus’s adverse outcomes by reframing the situation to improve mental health through: mindfulness, personal growth, building resilience, coping strategies, health problem solving, cultivating positive emotions, and curbing negative emotions through behavior modification. Adopting new behaviors such as mindfulness of hand-washing, healthy diet, physical activity; practicing introspection, meditation and minimalism; learning new skills of sketching, musical instruments, dancing; acquiring new languages; procuring knowledge of books, and podcasts; accumulating influential videos, series, movies, games, and music; and expressing gratitude through introspection and mindfulness – these activities could bring resilience, coping, wellbeing, gratitude, mindfulness and adapting and adjusting with the new changes outcome of coronavirus outbreak.
p	Psychiatrists, experienced and trained mental health practitioners, and counselling psychologists could provide empirically-evidence based perspectives on misinfodemics (rumors, conspiracy theories, myths, superstitions, misinformation, disinformation and false information), normalize communities about the mental health issues, optimize mental health availabilities through internet platforms, and empower individuals and communities through mental healthcare.
p	Government of Pakistan should incorporate psychological interventions as part of healthcare system in the context of public health emergency. Pakistan should introduce psychological crisis intervention program (see Mukhtar, 2020) to timely, effectively and efficiently mitigate the psychosocial and mental health impact of COVID-19. There is a paucity of research on the mental health factors prevalent in Pakistan during the COVID-19 pandemic outbreak so this commentary marks the preliminary suggestion to evaluate the impact of coronavirus outbreak on mental health in Pakistan. Government of Pakistan should strengthen personnel, optimize institutional good governance and offer advanced trainings and degrees in the field of counselling psychology and mental health.
sec	Financial disclosure The author declares no financial disclosure related to the submission.
title	Financial disclosure
p	The author declares no financial disclosure related to the submission.
sec	Declaration of Competing Interest The author declares no conflicts of interest.
title	Declaration of Competing Interest
p	The author declares no conflicts of interest.
back	Acknowledgment None.
ack	Acknowledgment None.
title	Acknowledgment
p	None.

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PMC:7179483 / 1603-2715 JSONTXT 8 Projects

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PMC:7179483 / 1603-2715 JSON TXT 8 Projects