What did you do to stay ‘sane’ during the pandemic? A qualitative study to identify self-care mental health strategies utilized in a socially vulnerable population

Abstract

Background Mental health has deteriorated during the COVID-19 pandemic. These impacts are likely to be more severe in socially vulnerable communities. Previous research has identified useful self-help strategies that individuals may use to maintain and improve mental health. However, these studies have typically ignored economically and socially marginalized communities and have used researcher pre-defined practices. Little is known what activities or actions members of poor urban communities from low and middle income countries may utilize to take care of their mental health.   Methods During March and April 2021, we conducted open-ended interviews with 317 community members in Complexo de Favelas da Maré, Rio de Janeiro, Brazil, one of the largest slum areas in South America. Individuals were interviewed in selected public spaces to provide a representative sample of the wider area. Our sample consisted of 178 (56.1%) cis women, 133 (41.9%) cis men, 3 (0.9%) trans men, and 3 (0.9%) classified themselves as other. The majority of participants had incomplete middle school or less (54.2%) and were between 30 and 60 years (54.1%).  Results Using thematic analysis, we identified eight major themes in the responses. The most common themes that emerged were work, leisure activities (including watching TV & physical exercise) and religion/prayer. These findings did not clearly align with previous mental health recommendations. Some results were noteworthy by their absence, e.g., cost-effective mental health practices such as yoga, meditation or mindfulness were not mentioned. Only 4 individuals reported consulting mental health professionals during the pandemic.  Conclusions Our findings highlight the need for better public health campaigns that disseminate information for effective mental health practices during acute crises, especially for communities that are most vulnerable during public health crises.