Counsellors report urgent demands for mental and psychosocial support, particularly among women and girls who are facing an increase in gender-based violence, in addition to challenges brought on by the crisis.

Pema, a mental health counsellor who volunteers with UNFPA in central Bhutan, has witnessed this first-hand.

“This lockdown has brought the whole country to a standstill, but domestic violence and violence against women and girls have proliferated,” she said recently.

Surge in gender-based violence

A volunteer counsellor since 2007, Pema pivoted to providing services over the telephone due to the pandemic.

Pema said she has been “extremely busy” providing telecounselling services to survivors of physical and sexual violence.

The UNFPA-supported One-Stop Crisis Centre, located at the National Referral Hospital in Thimphu, Bhutan’s capital, has also seen a surge in both gender-based violence and mental health concerns.

“During the first three months of COVID-19restrictions, 22 cases of rape/sexual assault perpetrated against minors were reported to the One-Stop Crisis Centre,” said Dechen Chime, a UNFPA programme officer.

She added that over a three-week period in August, “the national newspaper reported increased cases of suicide, and the One-Stop Centre reported a suicide case every fourth day.”

UNFPA-supported non-governmental organizations, as well as shelters across the country, have also recorded dozens of cases of violence against women and girls.

Demand for telecounselling

Bhutan, a landlocked kingdom in the Himalayas, recorded its first case of COVID-19 in early March, prompting movement restrictions and shuttering schools and other institutions.

During the first months of the closures, the civil society organization RENEW, a UNFPA partner, delivered more than 200 telecounselling services, reflecting a marked increase in demand.

For Pema, telecounselling is not always enough. Some survivors require in-person support.

“For the last five days, I have been attending to a severe marital rape case through the telephone. The perpetrator has already been reported and is under police custody,” she explained.

“Today, my client has called me over seven times, and I am a bit worried. I want to visit her so I am applying for a movement order from the COVID-19 taskforce.”

Community volunteer network

The taskforce is a multi-sectoral group formed under the patronage of Her Majesty Gyalyum Sangay Choden Wangchuck, the Queen Mother of Bhutan and a UNFPA Goodwill Ambassador.

Normally, the taskforce addresses issues such as HIV and sexually transmitted infections by bringing together district health, education, legal and cultural representatives. Today, it coordinates much of the pandemic response.

With UNFPA’s support, the taskforce has also been working closely with the community volunteer network over the past six years.  It is through this network that Pema, and more than 100 others like her, provide psychosocial support to survivors of violence.

The volunteers must travel over mountainous terrain to meet with clients, even in normal circumstances. Although the pandemic has complicated matters, the network has remained active in all 20 districts of the country.

“This is a time when nothing moves without proper coordination,” said Pema. “The multi-sectoral taskforce and community-based service system working together has really helped me to reach out to my clients, even during this lockdown.”

Needs are rising

When the pandemic was announced back in March, coordination efforts began almost immediately. Vulnerable populations were identified, and information about support and services was widely disseminated through television and social media by UNFPA and partners.

However, despite these efforts, UNFPA warned that needs are growing, and urgent attention is required.

This Saturday, 10 October, is World Mental Health Day, and experts across the globe are advocating for increased investment in services at a time when many lives have been upended.

“We are already seeing the consequences of the COVID-19 pandemic on people’s mental well-being, and this is just the beginning,” said Tedros Ghebreyesus, Director-General of the World Health Organization (WHO).

Supporting ‘Gross National Happiness’

Bhutan has recognized the importance of ensuring mental health, according to UNFPA.  Since the 1970s, the country’s official development policy has been guided by the concept of “Gross National Happiness”.

The Ministry of Health has established a dedicated hotline, led by senior psychiatrists, to respond to those in crisis.  Anyone at risk of suicide or self harm, or in need of any other mental health support, can access these services free of charge.

Additionally, the National Commission for Women and Children, and RENEW-UNFPA, also provide psychosocial counselling services and temporary shelter services, which are also free.