Student Suicide Risk and Gender: A Retrospective Study from Bangladeshi Press Reports

COVID-19 and Mental Health: A "Pandemic Within a Pandemic"

The COVID-19 pandemic has brought significant changes in daily life for humanity and has had a profound impact on mental health. As widely acknowledged, the pandemic has led to notable increases in rates of anxiety, depression, distress, and other mental health-related issues, affecting both infected patients and non-infected individuals. COVID-19 patients and survivors face heightened risks for various neurological and psychiatric disorders and complications. Vulnerable populations, including those with pre-existing mental health conditions and individuals living in poverty or frailty, may encounter additional challenges. Tragically, suicide rates have also risen, particularly among young people, due to factors such as unemployment, financial crises, domestic violence, substance abuse, and social isolation. Efforts are underway to address these mental health issues, with healthcare professionals urged to regularly screen both COVID-19 and post-COVID-19 patients and survivors for psychological distress, ensuring rapid and appropriate interventions. Ongoing periodic follow-up and multidimensional, interdisciplinary approaches are essential for individuals experiencing long-term psychiatric sequelae. Preventive strategies must be developed to mitigate mental health problems during both the acute and recovery phases of COVID-19 infection. Vaccination efforts continue to prioritize vulnerable populations, including those with mental health conditions, to prevent future complications. Given the profound implications of mental health problems, including shorter life expectancy, diminished quality of life, heightened distress among caregivers, and substantial economic burden, it is imperative that political and health authorities prioritize the mental well-being of all individuals affected by COVID-19, including infected individuals, non-infected individuals, survivors, and caregivers.

Analysis of Newspaper Reporting of Non-fatal Suicide Attempts During the Covid-19 Lockdown in Pakistan

Background: This study was aimed to observe newspaper reports about non-fatal suicide attempts in Pakistan during the COVID-19 lockdown. Methods: We performed content analysis of news reports about incomplete suicides from four vernacular newspapers of Pakistan between March and August 2020. Results: A total of 87 news reports about suicide attempts were examined; the vast majority of the suicide attempters was Muslims (78%), males (64%), females (36%) with (33%) mentions of age, ranging from 19-30 years, and married were (76%). However, occupation was largely missing from (93%) of the news. Self-poisoning was the commonly reported method in (65%) of suicide attempts, whereas familial discord was the leading risk factor for (72%) of suicide attempts. Conclusions: Although psychological intervention is crucial to reduce familial discords as risk factors, monitoring the mental health conditions of people vulnerable to suicide and the figures on attempted suicides should be maintained and collected nationally and regionally.

Trend and gender-based association of the Bangladeshi student suicide during the COVID-19 pandemic: a GIS-based nationwide distribution

BACKGROUND

Students are one of the most vulnerable groups to suicide. Before the COVID-19 pandemic, a Bangladeshi study was conducted assessing their suicide patterns regarding gender-based associations. But how has the pandemic changed the Bangladeshi students' suicide patterns is not studied yet, which is investigated herein. Besides, for the first time, this study provides GIS-based distribution of suicide cases across the country's administrative district.

METHODS

As Bangladesh has no suicide surveillance system, this study utilized media reporting suicide cases following the prior studies. A total of 127 students' suicide cases from March 2020 to March 2021 were finally analyzed after eliminating the duplicate ones, and data were synthesized following the prior studies. Arc-GIS was also used to distribute the suicide cases across the administrative district.

RESULTS

Results revealed that female (72.4%; n = 92/127) was more prone to die by suicide than males. About 42.5% of the cases were aged between 14 and 18 years (mean age 16.44 ± 3.512 years). The most common method of suicide was hanging (79.5%; n = 101), whereas relationship complexities (15.7%), being emotional (12.6%), not getting the desired one (11%), conflict with a family member (9.4%), academic failure (9.4%), mental health problem (8.7%), sexual complexities (6.3%), scolded or forbidden by parents (3.9%) were the prominent suicide causalities. In respect to gender and suicide patterns, only the suicide stressor was significantly distributed, whereas the method of suicide was significantly associated with GIS-based distribution. However, a higher number of suicide cases was documented in the capital (i.e. Dhaka) and the northern region than in its surrounding districts.

CONCLUSIONS

The findings reported herein are assumed to be helpful to identify the gender-based suicide patterns and suicide-prone regions in the time of the COVID-19 pandemic to initiate suicide prevention programs of the risky students.

Increased suicidal behaviors among students during COVID-19 lockdowns: A concern of student's mental health in Bangladesh

The COVID-19 pandemic has brought an unprecedented natural event on life. The mental health of students has been impacted due to the long-term closure of educational institutions. The suicide rate had been significantly increased during the COVID-19 pandemic compared to previous years among Bangladeshi students. Several COVID-19 responses might be responsible for this increased suicidality among students. Therefore, family members should give them mental supports to reduce additional burdens due to the pandemic. The government and non-government organizations can take suicide prevention programs such as awareness campaigns, student counseling, internet-based interventions, etc. Also, the authority should vaccinate students, teachers, and other staff to reopen the academic institutions on an urgent basis.

Risk Factors for Depression and Anxiety Disorders Among Bangladeshi Dental Students: A Cross-Sectional Survey Study

Dental students are highly prone to mental health suffering due to the stressors related to their educational, academic, and clinical environment. However, there are no previous studies that evaluated the mental health problems among dental students in Bangladesh. Therefore, the present study assessed the prevalence of depression and anxiety and its covariates. A cross-sectional survey was carried out among the students of five (out of a total of nine) Bangladeshi public dental institutes. The survey included the Patient Health Questionnaire, the Generalized Anxiety Disorder scale, and questions relating to sociodemographic factors, personal suffering, and family mental health history. Results indicated that the prevalence rates for moderate to severe depression and anxiety were 27.4% and 18.2%, respectively. The risk factors for depression and anxiety were being female, coming from city areas, having past-year psychological and physical suffering, having past-year traumatic events, and having a family history of mental illness, as well as a range of suicide-related behaviors. The prevalence rates of depression and anxiety in the present study were relatively lower than other dental student cohorts residing outside Bangladesh. Further investigations are suggested based on the limitations and strengths of the present study.

Psychological Impact of COVID-19 Pandemic in Bangladesh: Analysis of a Cross-Sectional Survey

The COVID-19 pandemic has generated fear, panic, distress, anxiety, and depression among many people in Bangladesh. In this cross-sectional study, we examined factors associated with different levels of psychological impact as a result of COVID-19 in Bangladesh. From April 1 to 30, 2020, we used a self-administered online questionnaire to collect data from 10,609 respondents. Using the Impact of Event Scale-Revised to assess the psychological impact of the COVID-19 pandemic on respondents, we categorized the levels of impact as normal, mild, moderate, or severe. Ordinal logistic regression was used to examine the associated factors. The prevalence of mild, moderate, and severe psychological impact was 10.2%, 4.8%, and 45.5%, respectively. Multivariate analysis revealed that the odds of reporting normal vs mild, moderate, or severe psychological impact were 5.9 times higher for people living in the Chittagong Division, 1.7 times higher for women with lower education levels, 3.0 times higher among those who were divorced or separated, 1.8 times higher for those working full time, and 2.4 times higher for those living in shared apartments. The odds of reporting a psychological impact were also higher among people who did not enforce protective measures inside the home, those in self-quarantine, those who did not wear face masks, and those who did not comply with World Health Organization precautionary measures. Increased psychological health risks due to COVID-19 were significantly higher among people who experienced chills, headache, cough, breathing difficulties, dizziness, and sore throat before data collection. Our results showed that 1 in 2 respondents experienced a significant psychological impact as a result of the COVID-19 pandemic. Public health researchers should consider these factors when targeting interventions that would have a protective effect on the individual's psychological health during a pandemic or future disease outbreak.

The first COVID-19 triadic (homicide!)-suicide pact: Do economic distress, disability, sickness, and treatment negligence matter?

INTRODUCTION

Dyadic suicide-pact is rare but possible incidence in the COVID-19 time. No prior evidences available on triadic suicide-pact, which is presented herein for the first-time.

CASE PRESENTATION

An Indian family consisting of three members, committed suicide. There is no evidence of homicide-suicide, which suggests the cases to be mutual suicide-pact. However, the suicide risk factors can be evidently noted as (i) economic distress, (ii) feeling burden of disability and sick people, and (iii) being stubborn as of not getting hospital treatment. Poisoning is reported for the suicide method; besides, the victims left a suicide note.

PRACTICAL IMPLICATIONS

The present case highlights the possibilities of further suicide-pacts in economically unprivileged family, whereas having disabled and/or sick people may add extra burdens in taking such extreme decision.

Suicide among Ugandan university students: evidence from media reports for 2010-2020

University students are in transition to adulthood and face multiple challenges that may lead to suicide. They are reported to have a higher risk of suicide by the World Health Organization. As there is no national suicide database in Uganda, we analysed student suicide using the press/media reports of suicides published between 2010 and 2020. A total of deaths by 23 suicide were identified: 19 were males, relationship problems were the main suicide reason (n = 6) and hanging was the most frequently used suicide method (n = 7). A strategic intervention to tackle suicide risk among university students is warranted.

The Determinants of Panic Buying during COVID-19

The COVID-19 pandemic has seen an unmatched level of panic buying globally, a type of herd behavior whereby consumers buy an uncommonly huge amount of products because of a perception of scarcity. Drawing on the health belief model, perceived scarcity, and anticipated regret theories, this paper formulated a theoretical model that linked the determinants of panic buying and analyzed their interrelationships. Subsequently, data were collated from 508 consumers through an online survey questionnaire in Singapore that was conducted during the early stage of the pandemic, before the onset of the circuit breaker in April 2020. Next, an analysis of the results was done through structural equation modeling. It showed that the effect of the health belief model dimensions (i.e., perceived susceptibility, perceived severity, outcome expectation, cues to action, and self-efficacy) on panic buying is partially mediated by the consumers' perceived scarcity of products. Furthermore, the effect of perceived scarcity on panic buying is partially mediated by consumers' anticipation of regret. This paper expands on the current theoretical understanding of panic buying behavior, giving insights into the possible measures and solutions that policymakers and relevant stakeholders can uptake to manage panic buying in future a pandemic or health crisis.

Suicidal behaviors and suicide risk among Bangladeshi people during the COVID-19 pandemic: An online cross-sectional survey

BACKGROUND

Suicide, a major public health concern, is a leading cause of injury and death worldwide. The present study aims to assess suicidal behaviors and suicide risk among Bangladeshi people during COVID-19.

METHODS

A cross-sectional online survey was conducted from July 10 to July 20, 2020, involving 1,415 Bangladeshi residents ages 18 years or older. Data was collected via an anonymous online questionnaire. The Suicide Behaviors Questionnaire-Revised was used to assess suicide risk. The depression and anxiety subscales of the Depression Anxiety Stress Scale 21 were used to assess depression and anxiety. Logistic regression analyses and Pearson's correlation were performed to examine the association of variables.

RESULTS

The prevalence of suicide ideation and planning among Bangladeshi people during the COVID-19 pandemic was 19.0% and 18.5%, respectively. Having suicidal risk during the COVID-19 pandemic was reported by 33.5% participants. Suicide risk was associated higher with females, divorced or widowed marital statuses and low educational attainment (i.e., secondary or below and higher secondary/diploma). Additionally, living in high COVID-19 prevalent areas, having economic loss due to the COVID-19 pandemic, relatives or acquaintances die from COVID-19, direct contact with COVID-19 patient(s), and fear of COVID-19 infection were associated with suicide risk.

CONCLUSIONS

The COVID-19 pandemic imposes significant psychological consequences on people, thus, concerned authorities should pay attention to people's mental health and focus on suicide prevention and awareness during and after the COVID-19 pandemic.

Suicidal Behavior and Flood Effects in Bangladesh: A Two-Site Interview Study

Background

Bangladeshi flood survivors are reported with such higher mental disorders that are not ever observed in any other cohorts. Although there are a few studies that assessed mental disorders, suicide or suicidal behaviors are not investigated yet. Hence, the present study for the first time investigated suicidal behaviors and its relationship with socio-demographics, flood effects and psychopathology.

Methods

A cross-sectional interview study was carried out between November and December 2019, after 4/5 months of the flood occurrence. Two completely affected villages from two districts residing in two parts of the country were randomly selected (whereas Manikganj district was less affected by the recent flood compared to Kurigram), and a total of 348 flood survivors were interviewed (45.53 ± 14.85 years). Questions related to basic socio-demographics, flood effects, psychological impacts, and suicidal behaviors were asked in the interviews.

Results

In the total sample, 57.5% of flood survivors reported having suicidal ideation, whereas 5.7% and 2.0% madea suicide plan and suicide attempt, respectively. Within two study sites, participants belonging to Kurigram reported significantly higher suicidal ideation compared to Manikganj (84.8% vs 33.2%, χ² = 94.475, p<0.001). Belonging to a lower-class family, having less education, and less earning members in the family, being affected severely by the flood, suffering from depression, anxiety, and PTSD, and experiencing financial threat, and economic hardship were suicidal behavior risk factors in the total sample.

Conclusion

Considering the present findings (ie, suicidality commensurately increases with flood effects), a multi-sectoral policy and its effective implementation should be adopted for alleviating the flood-related psychological burdens.

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Psychological and Livelihood Impacts of COVID-19 on Bangladeshi Lower Income People

The objective of this research is to understand the psychological and livelihood-related impacts of coronavirus disease 2019 (COVID-19) on Bangladeshi lower income group people who depend on daily earnings for their living. Following the convenience sampling method, 576 respondents were interviewed for quantitative data and 30 in-depth interviews for qualitative information in several districts of Bangladesh. To 94.1% respondents, livelihood has been affected by the COVID-19 outbreak with an overall score of 3.20 ± 0.77 on a 4-point Likert-type scale. In comparison to unemployed respondents, daily workers have been hardly affected by the COVID-19 outbreak (odds ratio [OR] = 7.957; P < .01), and so they are going outside more frequently in search of jobs (OR = 9.984, P < .01). Due to fear of COVID-19 infection and lack of livelihood means, respondents (76.6%) have been stressed out (overall score 3.19 ± 0.81 on a 4-point Likert-type scale), and those working in industries (OR = 5.818, P < .01), farmers (OR = 3.029, P < .05), and day laborers (OR = 2.651, P < .05) have been highly stressed.

The first COVID-19 infanticide-suicide case: Financial crisis and fear of COVID-19 infection are the causative factors

BACKGROUND

The global suicide occurrences have been aggravated because of COVID-19 crisis-related issues such as fear of infection, the financial crisis, being infected with COVID-19, loneliness, social boycott, etc. Although two studies reported about the seven dyadic suicidality cases (i.e., suicide pacts), child homicide-suicide has not been studied.

CASE PRESENTATION

On 14 May, two dead bodies (i.e., a 30-years old Indian woman and her six-month-old baby) were found in a Riyadh apartment complex. The perpetrator (a person who kills the others and later commits suicide) - a trained nurse, was in search of a job. The woman's husband was recently retrenched from his technician job at a company in Madinah Airport. Her husband was admitted to a hospital with symptoms related to the COVID-19 infection four days before the suicide incidence. The 70-year-old mother-in-law alerted the neighbors after finding that the apartment is locked from inside and there was no response on knocking the doors. After this, the neighbors gathered and called the police. Police found two dead-bodies after opening the flat and suspected that the child was killed before the woman committed suicide.

CONCLUSIONS

Based on the present findings, further child filicide-suicide possibilities in families with economically distressed and/or positive COVID-19 status are expected. Hence, proper financial supports, providing authentic information (COVID-19), and mental health promotional strategies are suggested for decreasing incidences of COVID-19 related infanticide-suicide cases.

Financial threat, hardship and distress predict depression, anxiety and stress among the unemployed youths: A Bangladeshi multi-city study

INTRODUCTION

Unemployment has a contributory role in the development of mental health problems and in Bangladesh there is increasing unemployment, particularly among youth. Consequently, the present study investigated depression, anxiety, and stress among recent graduates in a multi-city study across the country.

METHODS

A cross-sectional study was conducted among 988 Bangladeshi graduate jobseekers in six major cities of the country between August to November 2019. The measures included socio-demographics and life-style factors, study and job-related information, Economic Hardship Questionnaire, Financial Threat Scale, Financial Well-Being Scale, and Depression Anxiety Stress Scale-21.

RESULTS

Depression, anxiety and stress rates among the present sample were 81.1% (n = 801), 61.5% (n = 608) and 64.8% (n = 640) respectively. Factors related to gender, age, socioeconomic conditions, educational background, lack of extra-curricular activities, and high screen activity were significant risk factors of depression, anxiety, and stress. Structural equation modeling indicated that (while controlling for age, daily time spent on sleep study, and social media use), financial threat was moderately positively related to depression, anxiety, and stress. Financial hardship was weakly positively associated with depression, anxiety, and stress, whereas financial wellbeing was weakly negatively associated with depression, anxiety, and stress.

LIMITATIONS

Due to the nature of the present study (i.e., cross-sectional study) and sampling method (i.e., convenience sampling), determining causality between the variables is not possible.

CONCLUSIONS

The present results emphasized the important detrimental role of financial troubles on young people's mental health by showing that financial problems among unemployed youth predict elevated psychiatric distress in both men and women.

Prevalence and Predisposing Factors of Suicidal Ideation Among the University Students in Bangladesh: A Single-Site Survey

Recently, suicide among Bangladeshi university students has become a serious problem. However, to date, there have been no studies assessing suicidal behaviors among Bangladeshi students. Therefore, the present study investigated suicidal ideation (SI) and its risk factors among this population. A classroom-based convenience sampling method was utilized to survey 665 students of a university in Bangladesh (67.5% males; aged 21.16 years: SD ± 1.6). In addition to socio-demographic questions, the survey also included the Smartphone Application-Based Addiction Scale, Bergen Facebook Addiction Scale, and Depression Anxiety Stress Scale–21. Results showed that the prevalence of suicidal ideation was 2.3% in the past 24 h, 4.8% in the past 15 days, 6.9% in the past month, 14.7% in the past year, and 61.1% in the lifetime. The unadjusted regression model showed that being divorced (or separated) from a partner (OR = 4.486, 95% CI = 1.972–10.207, p < 0.0001), Facebook addiction (OR = 1.550, 95% CI = 1.006–2.388, p = 0.047), depression (OR = 1.657, 95% CI = 1.677–4.211, p < 0.0001), anxiety (OR = 2.649, 95% CI = 1.624–4.320, p < 0.0001), and stress (OR = 2.626, 95% CI = 1.673–4.122, p < 0.0001) were the risk factors of past-year SI. Compared with global prevalence rates, the present study reported higher levels of SI prevalence. Therefore, supportive suicide prevention programs are needed to tackle SI and alongside comorbid psychopathology.

Prevalence and risk factors of COVID-19 suicidal behavior in Bangladeshi population: are healthcare professionals at greater risk?

BACKGROUND

Current COVID-19 researches suggest that both general population and health-care providers (HCPs) are at risk of elevated psychological sufferings including suicidality. However, suicidality has not been addressed properly, although mental health problems are studied globally. Besides, the extreme fear of COVID-19 infection is being existed among the Bangladeshi HCPs, that is reported by a recent patients' suicide because of HCPs treatment negligence.

METHODS

A web-based cross-sectional study was administered through the social media platforms. A total 3,388 respondents took part in the survey (mean age 30.1 ± 6.4 years) among them 834 were frontline HCPs (30.7 ± 5.6 years). The measures included socio-demographics, PPE-related and patient-care related information and a question concerned with the COVID-19 suicidal behavior.

RESULTS

About 6.1% of the total participants had suicidal behavior, with no detectable differences within the groups (i.e., general population and HCPs). Regression analysis showed that being female, being divorced, and having no child were emerged as independent predictors for suicidality. There was no significant association between the PPE-related or patient-care related variables and suicidal behavior of the HCPs. Majority of the participants sometimes had fear of death although no significant relation of the factor was found with suicidality.

LIMITATIONS

The study can be limited because of its nature (i.e., cross-sectional self-reporting online survey) and not considering non-COVID-19 related suicide risk factors etc.

CONCLUSIONS

The present findings identified the substantial proportion of the HCPs and general population had COVID 19 related suicidal behavior. It can be used to advocate a large-scale suicide safety plan using a multidisciplinary approach herein.

COVID-19 suicides in Pakistan, dying off not COVID-19 fear but poverty? - The forthcoming economic challenges for a developing country

• Suicide increment during and afterwards a pandemic is highly common. • This study reports COVID-19 suicide cases in Pakistan for the first time. • Most of the suicides occur due to lockdown-related economic recession. • Fear of infection is the second suicide contributing factor. • Lockdown-related unemployment aggravates the life-threatening situation.

Exploring COVID-19 stress and its factors in Bangladesh: A perception-based study

BACKGROUND

The COVID-19 pandemic has aggregated mental health sufferings throughout the entire world. Suicide completions are the extreme consequences of COVID-19 related psychological burdens, which was reported in many countries including Bangladesh. However, there are lack of study assessing COVID-19 related human stress and its' associations with other relevant factors affecting quality of life in the country, and which were explored in the present study.

METHODS

An online based survey was carried out among 340 Bangladeshi adult populations (65.90% male; mean age 26.23 ± 6.39) by utilizing the socio-demographics, possible human stress due to COVID-19 pandemic and its consequences. Dataset were analysed through a set of statistical tools e.g., T-test, one-way ANOVA, Pearson's Correlation Matrix (PCM), Principal Component Analysis (PCA), and Cluster Analysis (CA).

RESULTS

About 85.60% of the participants are in COVID-19-related stress, which results in sleep shortness, short temper, and chaos in family. Fear of COVID-19 infection (i.e., self and/or family member(s), and/or relatives), hampering scheduled study plan and future career, and financial difficulties are identified as the main causes of human stress. Results of PCM explain the relationship among the factors of human stress, and found economic hardship and food crisis are linked together causes stress of mass people, while hamper of formal education and future plan create stress of career seeker. T-test, and one-way ANOVA illustrate demographic characteristics (i.e., occupation, age, gender, and marital status) have significant effects on elevated mental stress. Moreover, PCA and CA results revealed significant interface among the respondents' perception and factors of human stress, which matched with the existing scenario of the country.

CONCLUSIONS

Considering the present findings, it is essential to introduce time-oriented policy, and implement care monitoring plans in the country, which may help in managing the pandemic as well as nurturing the public mental health to combat COVID-19 related psychological challenges.

Psychosocial and Socio-Economic Crisis in Bangladesh Due to COVID-19 Pandemic: A Perception-Based Assessment

Background: The spread of the COVID-19 pandemic, the partial lockdown, the disease intensity, weak governance in the healthcare system, insufficient medical facilities, unawareness, and the sharing of misinformation in the mass media has led to people experiencing fear and anxiety. The present study intended to conduct a perception-based analysis to get an idea of people's psychosocial and socio-economic crisis, and the possible environmental crisis, amidst the COVID-19 pandemic in Bangladesh. Methods: A perception-based questionnaire was put online for Bangladeshi citizens of 18 years and/or older. The sample size was 1,066 respondents. Datasets were analyzed through a set of statistical techniques including principal component and hierarchical cluster analysis. Results: There was a positive significant association between fear of the COVID-19 outbreak with the struggling healthcare system (p < 0.05) of the country. Also, there was a negative association between the fragile health system of Bangladesh and the government's ability to deal with the pandemic (p < 0.05), revealing the poor governance in the healthcare system. A positive association of shutdown and social distancing with the fear of losing one's own or a family members' life, influenced by a lack of healthcare treatment (p < 0.05), reveals that, due to the decision of shutting down normal activities, people may be experiencing mental and economic stress. However, a positive association of the socio-economic impact of the shutdown with poor people's suffering, the price hike of basic essentials, the hindering of formal education (p < 0.05), and the possibility of a severe socio-economic and health crisis will be aggravated. Moreover, there is a possibility of a climate change-induced disaster and infectious diseases like dengue during/after the COVID-19 situation, which will create severe food insecurity (p < 0.01) and a further healthcare crisis. Conclusions: The partial lockdown in Bangladesh due to the COVID-19 pandemic increased community transmission and worsened the healthcare crisis, economic burden, and loss of GDP despite the resuming of industrial operations. In society, it has created psychosocial and socio-economic insecurity among people due to the loss of lives and livelihoods. The government should take proper inclusive steps for risk assessment, communications, and financial stimulus toward the public to alleviate their fear and anxiety, and to take proper action to boost mental health and well-being.

COVID-19 pandemic, socioeconomic crisis and human stress in resource-limited settings: A case from Bangladesh

Considering the population density, healthcare capacity, limited resources and existing poverty, environmental factors, social structure, cultural norms, and already more than 18,863 people infected, the community transmission of COVID-19 is happening fast. These exacerbated a complex fear among the public. The aim of this article is, therefore, to understand the public perception of socioeconomic crisis and human stress in resource-limited settings of Bangladesh during the COVID-19 outbreak. The sample comprised of 1066 Bangladeshi participants. Principal component analysis (PCA) was considered to design a standardized scale to measure the mental stress and socioeconomic crisis, one-way ANOVA and t-test were conducted to perceive different demographic risk groups; multiple linear regression was applied to estimate the statistically significant association between each component, and classical test theory (CTT) analysis was applied to examine the reliability of each item according to the components to develop a composite score. Without safeguarding the fundamental needs for the vulnerable ultra-poor group can undeniably cause the socioeconomic crisis and mental stress due to the COVID-19 lockdown. It has further created unemployment, deprivation, hunger, and social conflicts. The weak governance in the fragile healthcare system exacerbates the general public's anxiety as the COVID-19 testing facilities are centered around in the urban areas, a long serial to be tested, minimum or no treatment facilities in the dedicated hospital units for COVID-19 patients are the chief observations hampered along with the disruption of other critical healthcare services. One-way ANOVA and t-test confirmed food and nutritional deficiency among the vulnerable poorest section due to loss of livelihood. Also, different emergency service provider professions such as doctors, healthcare staff, police forces, volunteer organizations at the frontline, and bankers are at higher risk of infection and subsequently mentally stressed. Proper risk assessment of the pandemic and dependable risk communications to risk groups, multi-sectoral management taskforce development, transparency, and good governance with inter-ministerial coordination is required along with strengthening healthcare capacity was suggested to reduce mental and social stress causing a socioeconomic crisis of COVID-19 outbreak. Moreover, relief for the low-income population, proper biomedical waste management through incineration, and preparation for the possible natural disasters such as flood, cyclones, and another infectious disease such as dengue was suggested. Finally, this assessment process could help the government and policymakers to judge the public perceptions to deal with COVID-19 pandemic in densely populated lower-middle-income and limited-resource countries like Bangladesh.

Psychosocial and Socio-Economic Crisis in Bangladesh Due to COVID-19 Pandemic: A Perception-Based Assessment

Background: The spread of the COVID-19 pandemic, the partial lockdown, the disease intensity, weak governance in the healthcare system, insufficient medical facilities, unawareness, and the sharing of misinformation in the mass media has led to people experiencing fear and anxiety. The present study intended to conduct a perception-based analysis to get an idea of people's psychosocial and socio-economic crisis, and the possible environmental crisis, amidst the COVID-19 pandemic in Bangladesh. Methods: A perception-based questionnaire was put online for Bangladeshi citizens of 18 years and/or older. The sample size was 1,066 respondents. Datasets were analyzed through a set of statistical techniques including principal component and hierarchical cluster analysis. Results: There was a positive significant association between fear of the COVID-19 outbreak with the struggling healthcare system (p < 0.05) of the country. Also, there was a negative association between the fragile health system of Bangladesh and the government's ability to deal with the pandemic (p < 0.05), revealing the poor governance in the healthcare system. A positive association of shutdown and social distancing with the fear of losing one's own or a family members' life, influenced by a lack of healthcare treatment (p < 0.05), reveals that, due to the decision of shutting down normal activities, people may be experiencing mental and economic stress. However, a positive association of the socio-economic impact of the shutdown with poor people's suffering, the price hike of basic essentials, the hindering of formal education (p < 0.05), and the possibility of a severe socio-economic and health crisis will be aggravated. Moreover, there is a possibility of a climate change-induced disaster and infectious diseases like dengue during/after the COVID-19 situation, which will create severe food insecurity (p < 0.01) and a further healthcare crisis. Conclusions: The partial lockdown in Bangladesh due to the COVID-19 pandemic increased community transmission and worsened the healthcare crisis, economic burden, and loss of GDP despite the resuming of industrial operations. In society, it has created psychosocial and socio-economic insecurity among people due to the loss of lives and livelihoods. The government should take proper inclusive steps for risk assessment, communications, and financial stimulus toward the public to alleviate their fear and anxiety, and to take proper action to boost mental health and well-being.