key: cord-0054449-ise9b8j0
authors: Dalwai, S. H.; Rege, K. P.
title: Psychosocial Wellness During the COVID-19 Pandemic: Building an ARCH
date: 2021-01-05
journal: Indian Pediatr
DOI: 10.1007/s13312-020-2083-4
sha: abd88bc68c3eda141d5a253739bbd6d8ec755289
doc_id: 54449
cord_uid: ise9b8j0

nan

To support and protect psychosocial well-being of children, we propose the ARCH model for mental health workers, parents and teachers. ARCH is an acronym for Adapt and attempt, Resilience, Collaboration and care, and Humor and humility.

In an uncertain and evolving situation, children may be encouraged to adapt to the current scenario and attempt solutions in a new normal, rather than wait for familiar comfort zones. Options for physical activities have been drastically reduced. Children tend to spend their excessive free time on television or mobile phone [3] . Introducing positive adaptation skills is essential. Children need to feel safe, secure, and positive about The COVID-19 pandemic is associated with significant morbidity and mortality. However, little attention has been devoted to psychological factors, emotional distress and social disruption in children. It is believed that the disease, multiplied by forced quarantine and nationwide lockdowns can induce acute panic, anxiety, obsessive behaviors, paranoia, depression and post-traumatic stress disorder (PTSD) [1] . The pandemic is likely to be followed by a 'second pandemic' of mental health crises [2] . This necessitates a comprehensive public health response with VOLUME 57 __ DECEMBER 15, 2020 CORRESPONDENCE their present and future. Caregivers can help by focusing children's attention on stories about how people come together, find creative solutions to difficult problems, and over-come adversity during the epidemic [4] . Caregivers need to ensure against promoting negative adaptation skills.

Since failure may be a likely outcome due to unprecedented challenges, resilience needs to be fostered. This entails 'listening' and being emotionally available to the child. Letting children express their concerns, and participating in their activities are key initiatives. Children should be given an idea of what realistically to expect rather than painting rosy but ostensibly false pictures of the situation. Queries from children need to be answered with simple concrete explanations appropriate to their level of cognitive development. Being honest and supporting them with their challenges help build resilience in the situation.

Collaboration and care are imperative in a prolonged crisis. Children need to be encouraged to reach out to parents, siblings, peers, school mates, teachers, and other caregivers to pool resources and ideas, and work together collaboratively to find creative solutions to everyday challenges under super-vision and guidance, while caring for each other's contributions [5] .

Humor in daily life is vital for the child to withstand distress, and inculcating humility is imperative to help the child to maintain a sense of calm acceptance and balance.

Mumbai, Maharashtra, India. *samyrdalwai@gmail.com I appreciate the efforts of the authors of the article on integration in medical education published recently in the journal [1] . Competency-based under graduate medical curriculum for Indian medical graduates has given elaborate guidelines on how integration can be achieved in various subjects [2] . Competency tables of this document have suggested for areas of integration according to subject-wise competencies.

Integrated teaching activity has not received expected success, though attempted widely. There are many misconceptions among the faculty about implementation of integrated teaching sessions. Integrated teaching has been organized as a series of lectures involving faculty from many departments. The extra efforts required for inter-departmental coordination has made the organization of activity irregular and episodic, lacking in sustainability. The lengthy structure of the resultant sessions has also not been able to arouse sufficient interest among the students.

Integrated teaching can be made more meaningful if these misconceptions are addressed. It has been rightly pointed out in the competency-based undergraduate curriculum document that there should be integration of concepts and not necessarily of teachers [2] . The faculty can identify the topics in their curriculum where integration with other disciplines can reduce redundancy, duplication and increase the relevance of learning for the students.

Psychosocial impact of COVID-19

A second pandemic: Mental health spillover from the novel coronavirus (COVID-19)

Impact of COVID-19 on children: Special focus on the psychosocial aspect

Managing psychological distress in children and adolescents following the COVID-19 epidemic: A cooperative approach

Resources for supporting children's emotional wellbeing during the COVID-19 pandemic

Integration in medical education

Competency based Undergraduate Curriculum for the Indian Medical Graduate

The teachers from other departments may be consulted for planning of sessions and not for actual partici-pation in the sessions, unless deemed necessary. Integration of relevant concepts from other disciplines will help in enriching the routine teaching activity. The faculty from the parent discipline can perform this integration at their own level to make the learning experience for the student more meaningful and relevant.Integration should be an integral part of routine teaching program of each department, rather than an independent activity. Integration should be used as an opportunity to enrich the departmental teaching activities without compromising the departmental learning objectives. Integrated teaching sessions should be short and brief, to be completed in the routine allotted time, avoiding too many objectives in one session. Multiple teaching methods such as case discussions, group activity and panel discussions can generate interest in students. Intensive coordinated action by teachers is required to make integrated teaching successful activity.

Health Sciences, Nashik, Maharashtra, India. khamgaonkar_1@rediffmail.com