Is Maslow’s Hierarchy of Needs Applicable During the COVID-19 Pandemic?

To the Editor

Maslow’s “hierarchy of needs” is a well-known theory of motivation that ranks the needs of individuals according to their perceived importance. It is visualized as a pyramid, with the more indispensable needs at the base and the least essential at the peak. Maslow theorized that humans are typically motivated to attain lower basic needs before satisfying their higher human needs, although he later stated that based on external factors or individual differences, there might be exceptions. ¹ He also argued that failure to meet needs at various stages of the pyramidal model could lead to both physical and mental illness.

As the pandemic continues to bring the world to its knees, people worldwide are affected by its impact, ranging from quarantine and isolation to suffering and death. Different groups of people have been impacted by COVID-19 differently and to varying extents. Certain vulnerable groups such as the children, the older adults, and those with existing medical conditions are more severely affected by the pandemic. Children faced with school closures and lockdown experienced hopelessness and powerlessness, ² congruent with an increase in the prevalence of accidental injuries and suicides. ³ Another special population that comes into focus is healthcare workers. Frontline healthcare workers have had to bear the mental impact of directly providing care to COVID-19 patients in high-risk settings, resulting in increased levels of depression, anxiety, insomnia, and distress. ⁴

Let us examine how Maslow’s hierachy of needs is relevant in these times.

Physiological Needs

Many individuals are now driven by more fundamental necessities than they were before. Because many people’s job conditions have altered, satisfying basic requirements may now be more of a concern. Because so many individuals are under home-bound orders, doing other activities that one usually does to maintain physiological health may not be possible at this time.^5–7

Safety Needs

Some people’s primary objective right now is to keep themselves and their families safe. They will be most likely be doing their best to fulfill this demand for achieving safety. They must learn as much as they can about the infection rate in their region and never put pressure on themselves to achieve higher-order needs.^5–7

Social Needs

If you live with a caring family, your basic human needs will be satisfied. If you don’t feel connected to your surroundings, this might be a difficult time for you. Daily family activities are a good way to stay in touch with your loved ones. FaceTime, group chats, and positive social media channels are all good ways to communicate.^5–7

Esteem Needs

A vital component of professional wellness is what Maslow defines as esteem, which is used to define respect, fairness, and control as the four levels of needs.

Self-Actualization

In our adapted framework, self- actualization is defined as realizing one’s full professional potential, whether as a clinician, researcher, educator, or leader, which Maslow defined as realizing one’s full potential in athletics, poetry, or science. Maslow asserts that a person can only satisfy these higher order demands by their own efforts.^5–7

Maslow’s hierarchy of needs can be used as a framework to create interventions to tackle mental health issues like burnout in physicians. ⁸ The level of satisfaction of basic needs was related to scores of neuroticisms and belief in an internal locus of control, ⁹ which show that the fulfilment of basic needs directly impacts one’s psychological health and ability to cope with stressors. All five levels of human needs in the original Maslow’s hypothesis are interdependent and a change in one level of need would affect the satisfaction of one or more needs at the same or different level. This apparent flexibility in utilizing Maslow’s hierarchy of needs makes the relationship between each level a bidirectional one. For example, during the pandemic, many nations announced countrywide lockdowns, which even led to closure of basic outpatient departments of major hospitals. Instead, patients with mild to moderate illnesses were asked to have access to teleconsultation services where they could find the doctor for their specific illnesses. Such needs were fulfilled only when the basic needs for those patients like food supplies, medicines, and internet facilities were already available to them even during the lockdown. ¹⁰

In creating models for psychosocial interventions that are molded after Maslow’s hierarchy of needs, flexibility is required to link all tiers of the hierarchy interdependently and view the individual in equilibrium. This means that each need can be linked to many other needs despite their arrangement in the hierarchy, and a cause-effect model can be used to explain or predict the changes in needs an individual goes through. For example, when the individual’s physical health deteriorates, their ability to maintain social circles and access to other protective factors deteriorates too, causing a deterioration in their mental health. This decline in mental health may result in further deterioration in psychological needs such as self-esteem and love and belonging, which ensnares the individual into a depressive rut that seals the positive-feedback loop, creating a self-perpetuating cycle.

In other words, the positioning of mental health in Maslow’s hierarchy may have undergone a change during the COVID-19 pandemic. This, however, needs to be formally tested. Increased focus is needed to maintain basic needs, particularly, of individuals in quarantine and isolation, if they are to preserve their mental health needs. From an interventional perspective, Maslow’s hierarchical model provides a framework for intervention both from an individual and community perspective, particularly when it is integrated with social indicators of health; this understanding may have significant public health implications as nations try to stabilize and recover from the impact of COVID-19 pandemic and limit mental health sequelae.