Reducing the mental health burden of COVID-19: Is it possible?

A potential mental health crisis has been predicted in the aftermath of the COVID-19 pandemic. However, numerous people worldwide have already experienced or are currently experiencing anxiety, stress, or grief caused by the uncertainty, fear, or loss from a disease that has assaulted our plans and lifestyles. For some, the changes have been considerably minor, but for others they have been enormous and devastating. In countries where isolation in the household is strictly imposed, increasing concerns about the possible negative impact of this extended isolation on mental health have emerged. In a recent study conducted in China, those aged under 35 and those who consume three or more hours of COVID-19 related news per day report more anxiety and depressive symptoms, and medical professionals report getting less sleep due to long working hours (1).

Post-traumatic stress disorder (PTSD) is often identified as one possible mental health consequence of COVID-19. Research from the 2003 Severe Acute Respiratory Syndrome (SARS) outbreaks in Toronto suggests that strict quarantine measures could cause an increase in PTSD symptoms and depressive symptoms for those in quarantine, particularly if they are lower income households (2). However, this study only investigated PTSD symptoms in quarantined individuals roughly two months after quarantine. How long symptoms will last, and if they will develop into a PTSD diagnosis, is still unknown. Identifying key factors, such as low income, that predispose people to more severe mental health outcomes can be useful to extend help to those most at risk. The Pan-America Health Organization has identified other essential factors including being part of a minority group, having a history of mental illness or chronic disease, or working with large numbers of patients (3). But, as so much of the world’s population has been affected by the pandemic, reducing the mental health burden for individuals with one or multiple risk factors appears challenging.

Image shows a silhouette of a face on a blue background with red and white stickers on the brain saying "grief", "anxiety", "phobia", "post-traumatic stress'", "stress", "shame", "depression" and "panic".

Improving mental health after a disaster takes a broad approach, and frequently focuses on solving practical problems to alleviate stress from a lack of food or shelter (4). By relieving the excess stress caused by a disaster, basic emotional needs can be met, reducing the risk of mental health disorders [5]. In an ideal scenario, we imagine one-on-one or group therapy with a professional as a means of improving one’s mental health. On the contrary, and in the context of COVID-19, we face the reality that providing rapid mental health services to all who are in need is rather problematic, especially in many countries where these services have been limited even before the onset of the current pandemic. Thus, different approaches need to be undertaken to ensure the effectivity and sustainability of treatments.

One challenge unique to this pandemic is the lack of social contact, restraining social support amongst friends and families. With work and school taking place at home, many public mental health interventions that would typically occur in schools or offices are not permissible, although they may be useful in the later stages of the pandemic (5). Recently, there has been a call for online mental health help, such as counselling through WeChat, hotlines, or apps (6). Various organizations have also come up with helpful tips for handling coronavirus stress such as only looking at information from reliable sources, consuming less news, connecting with others, and accessing further help if they are in need (7,8). However, it is difficult to know where to access accurate information especially for those who do not have access to the internet as all online mental health resources rely on an internet connection. Finally, accessing such resources requires knowing that online mental health help is not a futuristic idea, but is currently available. Sharing and promoting these resources is helpful. Below are a few resources we find useful for mental health improvement:

Possible symptoms linked to stress, anxiety, or depression Tips from the Mayo Clinic Coping with traumatic events

COVID-19 pandemic has affected everyone in diverse ways and there has been an almost population-wide shared experience of lockdown stress. There are also many news stories and personal accounts of increased mental health burdens available online. Hopefully, the increasing attention to mental health will give those who are suffering the courage to speak out and seek help, in the comfort that they are not alone.

Originally published on Medium

Edited by Janice N. Averilla

About the author: Katharine Palmer, MPH: KP has studied Psychology and Public Health, and is currently working as a Research Assistant.

Bibliography 1.Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res. 2020 Jun 1;288:112954.

2. Hawryluck L, Gold WL, Robinson S, Pogorski S, Galea S, Styra R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 2004;10(7):1206–12.

3. Pan American Health Organization. Protecting Mental Health During Epidemics. Pan American Health Organization. 2006.

4. Reyes G, Elhai JD. Psychosocial interventions in the early phases of disasters. Psychotherapy. 2004;41(4):399–411.

5. Wahlbeck K. Public mental health: The time is ripe for translation of evidence into practice. World Psychiatry [Internet]. 2015 Feb 1 [cited 2020 Jun 8];14(1):36–42. Available from: http://doi.wiley.com/10.1002/wps.20178

6. Xiang YT, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. The Lancet Psychiatry [Internet]. 2020 [cited 2020 Jun 8];7(3):228–9. Available from: http://www.nhc.gov.cn/jkj/s3577/202001/6adc08b966594253b

7. Public Health England. Worried About Coronavirus? 10 Tips To Help Manage Anxiety | Every Mind Matters | One You [Internet]. [cited 2020 Jun 9]. Available from: https://www.nhs.uk/oneyou/every-mind-matters/coronavirus-covid-19-anxiety-tips/

8. Centers for Disease Control and Prevention. Mental Health and Coping During COVID-19 | CDC [Internet]. Centers for Disease Control and Prevention. 2020 [cited 2020 Jun 9]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html