Is a Crisis in Mental Health the Next Pandemic?

By Roberta Heale Deputy Editor for Social Media EBN and Alicia Grooms, M.A., Volunteer Stacey E. Roles & Associates Psychotherapy Services

As we enter World Mental Health Awareness Month, it’s almost surreal to look back on the year to date. Spring brought unexpected and momentous changes along with the most significant–the COVID 19 restrictions. Instead of welcoming the summer with vacations, patios, and lounging with friends, we were instead faced with the stark reality that the majority of the season would be spent isolated and confined indoors. Most places in the world are now battling a second wave. The pandemic brought with it an emotional upheaval for many who individuals who previously perceived the world to be a safe and predictable place, resulting in negative impacts on their mental health.  Unfortunately, people who had experienced mental health conditions such as anxiety disorders and depression in the past found that these feelings are magnified by the pandemic. In fact, those with a pre-existing mental health diagnosis were more likely to report worsening conditions since the pandemic (1, 2).

You often hear people saying that they feel more stressed, worried, and depressed due to COVID19 and studies have shown that stress levels have been reported to have doubled (1). People working from home joke about their alcohol consumption, but the reality is that there has been a significant increase in substance use, with alcohol consumption having increased by over 25% (1). People are not only concerned about their own mental health, but also that of their friends and family. This worry, combined with job loss, financial concerns and the social isolation that has come along with the lockdown has had a significant negative impact on mental health of the overall population around the globe.

Mental health issues are further compounded by those who do contract COVID 19.  As many as 1/3 people who have had COVID describe lingering neurological and cognitive symptoms such as difficulty thinking, fumbling with words, depression, anxiety or PTSD. There is growing consensus that the disease may have a long-lasting effect on the brain (3). The reality is sinking in that #LongCOVID, or #LonghaulCOVID, as it’s called in various countries, is a new chronic illness.

Studies of responses to disasters show that the majority of people are resilient and are able to cope with the stressors of the sudden change in environment (4).  However, many more people struggle and, along with an overall higher level of anxiety in our societies, there are reports of an increase in suicides and overdoses which are attributed to COVID -19(5).

The resulting mental health issues arising from COVID-19 have created a second pandemic–one which has yet to be fully recognized.  In fact, rather than an increase in mental health supports, the need to distance and isolate has resulted in the amalgamation or closure of amenities and has resulted in fewer or less accessible mental health services in an already underserviced and stigmatized sector (1, 2).  It’s important for health care systems to recognize mental health as a significant issue and put strategies in place to address it.

From a systems perspective, training about the mental health impact of COVID-19 should occur at all levels, from health care leaders, first responders, to health care workers. Given that COVID -19 is most likely to be assessed and treated by health care providers who focus on acute care and have little expertise in mental health, efforts must be made to integrate mechanisms for identifying, referring, and treating those with mental health concerns as part of their routine care. Health care sectors including emergency response, acute care, long-term care and community care, led by mental health care leaders, should work together to create an efficient, seamless plan for the identification and care of those with mental health issues (4).

Health care providers, and especially nurses, are well positioned to support patients and the public during this time. Offering stress management and coping strategies may be helpful such as suggesting a reduction of the triggers that set off anxiety (4). Turning off electronics that are constantly bombarding us with news of the pandemic such as phones and television, for example.  Engaging in mindful activities such as some light reading, puzzles, or exercising may also help. Maintain a healthy diet, while reducing smoking and alcohol can also decrease anxiety. Lastly, establishing a daily routine may be an extremely important factor when people are feeling stuck at home. Nurses can facilitate their patients in remembering that while the world feels like it may be on hold we can find enjoyment in the small things in life by practicing gratitude and focusing on the positive things that are to come in the future. In the cases where more comprehensive assessment and treatment are required, nurses can ensure that people have contacts to mental health assistance (4).

The COVID-19 pandemic has changed the world. As we all work to contain the virus, to keep as many people as possible safe, we mustn’t forget the mental health repercussions of this time.  COVID-19 will last in our memories long after a vaccine has been found and the virus contained, but the mental health crisis it brought may be with us for a much longer time.

1.CAMH. (July 2020).  Mental health in Canada. COVID -19 and Beyond. CAMH Policy Advice July 2020.http://www.camh.ca/-/media/files/pdfs—public-policy-submissions/covid-and-mh-policy-paper-pdf.pdf

2.Gilburt, H. (July 2020). Mental health care in the time of COVID-19/ https://www.kingsfund.org.uk/blog/2020/07/mental-health-care-time-covid-19

3.Cooney, E. (Aug 2020). Long after the fire of a COVID-19 infection, mental and neurological effects can still smolder. https://www.statnews.com/2020/08/12/after-covid19-mental-neurological-effects-smolder/#:~:text=Beyond%20the%20fatigue%20felt%20by,disorders%20and%20deeper%20cognitive%20impairment.

4.Pfefferbaum, B. & North, C.S. (April 2020). Mental health and the COVID-19 pandemic. New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/NEJMp2008017

5. Galka, M. (July 2020). Suicides, overdoses are up amid COVID-19 pandemic, according to health experts. https://www.fox10phoenix.com/news/suicides-overdoses-are-up-amid-covid-19-pandemic-according-to-health-experts

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