Author Name: Chuan Zou, Attending physician
Affiliation: Chengdu Fifth People’s Hospital, Chengdu university of TCM
Email: zou5chuan@163.com
Although I am a general practitioner (GP) with special interest in mental health, I cannot offer help when my father is hospitalized for depression and mother suffers from anxiety, due to their indirect contact with the suspected COVID-19 patient in the same train and then the experience of 14-day quarantine. In my recent outpatient clinic, I also encountered numerous similar patients with psychological problems caused by the epidemic, such as an anxious woman requiring repeated chest CT examination, an entrepreneur who had symptom of palpitation and chest compression after his factory had been forced to shut down and a middle-aged man with minor depression after one month staying at home.
This made me realize that the epidemic is not only threatening our physical health, but also challenging mental well-being. The majority of us are facing this crisis for the first time in our lives. There are concerns about safety, fear of infection, uncertainties relating to this disease, and media constantly showing the upward numbers of people infected and dead locally and globally. There is a lockdown that people had to stay home for unknown period of time, thereby losing their daily routine such as exercise and decreasing their entertainment and social activities. All these changes make people more prone to psychological distress and potentially lead to impaired immunity status. Unfortunately, current health care system is not well prepared to cope with all needs of patients.
As the GPs, we are often among the first contacts for patients and act as “gatekeepers” in the fight against outbreaks, and we should not ignore the psychological impact that COVID-19 bring to our patients.
Proactive measures, such as providing educational material and online/telephone counseling, should be adopted to prevent patients from excessive worry and panic, help them becoming resilient and maintain certain level of routine in the period of lockdown. GPs also need to raise the awareness of screening psychological distress by collecting psycho-social history and applying interpersonal communication skills during the encounter. For the patients who have experienced high level of stress or emotional distress during the pandemic, GPs should provide informal supportive counseling and some simple and feasible psychological interventions in primary care settings. Based on the literature and past experience from other disasters, these interventions might include psycho-education, relaxation, problem solving treatment, meditation, etc. As COVID-19 is a completely new crisis, it is essential for the government and professional bodies to investigate and develop suitable training manual for GPs to equip them in supporting families and patients in primary care.
Conflict of Interest: The author declares no conflicts of interest.