Keerthika Mathialagan, M.B.B.S., Steven Lippmann, M.D.

The COVID-19 pandemic has critical implications for mental health and personal well-being. Beyond the acute stress and anxiety aroused by this disease, the quarantine measures and economic shortages have increased depression, drug abuse, suicide, and domestic violence rates (1).

Stay-at-home measures cause harmful psychological repercussions among susceptible populations, for children, adults, and elderly people. Loneliness often becomes a problem. It becomes harder to access healthcare and even to maintain one’s housing, job, or childcare. For children, the extended social isolation, especially following school cancellations, are harmful to psychosocial growth and development. Quarantining results in increased psychiatric morbidity and mortality also for adults, particularly older and/or isolated ones, and those with pre-existing physical or psychological disabilities (2). People with psychiatric illness usually do not tolerate coronavirus stresses very well.

Interventions are available to curtail the psychiatric implications of coronavirus infections. The United Nations Children’s Fund (UNICEF) offers plans to help children cope with stress by suggested daily routines, virtual platforms to maintain social connections, and engaging in recreational activities (3). Similar ideas apply to the emotional care of adults. Medical service teams should also implement individualised approaches to mental health concerns and interventions (4).

Physicians and other health care workers are at the forefront of the COVID-19 pandemic. Besides others being fearful of contact with them, they are also susceptible to contagion and their own emotional stress, with negative consequences to family, social, and professional life. Limited training and inexperience negotiating an epidemic heightens worries and worsens emotions such that it may lead to a residual post-traumatic stress disorder.

Help to manage the psychological stress of frontline healthcare workers includes to identify persons of infection risk, isolate or quarantining anyone who is sick, provide proper hygiene and protective apparel, offer peer-support, and keep collegial communication open. Clinicians should maintain prolonged awareness about the long-term psychiatric consequences of this pandemic to best recognize and curtail future psychosocial issues.

References

1. Reger M, Stanley I, Joiner T. Suicide Mortality and Coronavirus Disease 2019—A Perfect Storm?. JAMA Psychiatry. April 10, 2020. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2764584. Accessed August 14, 2020.
2. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) in the U.S.  https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html. Accessed August 14, 2020.
3. The United Nations Children’s Fund (UNICEF). Supporting your child’s mental health as they return to school during COVID-19 https://www.unicef.org/coronavirus/supporting-your-childs-mental-health-during-covid-19-school-return. Accessed August 14, 2020.
4. Addressing Mental Health and Psychosocial Aspects of COVID-19 Outbreak. Inter-Agency Standing Committee; 2020:1-14. https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/technical-guidance/mental-health-and-covid-19. Accessed August 14, 2020.