News & Perspective

Psychiatrists provide mental health considerations during the COVID-19 pandemic

Psychiatry
6 months ago, OP Editor

World Health Organization (WHO) had declared the coronavirus disease 2019 (COVID-19) as a phase 6 pandemic. As of April 1, 2020, there are 856,669 COVID-19 cases reported in 202 countries.1 As the global trajectory for the evolving coronavirus outbreaks continues, numerous public health measures have been put in place to address the COVID-19 pandemic. As part of the strategy, preventive measures such as rapid case identification and quarantine, social distancing, self-isolation, and travel restrictions are imposed. However, this pandemic is not just a medical phenomenon. Mental health considerations have also become an integrated part of the pandemic response.

Escalation of the COVID-19 pandemic is causing a growing fear and anxiety. Consequently, strict quarantine and control measures are one of several public health measures to prevent the spread of this infectious virus. Many people are feeling stressed while adjusting to the limitations of life under lockdown. A wide range of mental disorders emerging from COVID-19, such as rising rates of depression and anxiety, suicides, and increases in domestic violence and substance abuse, have appeared. Studies have also reported that quarantine is often associated with a negative psychological effect.2 The negative psychological impact of quarantine is felt by many and prove additionally challenging for the vulnerable population, such as the homeless and patients with addictions. Moreover, this pandemic is exacerbating the existing psychological consequences in high-risk populations.3

As the COVID-19 pandemic continues, a spike in mental health cases was observed. Psychiatrists are anticipating a further significant increase in the mental health burden globally, due to the lack of clarity regarding the physical and economic outcome of COVID-19. To date, most of the mental health patients either have addictions or come from socioeconomically disadvantaged backgrounds and are often homeless or with unstable housing.2

As such, psychiatrists and mental health clinicians are providing fundamental support by creating an infrastructure to help mitigate the mental health consequences of COVID-19.2 At present, they have compiled numerous resources for treating patients amidst developing the pandemic and devising the policy changes. Primarily, psychiatrists should encourage their patients to engage in activities that would alleviate their stress and anxiety, such as setting aside time for relaxation at home, exercising and, most importantly, taking regularly prescribed or over-the-counter medication.2,3,4

The waiting rooms and other spaces in the clinics should also be re-arranged to provide more room between chairs and tables, thus keeping a distance between patients. In addition, psychiatrists are offering online services to long-distance patients by providing telehealth services. These virtual psychiatric appointments allow mental healthcare workers to work from home offices across the country by limiting their potential exposures to the virus and keeping outpatient visits to a minimum. Besides, telepsychiatry is beneficial for quarantined patients. However, telemedicine is not applicable for patients with no access to the internet, specifically the homeless or the socioeconomically disadvantaged.4

Also, psychiatrists can help in social distancing by providing patients with refills for psychotropic medications without requiring an in-person visit and play a crucial role in educating their patients on the correct usage of personal protective equipment (PPE) and sanitizers. Another strategy to help combat the risk of COVID-19 spread in the inpatient psychiatric units is the reinforcement of standard operation protocols. The execution of critical steps such as limiting visitation, screening patients for symptoms, arranging transfer when appropriate, and performing optimal sanitizing communal areas and items are vital to ensure the safety of both patients and staff.2,3

Lessons from the past outbreaks tell us that healthcare workers are most susceptible to mental breakdowns due to the immense pressure they are under during pandemic. Incorporating the Mental Health Gap Action Programme (mhGAP) humanitarian intervention guide specifically for the healthcare-workers, WHO has developed a comprehensive guideline for addressing the mental health and psychosocial considerations amid the COVID-19 outbreak.4

As the psychiatric morbidity in the world populations worsens, mental health and psychosocial support programs, such as well-coordinated mental health strategy, are of paramount importance. The mental health practitioners should positively help shape the mental health of people by adopting more effective interventions.

  1. World Health Organization (2020a). Coronavirus disease (COVID-19) outbreak.

    https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Accessed 16 March 2020.

  2. Brooks S et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet 395, 912-920 (2020).
  3. Ritchie EC et al. Psychiatric, patients and pandemics. Medscape (2020).

    https://www.medscape.com/viewarticle/926931

  4. World Health Organization (2020). Mental health and psychosocial considerations during the COVID-19 outbreak.

    https://www.who.int/docs/default-source/coronaviruse/mental-health considerations.pdf?sfvrsn=6d3578af_8

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