The intersection of COVID-19 and mental health

10/08/2020 Health, World



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On October 6, 2020, WHO released the results of a survey on the impact of COVID-19 on mental, neurological and substance use (MNS) services in 130 WHO Member States, ahead of World Health Day. Mental Health on October 10. revealed that most countries are experiencing some interruptions in MNS services, with the greatest impact on community services and prevention and promotion. Reasons for the disruption included insufficient numbers or redeployment of healthcare workers to the COVID-19 response (in 30% of countries), use of mental health facilities as treatment facilities or COVID-19 quarantine ( in 19% of countries) and insufficient supply of personal protective equipment (in 28% of countries). Although 116 (89%) countries reported that mental health and psychological support was part of their national COVID-19 response plans, only 17% said they had committed additional funds for this. This report is based on growing evidence that the COVID-19 pandemic is having monumental effects on the mental health and well-being of populations around the world. With a seemingly low capacity to respond, it is unclear how the world will deal with this looming mental health crisis.

Historical examples show the detrimental impact that events such as a pandemic can have on the mental health of affected populations. For example, research in communities affected by outbreaks of Ebola virus disease (EVD) revealed widespread panic and anxiety, depression resulting from the sudden death of friends, family and colleagues, and stigmatization and social exclusion of survivors. A meta-analysis found that depressed mood, anxiety, impaired memory, and insomnia were present in 33-42% of patients admitted to hospital for severe acute respiratory syndrome or Middle East respiratory syndrome, and that in some cases these effects continued beyond recovery.

In the case of COVID-19, non-pharmaceutical interventions (NPI), while essential to stop the transmission of the virus, have led to physical isolation, the closure of schools (with incalculable effects on the development and well-being of children) and the generalization of employment. losses. The abuse of substances, particularly alcohol, is increasing. Emerging evidence suggests that COVID-19 could even have direct neurological consequences. And as with many other features of this pandemic, not all people have been affected equally. Disruptions in MNS services, as reported by WHO, are disproportionately affecting people with pre-existing mental health conditions by limiting access to essential treatment and support services. People in salaried jobs are much less likely to be affected than those in informal jobs with a daily wage, which include a substantial proportion of the workforce in lower-income countries. Front-line workers are experiencing increased workload and trauma, making them susceptible to stress, burnout, depression, and post-traumatic stress disorder (PTSD).

Even under normal circumstances, good mental health is essential to the functioning of society. However, during a pandemic, it can affect the way we respond and recover. Healthcare workers are essential to the response to COVID-19, but may have to leave the workforce if their mental health is not protected. Poor mental health can also affect vaccine absorption and adherence to NPIs, with some evidence suggesting that poor mental health could increase susceptibility to infection and transmission of the virus. For example, a study in Sierra Leone found that EVD risk behaviors were associated with the intensity of depression symptoms, PTSD symptoms, and exposure to war. People with dementia may be at high risk of exposure to COVID-19 due to difficulty remembering instructions and the importance of physical distancing and hand hygiene. The confinement of people with and without mental illness in institutions can increase their risk of infection, as witnessed in long-term care facilities and prisons.

Even before COVID-19, mental health conditions were prevalent, accounting for approximately 13% of the global burden of disease. However, the world was unfortunately not prepared to deal with the mental health impact of this pandemic. Years of underinvestment in mental health, especially in low- and middle-income countries, have left us vulnerable. It is well known that our ability to respond to and recover from the COVID-19 pandemic will require the development of effective vaccines and treatments and strict adherence to NPIs. Less well known is that to minimize the impact of the pandemic, we must also address the substantial unmet mental health needs of entire societies, with a focus on the most vulnerable.