COVID-19 pandemic has caused 'dramatic changes' in approach to mental health care
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The COVID-19 pandemic may have lasting effects on the psychiatric care of patients, according to a presenter at the NEI Max Virtual Conference.
“The impact of the COVID-19 pandemic may go well beyond the physical complications,” William M. Sauvé, MD, medical director of the Virginia region of Greenbrook TMS NeuroHealth Centers, said during a presentation. “Emerging data, historical studies and expert opinion point to a tremendous impact of COVID-19 on the development and exacerbation of psychiatric issues. The pandemic has served to amplify personal, social and economic costs of mental illness to a magnitude that's unprecedented.”
According to Sauvé, CDC data have shown a significant increase in symptoms of anxiety disorder and depressive disorder since the pandemic began. Numerous study findings have shown adverse psychiatric outcomes, including increased psychosocial stressors, such as life disruption, fear of illness or fear of negative economic effects; phobic anxiety; binge-watching television, which has been linked to mood and sleep disturbances; increased social media exposure; increased alcohol sales and use; and increased calls to domestic abuse and child abuse hotlines.
Moreover, those with pre-existing mental health disorders appeared to be at increased risk for infection with COVID-19 compared with those without mental health disorders. This population is also more likely to develop severe organ dysfunction and to die in ICUs vs. those without mental disorders. Additional complications wrought by the pandemic among those with pre-existing mental health disorders include increased symptoms and poorer access to services and supports since the pandemic’s onset, as well as a reduction in the availability of many family, social and psychiatric supports due to physical distancing, Sauvé said.
The mental health effects of the pandemic also have been seen among health care workers, particularly those on the frontline. This population has reported adverse outcomes including stress exposure, fear of infecting themselves and fear of infecting loved ones. Results of a cross-sectional study of 1,257 health care workers in China revealed 50% reported symptoms of depression, 45% reported anxiety, 34% reported insomnia and 72% reported distress. Risk factors among frontline health care workers included a lack of social support and communication, maladaptive coping strategies and a lack of training.
The psychiatric field has adapted to meet the needs of patients during the COVID-19 pandemic, according to Sauvé. Telepsychiatry has preserved the ability for a significant proportion of interactions between clinicians and patients, and this interface method may provide additional benefit for individuals with severe anxiety disorders. However, Sauvé said additional research is necessary to pinpoint optimal methods for video teleconference group delivery.
According to Sauvé, the pandemic has resulted in potential negative effects of changes to mental health care, such as resource reallocation to physical health care needs, fewer in-person meetings within and across treatment teams, mental and physical strain on health care workers and a shortage of health care workers. Potential positive effects of changes to mental health care include an increase in overall mental health literacy in the population linked to education about mental health effects of COVID-19 and an opportunity to emphasize the importance of self-care, coping strategies and family support.
“Because of the pandemic, dramatic changes have been implemented in the approach to mental health care treatment, for better or for worse,” Sauvé said. “But I think there are some opportunities that if we jump on it, we can see things getting better in the very near future. It is essential that mental health care providers continue to monitor the effects of these changes and prepare for long-term incorporation, meaning I think we're going to see mental health consequences manifesting for years to come that are going to be attributed to everything that we've just been through.
“[There will also be] incorporation of some mandatory new ways of doing things, and if we do it right, they might actually be better ways of doing things,” Sauvé added.