[Comment] The challenges of planetary mental health in the COVID‑19 era

Abstract

As the focus of the COVID-19 crisis is gradually taken away from emergency healthcare needs, increased attention is warranted on the psychological impact of the pandemic on a global level. Existing guidance on managing the COVID-19 related distress needs to be better informed by upcoming larger-scale research. Applying e-Health can be useful in dealing with the immediate psychological needs, while developing strategies to identify vulnerable populations and shifting the provision of mental health and social care to community services need to be prioritised when looking at the future. Focusing on global mental health during this universal crisis is an opportunity for promoting a more compassionate and less discriminating society. While COVID-19 continues its lethal spread (1) and the focus on dealing with the immediate healthcare needs is reducing, it is increasingly important to acknowledge the significant psychological burden on global mental health. The stress surrounding COVID-19 ('COVID-stress') has not only been affecting the mental well-being of individuals and local communities (2); it has created an almost global psychological distress (3). Although it is nearly half a year into the pandemic, we are still steering through unchartered waters, whilst the endpoint of COVID-19 is still not in sight. The anxiety stemming from the inability to neither 'fight or fly' away from the virus and the mourning of the loss of our everyday routine

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“…Hence, it has been highlighted that remotely collected data can reduce the need to commute for these patients while providing real-time insights into disease progression and treatment response [73]. These novel digital healthcare solutions could assist in addressing some of the challenges in relation to detecting DLB and monitoring cognitive decline [73, 74]. Of particular interest are fluctuations, visual hallucinations, and autonomic instability.…”

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“…However, at a time when they are suffering more distress, mentally ill patients experience significant reductions in availability of care. More specifically, according to a recent WHO assessment, COVID-19 pandemic has resulted in significant disruptions of MNS services, such as school and work-related mental health programs, services for children, adolescents and older adults, interventions for caregivers, psychotherapy/counselling/psychosocial interventions, home or community outreach services, critical harm reduction services, mental health interventions during antenatal and postnatal period, suicide and overdose prevention and management programs, opioid agonist maintenance treatment of opioid dependence and management of emergency MNS manifestations ( 6 ). Finally, immature discharge from psychiatric units may lead to relapse, suicidal behavior, anxiety, depression and post-traumatic incidents, including insomnia ( 18 ).…”

“…In order to overcome MNS service disruptions, most countries (70%) utilized tele-medicine /tele-therapy in order to replace in person consultations, 67.7% established helplines for mental health and psychosocial support, 65.4% specific measures for infection prevention and control in mental health services, while 44.6% trained COVID-19 health care providers in basic psychosocial skills, 44.6% discharged or redirected patients to alternate health care facilities 33.1% utilized home or community outreach services and 20.8% recruited counsellors ( 6 ). Moreover, concerning HCP many hospitals utilized caregiver support strategies, such as providing a place of rest in order to isolate staff from family, developing video records to share with family, training on personal protective equipment, provision of security to manage agitated/aggressive patients and leisure activities ( 19 ).…”

“…Although psychiatric and neuropsychiatric clinical manifestations of COVID-19 are well-established ( 3 ) and insight into potential infectious and post-infectious pathogenetic mechanisms linking SARS-CoV-2 to acute and long term neuropsychiatric complications is continuously updated ( 4 ), it is the direct and indirect psychological and social effects of the ongoing COVID-19 pandemic, comprising the most prolonged global crisis since World War II ( 5 , 6 ), together with the subsequent disruptions of mental, neurological and substance use (MNS) services ( 7 ) that mainly compromise public mental health. Very recent meta-analytic data exhibited that mental health problems are common in different populations with an overall pooled prevalence of depression, anxiety, distress, and insomnia 31.4, 31.9, 41.1 and 37.9%, respectively.…”

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