Mental Health Policy in the Era of COVID-19

Goldman, Matthew L.; Druss, Benjamin G.; Horvitz-Lennon, Marcela; Norquist, Grayson S.; Ptakowski, Kristin Kroeger; Brinkley, Amy; Greiner, Miranda; Hayes, Heath; Hepburn, Brian; Jorgensen, Shea; Swartz, Marvin S.; Dixon, Lisa B.

doi:10.1176/appi.ps.202000219

Cited by 85 publications

(68 citation statements)

References 15 publications

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“…Moreover, being affected by a pre-existing mental health problem represents an independent significant risk factor for the development of depressive, anxiety and stress symptoms, as already reported by Plunkett et al [90] and Hao et al [14]. This finding suggests the need to provide as soon as possible adequate and tailored supportive interventions to mentally ill patients, who represent fragile and at-risk individuals that have been overlooked during the initial phases of the pandemic [91][92][93][94][95].…”

Section: Discussionmentioning

confidence: 55%

Effects of the lockdown on the mental health of the general population during the COVID-19 pandemic in Italy: Results from the COMET collaborative network

et al. 2020

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Background. The Coronavirus disease 2019 (COVID-19) pandemic is an unprecedented traumatic event influencing the healthcare, economic, and social welfare systems worldwide. In order to slow the infection rates, lockdown has been implemented almost everywhere. Italy, one of the countries most severely affected, entered the "lockdown" on March 8, 2020. Methods. The COvid Mental hEalth Trial (COMET) network includes 10 Italian university sites and the National Institute of Health. The whole study has three different phases. The first phase includes an online survey conducted between March and May 2020 in the Italian population. Recruitment took place through email invitation letters, social media, mailing lists of universities, national medical associations, and associations of stakeholders (e.g., associations of users/ carers). In order to evaluate the impact of lockdown on depressive, anxiety and stress symptoms, multivariate linear regression models were performed, weighted for the propensity score. Results. The final sample consisted of 20,720 participants. Among them, 12.4% of respondents (N = 2,555) reported severe or extremely severe levels of depressive symptoms, 17.6% (N = 3,627) of anxiety symptoms and 41.6% (N = 8,619) reported to feel at least moderately stressed by the situation at the DASS-21. According to the multivariate regression models, the depressive, anxiety and stress symptoms significantly worsened from the week April 9-15 to the week April 30 to May 4 (p < 0.0001). Moreover, female respondents and people with pre-existing mental health problems were at higher risk of developing severe depression and anxiety symptoms (p < 0.0001). Conclusions. Although physical isolation and lockdown represent essential public health measures for containing the spread of the COVID-19 pandemic, they are a serious threat for mental health and well-being of the general population. As an integral part of COVID-19 response, mental health needs should be addressed.

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Section: Discussionmentioning

confidence: 55%

Effects of the lockdown on the mental health of the general population during the COVID-19 pandemic in Italy: Results from the COMET collaborative network

et al. 2020

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“…Most countries have strengthened public health protocols, including guidance on how to access mental health support. 88 , 104 Policy changes have included adjustments to access policies, insurance coverage, privacy laws, 92 and access to controlled drugs. 105 Countries have also allowed pharmacies to accept expired prescriptions 53 and have loosened monitoring requirements for drugs with potential side-effects, such as lithium or clozapine.…”

Section: Mental Health Service Responses To Covid-19mentioning

confidence: 99%

How mental health care should change as a consequence of the COVID-19 pandemic

Moreno

Wykes

Galderisi

et al. 2020

The Lancet Psychiatry

1,381

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The unpredictability and uncertainty of the COVID-19 pandemic; the associated lockdowns, physical distancing, and other containment strategies; and the resulting economic breakdown could increase the risk of mental health problems and exacerbate health inequalities. Preliminary findings suggest adverse mental health effects in previously healthy people and especially in people with pre-existing mental health disorders. Despite the heterogeneity of worldwide health systems, efforts have been made to adapt the delivery of mental health care to the demands of COVID-19. Mental health concerns have been addressed via the public mental health response and by adapting mental health services, mostly focusing on infection control, modifying access to diagnosis and treatment, ensuring continuity of care for mental health service users, and paying attention to new cases of mental ill health and populations at high risk of mental health problems. Sustainable adaptations of delivery systems for mental health care should be developed by experts, clinicians, and service users, and should be specifically designed to mitigate disparities in health-care provision. Thorough and continuous assessment of health and service-use outcomes in mental health clinical practice will be crucial for defining which practices should be further developed and which discontinued. For this Position Paper, an international group of clinicians, mental health experts, and users of mental health services has come together to reflect on the challenges for mental health that COVID-19 poses. The interconnectedness of the world made society vulnerable to this infection, but it also provides the infrastructure to address previous system failings by disseminating good practices that can result in sustained, efficient, and equitable delivery of mental health-care delivery. Thus, the COVID-19 pandemic could be an opportunity to improve mental health services.

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“…Some of these treatment options have a particular relevance for complex mental health conditions such as PDs. Reduced inpatient treatment capacities and early discharges [76][77][78][79] might have detrimental effects on patients with PDs. Also, group interventions (e.g., skills training groups or peer support meetings) are a treatment component in many therapies for patients with PDs, and their reduction or cancelation [80,81] can affect the course of treatment for these patients.…”

Section: Resultsmentioning

confidence: 99%

Personality Disorders in Time of Pandemic

Preti

Pierro

Fanti

et al. 2020

Curr Psychiatry Rep

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Purpose of Review We report evidence on the negative psychological effects of pandemics in people with personality disorders (PDs) and on the role of personality pathology in compliance with mitigation-related behaviors. Considering the paucity of studies, after a description of the main features of PDs, on the basis of the current literature on pandemic and quarantine mental health impact, we trace some clinical hypotheses. Recent Findings Paranoid traits and detachment (cluster A) might lead to worse psychological outcomes. Cluster B patients may show more intense stress-related reactions and react strongly to social distancing, especially considering borderline personality disorder. Cluster C patients might be particularly prone to anxiety and stress due to fear of contagion and may be less flexible in adaptation to new routines. Evidence on compliance with mitigation measures is mixed, with lower compliance in cluster B patients and higher in cluster C ones. Summary We suggest that PD patients might be particularly affected by pandemics. Furthermore, they might react differently, according to their main diagnosis. Similarly, compliance with mitigation measures may differ according to specific PDs. Our results should be considered as a starting point to reflect on therapeutic strategies to be adopted in the post-COVID-19 situation.

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Mental Health Policy in the Era of COVID-19

Cited by 85 publications

References 15 publications

Effects of the lockdown on the mental health of the general population during the COVID-19 pandemic in Italy: Results from the COMET collaborative network

Effects of the lockdown on the mental health of the general population during the COVID-19 pandemic in Italy: Results from the COMET collaborative network

How mental health care should change as a consequence of the COVID-19 pandemic

Personality Disorders in Time of Pandemic

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