Psychopathological effects of the Coronavirus (Sars-CoV-2) imposed lockdown on vulnerable patients in treatment in a mental health outpatient department for migrants and individuals in poor socioeconomic conditions

Abstract

Background: The effects of Sars-Cov-2 pandemic may increase vulnerability of migrants. Aims: To investigate the effects of the governmental lockdown on the mental health of vulnerable migrants in treatment at an outpatient department. Method: In a telephone survey post-migration living difficulties and psychopathological symptoms were investigated, particularly post-traumatic thoughts and nightmares, anxiety, depression, feelings of tension and irritability, other sleep problems, as well as COVID-19 related fears. Psychopathological changes during the lockdown were detected and rated by clinicians. Rates of treatment discontinuation and reasons why were also recorded. Results: Of 103 eligible patients, 81 answered the phone call and were included in the study. Mental symptoms were frequent but not as severe as expected. About 32% of patients in psychopharmacological treatment and almost 52% of patients in psychotherapy had discontinued treatment. Patients who were globally considered to have worsened if compared to their pre-coronavirus mental health conditions had in fact higher scores on several mental symptoms but mild specific fears about coronavirus issues, similar to those of patients improved or stable. Worsening was significantly associated with unemployment, lack of VISA, and treatment discontinuation. Shifting the way of providing psychotherapy into a web-based modality was significantly more frequent in stable/improved patients. Conclusion: Findings suggest that concrete life problems and treatment discontinuation more than the coronavirus fear, have predominantly affected the mental health conditions of our patients.

“Lived the Pandemic Twice”: A Scoping Review of the Unequal Impact of the COVID-19 Pandemic on Asylum Seekers and Undocumented Migrants

“…In one French study, the prevalence of depression increased (72% vs. 65%) [ 37 ]. Symptoms also worsened among undocumented migrants in Italy (50% worsened anxiety, 38% worsened depression) [ 25 ] and the U.S. (49% worsened anxiety, 46% worsened depression) [ 51 ].…”

“…The mental health of asylum seekers and undocumented migrants was further compromised by reduced access and use of health services during the pandemic. For instance, fewer undocumented migrants visited a free psychiatric clinic for migrants in Italy, with only 17.5% returning for follow-up treatment during the peak of the pandemic [ 26 ] and 32% discontinuing psychopharmacological treatment [ 25 ]. A similar pattern was observed in another general Italian clinic, with women experiencing the sharpest decline (77%) in visits [ 35 ].…”

“…Economic instability from loss of work with flow-on consequences of food and housing insecurity was “by far the largest impact” of government-imposed curfews, lockdowns, and travel restrictions on asylum seekers and undocumented migrants [ 25 , 49 ]. Asylum seekers and undocumented migrants often work in the informal sector [ 45 ] and rely on work in people’s homes [ 7 ], all sectors and services that were heavily impacted by pandemic control measures.…”

Forced migration as a risk factor for COVID-19 infection in Africa: insight from Agadez, Niger

“…We found that migrants are more likely of being young [ 1 , 2 ] and at increased risk for SARS-COV-2 infection [ 2 ]. In addition to language as barrier to quality of care access in the emergence room [ 3 ], mental health has been of concern among migrants worldwide [ 4 - 6 ]. The continuous arrival of migrant in this region makes hard contact tracing of positive cases.…”

A longitudinal study of mental health before and during the COVID-19 pandemic in Syrian refugees

“…In this context, multiple studies have indicated elevated rates of depression and anxiety in Middle Eastern countries hosting Syrian refugees during the pandemic, including Jordan (Al-Ajlouni et al, 2020 ; Naser et al, 2020 ) and Lebanon (Hajjar & Abu-Sittah, 2021 ). There is also initial evidence that refugees are experiencing marked anxiety and mood problems during the pandemic (Aragona et al, 2021 ; Hajjar & Abu-Sittah, 2021 ).…”