Rapid Support for Older Adults during the Initial Stages of the COVID-19 Pandemic: Results from a Geriatric Psychiatry Helpline

Abstract

Background. The COVID-19 pandemic and governmental lockdown measures disproportionally impact older adults. This study presents the results from a psychiatric helpline for older adults in Mannheim, Germany, during the lockdown, set up to provide information and psychosocial support. We aim to elucidate the needs of older adults, their reported changes, and the psychological impact during the initial stages of the health crisis. Methods: A total of 55 older adults called the psychiatric helpline between April and June 2020. Information on demographics, medical and psychiatric history. as well as changes in daily life due to the pandemic was collected anonymously. Mental health status was assessed using the 7-Item Hamilton Depression Rating Scale (HAMD-7) and the Hamilton Anxiety Rating Scale (HAM-A). Results: Most callers were women, older adults (M = 74.69 years), single, and retired. In total, 69% of callers reported new or an increase in psychiatric symptoms, with anxiety and depressive symptoms being the most common ones. Age was significantly negatively correlated to higher levels of anxiety and depression symptoms. Individuals with a previous diagnosis of a psychiatric disease reported significantly higher levels of depressive and anxiety symptoms than those without a diagnosis. Conclusion: In older adults, the perceived psychological impact of the COVID-19 crisis appears to ameliorate with age. Individuals with a history of psychiatric disease are most vulnerable to negative mental health outcomes. Rapid response in the form of a geriatric helpline is a useful initiative to support the psychosocial needs of older adults during a health crisis.

The Use of Helplines and Telehealth Support in Aotearoa/New Zealand During COVID-19 Pandemic Control Measures: A Mixed-Methods Study

“…Earlier studies suggested that younger people were more likely to be affected by the COVID-19 pandemic (7,11,13), and our study found that contacts by young people under 25 years increased throughout the study period, whereas contacts by people those older than 25 years gradually declined once the first lockdown lifted. In addition the number of over 65 year olds contacting services was smaller than by people under 65 years, similar to other studies (30).…”

“…Service providers reported that some callers were reluctant to overload their usual service providers, or some were having difficulty accessing these (20,21). From a qualitative perspective, providers attributed the increase in helpline demand between January 2020 and the end of March 2021 to COVID-19 related anxieties such as fears of infection, general anxiety about accessing healthcare, uncertainty about COVID-19 rules, questions about vaccination, and feelings of loss of control similar to other international studies (25,26,30,31) and observations in Brooks and colleagues rapid review (2020). Although, similar to the data from Greece and Malta (26,31), our qualitative results indicated potential increases in generalized anxiety; however, depression has not featured strongly in our data.…”

“…The former may be especially relevant for communities who hold collectivistic values (e.g., Māori, Asian, Pacific Peoples), elderly, and people with pre-existing mental health conditions. The latter was exacerbated by difficult relationships or younger age and the loss of freedom as observed in international studies (22,30,31). Service-providers described increased duration of contacts with service-users going into more depth about their difficulties, or contacting the service more often.…”

“…Within the methodological constraints outlined above, these studies suggest that nearly two-thirds of contacts to helplines at the start of the pandemic were coming from females (25,26), although lower proportion of female callers were found in a study from India (13% females) (24) and higher proportions of females in the elderly (30) and younger populations (22) (85% and ∼75% respectively). In an Australian study of younger people, the increase in demand was also higher for females (5% monthly increase from January to August 2020) than for males (4% monthly increase from September 2019 to August 2020).…”

“…Contacts from people seeking help about family relationships also increased, especially during spikes in infection rates and associated control measures (22). Studies have also shown increased rates of people contacting helplines with symptoms of anxiety and depression (26,30,31), and an increase in crisis calls in younger populations was observed in Australia (22). Again, with an exception of two studies (22,25), these observations should be interpreted with caution due to methodological limitations.…”