How mental health care should change as a consequence of the COVID-19 pandemic
THE LANCET PSYCHIATRY
VOLUME 7, ISSUE 9, P813-824, SEPTEMBER 01, 2020
Some evidence of COVID-19-related mental health issues has been published, but it is preliminary and needs to be supported by well designed longitudinal studies. Most surveys of the general public show increased symptoms of depression, anxiety, and stress related to COVID-19, as a result of psychosocial stressors such as life disruption, fear of illness, or fear of negative economic effects. The results of these surveys are heterogeneous, probably because of differences in methods used, study locations, and the timing of the studies in terms of the course of the pandemic. Phobic anxiety, panic buying, and binge-watching television (which has been associated with mood disturbances, sleep disturbances, fatiguability and impairment in self-regulation) have been reported, and social media exposure has been associated with increased odds of anxiety (odds ratio 1·72 [95% CI 1·31–2·26]) and combined depression with anxiety (1·91 [1·52–2·41]).
Quarantine can also contribute to stress, anger, and an increase in risky behaviours such as online gambling. Young people might be at particular risk. In previous pandemics, quarantined children were more likely to develop acute stress disorder, adjustment disorders, and grief than were those who had not been quarantined. An increase in young people making calls to helplines with symptoms of anxiety has been reported. Increased alcohol sales and alcohol use in the home have also been recorded, which could potentially increase alcohol use disorders and domestic violence (both in young people and in adults).
Although published data are few, individuals, including children, could be at increased risk of physical and sexual abuse at home during the pandemic. The pandemic could also exacerbate mental health conditions—and further limit scarce access to mental health services—in people living in humanitarian and conflict settings.