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“In the context of the COVID-19 pandemic, it appears likely that there will be substantial increases in anxiety and depression, substance use, loneliness, and domestic violence; and with schools closed, there is a very real possibility of an epidemic of child abuse,” wrote Sandro Galea, M.D., of Boston University School of Medicine; Raina M. Merchant, M.D., of Perelman School of Medicine; and Nicole Lurie, M.D., of the Coalition for Epidemic Preparedness Innovations in Norway, in an article in JAMA Internal Medicine. “This difficult moment in time nonetheless offers the opportunity to advance our understanding of how to provide prevention-focused, population-level, and indeed national-level psychological first aid and mental health care and to emerge from this pandemic with new ways of doing so.”
Galea, Merchant, and Lurie recommended three steps they believe can help to address the likely rise of mental disorders and related challenges from the pandemic:
Make plans to address loneliness and its aftereffects as populations physically isolate and to develop ways to intervene. Even while physically separated, digital technologies can be used to create spaces for connection and structure through shared online activities and gatherings, the authors wrote. They emphasized the importance of “developing and implementing routines, particularly for children who are out of school, ensuring that they have access to regular programmed work,” but noted that not all children have access to technologies that allow them to connect remotely. They also described the importance of reaching out to groups often marginalized (including elderly people and those with mental illness) and the ways that social media can be used to connect individuals to reputable resources for mental health support.
Have mechanisms in place for surveillance, reporting, and intervention, particularly when it comes to domestic violence and child abuse. “Individuals at risk for abuse may have limited opportunities to report or seek help when shelter-in-place requirements demand prolonged cohabitation at home and limit travel outside of the home. Systems will need to balance the need for social distancing with the availability of safe places to be for people who are at risk, and social services systems will need to be creative in their approaches to following up on reports of problems,” they wrote.
Bolster the mental health system. Innovative approaches will also need to be developed to meet the need for mental health services, Galea, Merchant, and Lurie wrote. They described the value of stepped care to identify patients with the greatest mental health needs early on and refer for additional treatment as needed. “Telemedicine mental health visits, group visits, and delivery of care via technology platforms will be important components of stepped care for both acute crisis management and more routine communication and support.”
Additionally, the authors recommended that communities and organizations consider training nontraditional groups to provide psychological first aid and educate the public on ways to check in with one another and provide support. “Even small signs that someone cares could make a difference,” they wrote.
“The worldwide COVID-19 pandemic, and efforts to contain it, represent a unique threat, and we must recognize the pandemic that will quickly follow it—that of mental and behavioral illness—and implement the steps needed to mitigate it,” they concluded.
(Image: iStock/filadendron)
APA’s COVID-19 Resource Center Keeps You Updated
APA’s COVID-19 Resource Center brings together a number of useful resources from APA and other authoritative sources to help you deal with the COVID-19.