Wednesday, October 14, 2020

Overwhelming Second Wave of Psychiatric Disorders Expected Due to Pandemic

Even as public health experts warn of a new tide of COVID-19 cases and deaths, another “second wave” is building in the form of mental and substance use disorders associated with social isolation, economic insecurity, and loss of family and community supports, cautioned Naomi M. Simon, M.D., M.Sc., director of the Anxiety and Complicated Grief Program at the NYU Grossman School of Medicine, and colleagues in an article published Monday in JAMA.

They especially emphasized the risk of psychiatric disorders related to grief from the loss of loved ones. “This interpersonal loss at a massive scale is compounded by societal disruption,” they wrote. “The necessary social distancing and quarantine measures implemented as mitigation strategies have significantly amplified emotional turmoil by substantially changing the social fabric by which individuals, families, communities, and nations cope with tragedy.”

The piece accompanied another report in the journal on the number of excess deaths in the United States between February and August attributed to COVID-19.

Simon and colleagues wrote that in the wake of so much death related to the pandemic—and in the absence of normal social, cultural, and religious connections and rituals for coping with grief—survivors are at risk of prolonged grief disorder, major depressive disorder, and posttraumatic stress disorder. 

“This imminent mental health surge will bring further challenges for individuals, families, and communities including increased deaths from suicide and drug overdoses,” they wrote.

To cope with the coming tsunami of psychiatric disorders, Simon and colleagues called for a three-pronged public health strategy of screening, mental health risk assessment, and treatment for those at highest risk for prolonged grief and posttraumatic stress.

Crucial to prevention is rebuilding forms of social and community support. “Clinicians can help bereaved families find creative ways to safely honor traditions, memorialize the deceased, and improve social support,” they wrote. “Public health campaigns and public policy initiatives could be created to support the implementation of these preventive strategies.”

They concluded: “A second wave of devastation is imminent, attributable to mental health consequences of COVID-19. The solution will require increased funding for mental health; widespread screening to identify individuals at highest risk including suicide risk; availability of primary care clinicians and mental health professionals trained to treat those with prolonged grief, depression, traumatic stress, and substance abuse; and a diligent focus on families and communities to creatively restore the approaches by which they have managed tragedy and loss over generations.”

For related information, see the Psychiatric News article “Expect a ‘Long Tail’ of Mental Health Effects From COVID-19.”


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