Science

Flattening the Mental Health Curve is Next

Earlier this week a webinar was offered and recorded which I have included a link to below. There are also slides for those of us who prefer to flip through the slides (although I will say, he’s got a pleasant voice to play it in the background and he is a clinician so it’s like hearing from one of our own!) Something he said that I will now be repeating every time I can is that we are all very familiar with “flattening the curve” for the pandemic, however, our next task will be to “flatten the curve” for the mental health tsunami that is coming our way through daily practices of mental health hygiene. We hear every day to wash our hands, stay home, cover our coughs, stay 6 feet away. Do we hear every day to sleep 8 hours, spend time in nature, connect with a loved one, eat plants, drink water, breathe deep, raise our heart rates, and stick with your treatment if you require it? Something to seriously ponder… what is our role in flattening the mental health curve?

Video: Dr. Blaise Aguirre Offers COVID-19 Coping Tips for Health Care Workers

Dr. Blaise Aguirre offers strategies from dialectical behavior therapy to help mental health professionals and health care workers from all disciplines cope with the challenges they are facing during COVID-19.

Quarantine Raises Mental Health Concerns...

The full article can be found here. Excerpts are included below.

The bad news is that quarantine and isolation are usually accompanied by unwelcome side effects, including depression, anxiety and post-traumatic stress. The medical professionals treating patients and managing quarantines often face mental-health burdens of their own. For China, containing and treating the virus must come first. But to successfully recover, mental-health care must be a part of the response. Long-term psychological effects could be among the outbreak’s most durable legacies, with consequences for the next epidemic.

Mental health is not a subject that Chinese and their government are accustomed to discussing. Sufferers and their families are often stigmatized, with negative consequences for their social and working lives. Like most developing countries, the Chinese government has historically devoted most of its health-care budget (including medical education) to meeting primary-care needs.

Yet mental illness, like any illness, isn’t something that can be pretended away. Official statistics document how mental illness — especially depression and anxiety-related disorders — has been increasing for 30 years in China. A growing number of researchers have documented the mental-health impacts on Chinese of violent crime and natural disasters. Although there are no good estimates on the social and financial costs of mental illness in China, they promise to be significant. Mental and substance-use disorders account for more than 10% of the global disease burden, and — among other issues — disrupt family life, limit academic outcomes and reduce job performance.

As far back as the SARS cases of 2002-3, researchers and clinicians identified the outbreak as an event that could take a mental toll on medical staff and patients. A 2006 study of 549 employees of a Beijing hospital that treated SARS patients found that 10% exhibited symptoms of post-traumatic stress, a condition triggered by terrifying events. Symptoms can include flashbacks, nightmares, and changes in mood and thinking. Staff who had worked most closely with patients had the highest incidence, and their symptoms could persist for three years (and, presumably, past the study date). Problems weren’t confined to Beijing, either. A study of 233 SARS survivors in Hong Kong found that 40% had “active psychiatric illness” years after the outbreak, including post-traumatic stress, depression and obsessive compulsive disorder. Health workers had more than triple the risk of others.

During SARS, thousands of patients globally — including in China — were ordered into quarantines. In Toronto, one of the most severe hotspots, researchers surveyed 129 individuals who were quarantined, shortly after their isolation ended. Post-traumatic stress was identified in 28.9% of patients, and depression was found in 31.9%. Patients subject to quarantines during other outbreaks outside of China, including of Middle East Respiratory Syndrome and Ebola, have experienced mental stresses and health burdens. For those who already have mental illness, the isolation of quarantine can make their conditions worse.

Those studies aren’t an argument for doing away with quarantines. But a failure to monitor and treat mental health in medical professionals and patients can serve to undermine a successful quarantine. Mentally distressed patients are more likely to disobey containment orders — or outright flee. There also concerns that distressed and depressed patients may be less willing or able to reveal recent personal contacts necessary to trace, and halt, an epidemic.

...In early February, the Chinese Psychology Society surveyed 18,000 citizens for anxiety related to the coronavirus outbreak; 42.6% registered a positive response. Hashtags and discussions related to self-care and mental illness have surged on social media.

To an extent, the government was prepared. The National Health Commission recently released guidelines for psychological care during the epidemic, and relocated mental health professionals to Wuhan.