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Mental health and COVID-19: How are we coping?

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Faced with new realities, a look at how the pandemic is affecting the mental health and wellbeing of patients.

Fear, worry, and stress are normal responses when we are faced with uncertainty or the unknown. So, it is understandable that people are experiencing fear in the context of the COVID-19 pandemic.

Faced with new realities of working from home, temporary unemployment, home-schooling of children, and lack of physical contact with other family members, friends and colleagues, the World Health Organisation (WHO) highlight that it is essential that we look after our mental, as well as our physical, health.

Omnia Health Insights spoke to Sneha John, who is a clinical psychologist at Medcare's Camali Clinic Child & Adult Mental Health in the United Arab Emirates, about how the pandemic is affecting the mental health and wellbeing of patients and how they are coping with the significant changes to our daily lives.

As the virus continues to spread and many countries continue to go in and out of lockdown, how do you think this will continue to impact mental health in general?

The pandemic has caused a significant impact on mental health globally. Quarantine and self-isolation lead to boredom, stress, uncertainty and low mood.

In the long term, mood and trauma-related disorders may be prevalent. The pandemic has also laid the foundation for a worldwide increase in suicide rates due to job loss, economic pressure, job insecurity, unemployment and social isolation. 

Substance abuse has become rampant, with people relying on substances to cope with the uncertainty and disappointment linked to the pandemic. 

Prolonged school closures have impacted the mental health and social anxiety levels of children and adolescents. Schools have an essential role in shaping friendships, socio-emotional development. The switch to online learning has impacted social interactions with their peers and teachers. This has resulted in some students becoming more withdrawn, isolated, anxious, de-motivated, irritable and depressed. 

What are the gender differences in mental health effects of COVID-19?

The gender differences in mental health effects of Covid-19 are two-fold. The gender gap arises because men and women experience situations differently. Women are taking on more roles at home, centred on taking care of the family. Working mothers may be most affected by this, as taking care of the housework and children simultaneously would interrupt their work-time. Research shows that women find it challenging to stay positive during the pandemic compared to men. This could be due to their work being impacted by the pandemic and care burden at home. 

Men may have concerns addressing their mental health. Their intimate emotions and thoughts may not be validated. Men have been seen as the providers, seen as strong and dependable. However, they too have experienced isolation, anxiety, stress and depression alone. The societal stigma around men’s mental health is still prevalent. This may cause men to avoid being open and vulnerable about themselves.

How can clinicians use this information to treat their patients better?

Healthcare providers should assess mental health needs along with physical health during patient check-ups. This could be done in the form of a quick mental health screening assessment and consequent referral to Psychiatry or Psychology. 

Very often, patients are reluctant to share mental health concerns due to fear of being stigmatised. Taking the effort to form a rapport with the patient where the Physician asks questions about their emotional wellbeing would allow them to open up. 

The assessment could also include coping methods to stress and uncertainty, which will help determine whether they are at risk of self-neglect. The provision of low-cost psychology services would also make services easily accessible. With the advancement of telemedicine, patients can be encouraged to schedule mental-health check-ups from the comfort of their homes as they cope with the new normal. 

Suicide prevention training should be widely endorsed among companies, healthcare sectors and the public in general. As time and resources permit, frontline workers should have training on basic psychosocial care principles and psychological first aid. Online training may be used if it is not possible to train staff in person due to remote or distributed work, limited time and concerns about infection risk. 

Emotional distress and anxiety are common during pandemics such as the COVID-19 outbreak. It is important to help patients acknowledge that stress exists and help normalise it. Basic strategies can teach them how to recognise signs of distress (such as worry, fear, insomnia, etc.) and discuss ways to reduce them (e.g., healthy diet, exercise, talking to loved ones, etc.). 

What studies would you like to see done in the future to be able to treat patients better?

With the increased use of telehealth during COVID-19, current tele-therapeutic practices can be used to improve services for patients. Preventative measures can be taken after the pandemic subsides to avoid mental health care burdens in the future. 

There will be greater demand for primary care when it is already overloaded. In the following stages of the pandemic, it will be essential to study how stress on the primary care system can be eased, especially due to the high demand caused by mental health problems. Studies can also investigate methods of preventing suicide and setting up 24/7 hotlines for crisis situations in the UAE. A comparison study between delivering psychotherapy online and psychotherapy sessions conducted in-person while wearing masks would be beneficial.

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