Mental Health Repercussions of COVID-19 and Social Distancing
After the first case of novel coronavirus disease, 2019 (COVID-19) was diagnosed in December 2019, it has galvanized global action and spread across the globe. This has prompted unprecedented attempts to introduce the practice of physical distancing (called "social distancing" in most cases) in countries around the world, leading to shifts in national behavioral norms and shutdowns of normal day-to-day functioning. While these steps may be crucial in reducing the spread of this disease, they will certainly have both short- and long-term implications for mental health and well-being. Such implications are of significant concern to warrant concerted actions based on prevention and direct action to resolve the effect of the epidemic on mental health at the individual and population levels. In the COVID-19 pandemic sense, it is possible that anxiety and depression, drug use, isolation, and domestic violence will rise substantially; and with schools closed, there is a very real risk of child abuse epidemics. The concern is so important the Mental Health UK has provided guidelines on psychological first aid. Although the literature on population-level prevention science is not conclusive, it leads us to believe that three steps taken now will help us proactively plan for the imminent increase in mental health problems and related sequelae that are the consequences of this pandemic.
First, when societies become physically and socially separated, it is important to prepare for the inevitability of isolation and its complications and to establish ways of intervening. The use of digital technology will cross the social distance, even if there are physical distancing steps. Regular structures where people gather, including worship places or gyms, and yoga studios, will carry out online activities on a schedule similar to what was in place before social distancing. Many workplaces build a virtual workspace that allows people to work and communicate through video connections, so that they are not digitally alone. Extra efforts will be made to maintain interactions with traditionally disadvantaged and alienated people, including the elderly, illegal immigrants, disabled, and mentally ill. Social media may also be used to promote communities to link people to reliable mental health support services and guide them to them. Even with all of these steps, parts of the population would always be lonely and segregated. This demonstrates the need for remote approaches to isolation outreach and screening and the related mental health issues in order to provide social support.
Second, it's important that we have monitoring, reporting, and intervention processes in place, particularly when it comes to domestic violence and child abuse. Individuals at risk of violence will have restricted opportunities to disclose or receive assistance when shelter-in-place conditions include extended home cohabitation and restrict travel outside the home.
Third, in preparation for the imminent problems precipitated by the COVID-19 pandemic, it's time to improve our mental health system. Stepped-up care, the method of presenting patients in need with the most appropriate, least resource-heavy treatment, and then jumping up to more resource-heavy treatment based on patient needs, is a valuable strategy. It will take programs that are both well planned and well equipped to provide patients with this treatment, from screening to overwhelming mental illness that will eventually arise from this pandemic. It will require innovative thinking to scale up care in the midst of a crisis. In the early stages of social isolation only small signs that somebody cares could make a difference. Visits to mental health via telemedicine, community visits, and care delivery through technology channels would be critical components of stepped treatment for both acute crisis management and more regular contact and assistance.
The COVID-19 pandemic worldwide, and efforts to control it, pose a specific challenge, and we must consider the pandemic that will follow it quickly-that of mental and behavioral disease-and adopt the measures required to mitigate it.