Mental health and COVID-19: which role can digital technology play?

Global health crises such as the COVID-19 crisis are synonymous with anxiety and can have a significant impact on our mental health. Public Health France reports an increase in sleep disorders and a decrease in current life satisfaction during the period of confinement [1], which translates into a decrease in mental well-being. At the same time, digital technology is increasingly seen as a tool for mental health. In this context, Alcimed deciphers the links between mental health, COVID-19 and digital.

Mental Health: a Multifaceted Definition and a Global Concern

Mental health, as defined by the World Health Organization, is “a state of well-being in which a person can achieve self-fulfillment, overcome the normal stresses of life, perform productive work and contribute to the life of his or her community”. The WHO considers that the mental health of individuals can be impaired if any of the pillars among individual factors (genetic and biological), environmental factors (access to infrastructure, cultural practices) or social context (living, educational and working conditions) is undermined.

Among the disorders that prevent good mental health are, of course, diseases such as Alzheimer’s, depression, and bipolar disorders. But good mental health is not only defined as the absence of illness. Anxiety, for example, is also an impediment to well-being. Mental ill-being affects a large part of the world’s population. The WHO estimates that one in four people will suffer from a mental disorder at some point in their lives [2].

According to the Institute for Metrics and Evaluation (IHME), mental disorders will affect 17.3% of the European population in 2018 [3]. Mental ill-being seems to be on the rise in recent years. Between 2007 and 2017, the Gallup Organization surveyed the mental well-being of more than 150,000 people in 145 countries. They introduced a “Positive Experience Index”, which captures the number of experiences that individuals feel positively, and a “Negative Experience Index”. The Positive Experience Index increased from 68/100 to 69/100 in 10 years, while the Negative Experience Index increased by 7 points from 23 to 30 out of 100 [4].

Confinement, anxiety, social distancing: coronavirus impacts our mental health

The COVID-19 crisis and containment have a significant impact on environmental factors and the social context related to our mental health. They appear to be leading to an increase in mental ill-being. While figures on mental well-being during containment remain limited due to the recentness of the crisis, the trend is towards a global decline in mental health. An initial study conducted as early as January in China [5] showed that 35% of the 52,730 people surveyed were in psychological distress during the epidemic. Similarly, a study by the Kaiser Family Foundation reveals that nearly 50% of Americans consider that the COVID-19 crisis is damaging their mental health.

With tools like Google Trends, it is possible to analyze Google searches over a given time period and geographic region. Taking as a term “crisis, anxiety”, and comparing the number of searches for this term carried out in France in February – where the Coronavirus was still quite “remote” and where containment was not in force – and in March – the month when containment began and the number of cases in France exploded – we note a 165% increase in searches [6].

This mental ill-being affects a large proportion of young people in France. According to an OpinionWay survey carried out at the end of May 2020 [7], 46% of 18-30 year olds say they are worried about their mental health during periods of confinement. The CONFINS study on the psychological state of French people in confinement is currently being conducted by INSERM, among others, and should provide a more detailed analysis of the situation.

Digital solutions available but some barriers to break down

Digital tools can help preserve mental health. As a study by the company App Annie revealed [8], health and fitness applications saw a 40% increase in downloads between late 2019 and early 2020. Teleconsultation platforms have also exploded: 1% of medical consultations were done remotely before confinement, today, we count 11% [9]. Consultations concerning mental health are all the more adapted to this format as they rarely require direct contact with the practitioner.

Some research institutes are putting solutions online to keep up morale, such as INSERM, which offers a StopBlues device that “aims to prevent mental suffering and its consequences“ through short videos, advice, sports or stretching sessions. Other applications aim to reduce stress and anxiety by accompanying meditation, such as Petit BamBou, Mind or Headspace. These applications focused on mental well-being experienced a peak in downloading during the COVID-19 crisis. Petit Bambou went from 5,000 to 15,000 new users per day during the period of confinement [10]. It should also be noted that videoconferencing applications and social networks allow the maintenance of social links, especially during the period of confinement. At the beginning of April, according to Laurent Soly, Facebook Vice-President for France and Europe, the use of Facebook, Instagram, Messenger and WhatsApp had increased by 11% compared to the pre-confinement period [11]. A call for testimonials made by Le Monde shows that this is due to the need to keep a “vital social link” [12].

However, some questions remain. The issue of digital addiction regularly resurfaces: can we really claim to improve people’s mental health if they become “addicted” to digital technology? The lack of scientific validation is also problematic and the multitude of tools available can lead to self-medication behavior, which is based solely on the personal judgement of the user of these tools. This indirectly leads to the risk of abandoning the use of non-digital solutions, such as making appointments with doctors specializing in mental disorders when this might sometimes prove necessary.

It is therefore recommended to systematically check who proposes a tool, who finances it, but also to check as far as possible whether the health information is reliable, whether the tool is relevant, secure and certified or labelled. It is difficult to distinguish between what is reliable and what is not in the multitude of tools available – remember that more than 325,000 mobile health applications have been identified, the vast majority of which have never been evaluated.  A more systematic monitoring of these tools would perhaps in the long term allow an increase in the reliability of digital tools for managing mental health, and therefore their use on a larger scale with a lower risk of drift.

About the author

Amélie, Consultant in Alcimed’s Healthcare team in France

[1] https://www.santepubliquefrance.fr/etudes-et-enquetes/covid-19-une-enquete-pour-suivre-l-evolution-des-comportements-et-de-la-sante-mentale-pendant-le-confinement
[2] https://www.who.int/whr/2001/media_centre/press_release/fr/
[3] https://www.irdes.fr/documentation/syntheses/la-sante-mentale-en-france-et-dans-les-pays-de-l-ocde.pdf
[4] https://www.gallup.com/analytics/241961/gallup-global-emotions-report-2018.aspx
[5] https://gpsych.bmj.com/content/gpsych/33/2/e100213.full.pdf
[6] Source : Google Trends. Analyse réalisée le 6 mai 2020 sur la chaîne de caractères « crise angoisse »
[7] https://www.opinion-way.com/fr/component/edocman/opinionway-pour-20-minutes-et-heyme-moijeune-moijeune-confine-et-demain-vague-5-4-mai-2020/viewdocument/2294.html?Itemid=0
[8] https://www.lefigaro.fr/secteur/high-tech/avec-le-confinement-l-industrie-des-applications-mobiles-tutoie-de-nouveaux-sommets-20200403
[9] https://www.lepoint.fr/sante/face-au-coronavirus-le-boom-des-teleconsultations-02-04-2020-2369810_40.php
[10] https://www.challenges.fr/club-entrepreneurs/confinement-l-appli-star-de-meditation-petit-bambou-decolle_705310
[11] https://bfmbusiness.bfmtv.com/hightech/les-chiffres-impressionnants-de-facebook-messenger-et-whatsapp-pendant-le-confinement-1904580.html
[12] https://www.lemonde.fr/planete/article/2020/03/19/face-au-confinement-le-reconfort-des-groupes-whatsapp_6033694_3244.html