Impact of COVID-19 on mental health: what are the long-term consequences?

The future implications of the COVID-19 crises are unknown. Not only the financial and environmental sector are thought to be affected, but also implications on mental health are expected. The discussion about the impact of COVID-19 on mental health is often not on the top of the agenda, due to easier tracking of changes to economic and physical health. Further, the financial investment, coming from the emergency coronavirus funding, covering mental health issues is substantially low for now. What are the expected long-term mental health consequences of COVID-19? What will be important to focus on following the crises?

What are the mental health impacts of COVID-19?

What is mental health?

Mental health is a broad term including emotional, psychological, and social wellbeing which is formed by  experiences. Additionally, it plays a role in how we handle stress, make choices, and relate to others. Today, the world is entering the biggest health crisis of the 21st century.

The mental health of the population affected by several consequences of COVID-19

COVID-19 has led to a growth of anxiety, deteriorated sleep quality, racism, panic-buying, sporadic instances of looting and theft, and the circulation of conspiracy theories. Additionally, the mental health state is negatively affected by the economic downturn and financial hardship that many people are suffering from.

Mental health and COVID-19: reported increase in levels of worry, anxiety, and stress

Even though it is not appropriate to compare living through a war and a pandemic lockdown, parallels have been drawn. Feeling like a prisoner in social isolation  lockdown or experiencing new threats such as losing one’s job or getting infected when socializing, are all leading to worry and fear. Nearly half (45%) of adults in the US have reported worry and stress due to the COVID-19 crisis.

The term “Covid stress syndrome” was introduced by scientists due to the high amount of people experiencing intense fears and anxiety with the most prevalent being anxiety for the mortality of themselves and loved ones. Many people have suffered from the loss of friends or family members leading to grief and possible depression.

Losing one’s job is scientifically proven to be associated with depression, anxiety, distress, and low self-esteem, which is only reinforced by the record-breaking levels of unemployment and reduced number of hires during the crisis. This economic upheaval is scientifically linked to suicide and substance use, and accordingly, there has been a substantial increase in mental substance use disorders during the crisis. Further, relationships and family ties are facing new challenges due to the pressure and circumstances of the lockdown.

Mental health and COVID-19: great reliance and impact on front-line workers

The crisis has put a large amount of pressure on health care personal. Doctors and nurses are at high risk of burnout due to workload, pressure, and a chaotic daily environment. A Chinese study of doctors and nurses during the coronavirus’ peak shows that 50% of workers reported depression, 45% anxiety and 34% insomnia.

Psychiatry funds and call centres worldwide have reported throughout the crisis to receiving a sharp increase in calls related to depression, suicidal thoughts, self-harm, domestic abuse, and grief. A federal emergency hotline in the US for people in emotional distress registered a more than 1,000% increase in April 2020 compared to the same time.

Further, despite this increase, the UK is perceiving the crises as a build-up of a mental health epidemic following the crisis, since many people are not asking for help on mental health issues currently to avoid putting further load on the healthcare system.

What can we learn from former outbreaks?

Each major outbreak is different, which makes it difficult for experts to predict what we can learn from the past to prevent consequences of future pandemics. Previous outbreaks, like the flu-pandemic in 1918 and 2009 and SARS, the first pandemic of the 21^st century, in 2003, all suggest that a public health threat can have lasting effects on the psychology of a population. A follow-up study on SARS survivorsfound that 44% developed PTSD up to 4 years after the pandemic.

Especially vulnerable populations, such as older adults and people with special medical history, have isolated themselves during earlier outbreaks, as well as COVID-19, to avoid developing serious health issues. The medical downside, however, is not fully understood: A broad collection of research links social isolation and loneliness to higher suicidal rates and poor mental health, last mentioned being particularly applicable for older adults. Studies of the psychological impact of quarantine during other disease outbreaks suggest negative mental health outcomes as one of the consequences, where even a few weeks of isolation are found to cause lasting anxiety.

What mental health action plan should be implemented in this COVID-19 crisis?

Proactive support and investigation

Federal agencies and experts in the US warn that the crisis will lead to a historical wave of mental health problems. Health care providers, grocery store workers, delivery people.are experiencing an extended amount of pressure and will presumably be especially vulnerable to the coming storm of mental health problems. It is important to investigate how to provide proactive support for these front-line workers.

The crisis is affecting  single individuals differently according to earlier experiences, current health status and understanding of risk. When creating psychological interventions, it is important to keep in mind these adverse psychological impacts of the pandemic. Further, the crisis can potentially create more barriers for people already suffering from mental illnesses, which will need particular attention when providing support.

Our teams are ready to perform a quality analysis of the player-specific mental health impacts of the crisis on the ecosystem to point out the elements to which specific players should prepare to react on.

Monitoring of mental health impact numbers

The mental health impact could lead to a great deal of pressure on the public psychology which would require adequate preparedness to be able to give the right amount of support. It is important to prepare the mental health system by monitoring the increasing numbers of depression, anxiety and stress cases, substance abuse, domestic violence, post-traumatic stress disorder and suicide. The increasing demand for services could lead to a discussion of increased numbers and additional trainings of mental health professionals.

Hospitals need to brace for the coming wave of behavioural health needs.by providing widespread mental health screenings and better access to services through telehealth. The sudden push into telemedicine would make it interesting for companies to work with our teams to explore the opportunities within this growing market.

Acknowledging the dependency on and the influence of digital technologies

It is obvious that times have changed since earlier pandemics. The coronavirus is the first pandemic in the digital age and may have pushed our actions towards a direction we were already heading. E.g. buying groceries and shopping online, catching up with friends and relatives over facetime, using dating  apps and working from home with meetings on zoom. The pandemic has functioned as an eye-opener to make us realise how depended we, are on digital technologies. As an interesting insight Alcimed’s health care team is ready to investigate how innovative technologies can help in supporting our mental health in a crisis like this.

Understanding possible new patterns in consumer choices and needs

Another valuable insight would be an investigation on which possible role the mental health impacts will have on consumers choices and needs – what they might deprioritize due to change trends and perceptions and what they will expect from specific tools and/or services to support them. In this way Alcimed could help in exploring new product development possibilities and in preparing and optimizing the positioning of a treatment or launch of a product following the crisis.

We need to be prepared to offer early and proactive support to both front-line workers as well as the rest of the population and do what is in our power to understand and prepare for the mental health consequences following the crises. We at Alcimed are convinced that a further investigation of the mental health impacts is of high value and that the possibilities for inspiration on how to prioritize and support possible areas of improvement are endless! Even a small investment in our mental health now could create big consequences in the future. We need to act now before above-mentioned mental health problems become the next main factor to overwhelm our health care system as experienced with COVID-19.

About the author

Josefine, Consultant in Alcimed’s Healthcare team in Germany