Psychiatric emergency admissions during and after COVID-19 lockdown: short-term impact and long-term implications on mental health

Abstract Background The ‘lockdown’ measures, adopted to restrict population movements in order to help curb the novel coronavirus disease 2019 (COVID-19) pandemic, contributed to a global mental health crisis. Although several studies have extensively examined the impact of lockdown measures on the psychological well-being of the general population, little is known about long-term implications. This study aimed to identify changes in psychiatric emergency department (ED) admissions between two 8-week periods: during and immediately after lifting the lockdown. Methods Socio-demographic and clinical information on 1477 psychiatric ED consultations at the University Hospital of Geneva (HUG) were retrospectively analyzed. Results When grouped according to admission dates, contrary to what we expected, the post-lockdown group presented with more severe clinical conditions (as measured using an urgency degree index) compared to their lockdown counterparts. Notably, after the lockdown had been lifted we observed a statistically significant increase in suicidal behavior and psychomotor agitation and a decrease in behavior disorder diagnoses. Furthermore, more migrants arrived at the HUG ED after the lockdown measures had been lifted. Logistic regression analysis identified diagnoses of suicidal behavior, behavioral disorders, psychomotor agitation, migrant status, involuntary admission, and private resident discharge as predictors of post-lockdown admissions. Conclusions Collectively, these findings can have implications concerning the prioritization of mental health care facilities and access for patients at risk of psychopathological decompensation in time of confinement policies, but above all, provide a foundation for future studies focusing on the long-term impact of the pandemic and its associated sanitary measures on mental health. Trial registration Research Ethics Committee of Geneva, Registration number 2020–01510, approval date: 29 June 2020.

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Depression during the COVID-19 pandemic amongst residents of homeless shelters in France.

10.1101/2021.04.23.21255993 ◽

2021 ◽

Author(s):

Honor Scarlett ◽

Camille Davisse-Paturet ◽

Cecile Longchamps ◽

Tarik El Aarbaoui ◽

Cecile Allaire ◽

...

Keyword(s):

Mental Health ◽

Eastern Mediterranean ◽

Global Mental Health ◽

Severe Depression ◽

Well Being ◽

Homeless Persons ◽

Homeless Population ◽

Health Crisis ◽

Metropolitan Regions ◽

The Impact

Background: Accumulating evidence suggests that the COVID–19 pandemic has negatively affected global mental health and well–being. However, the impact amongst homeless persons has not been fully evaluated. The ECHO study reports factors associated with depression amongst the homeless population living in shelters in France during the Spring of 2020. Methods: Interview data were collected from 527 participants living in temporary and/or emergency accommodation following France's first lockdown (02/05/20 – 07/06/20), in the metropolitan regions of Paris (74%), Lyon (19%) and Strasbourg (7%). Interviews were conducted in French, English, or with interpreters (33% of participants, ~20 languages). Presence of depression was ascertained using the Patient Health Questionnaire (PHQ–9). Results: Amongst ECHO study participants, 30% had symptoms of moderate to severe depression (PHQ–9≥ 10). Multivariate analysis revealed depression to be associated with being female (aOR: 2.15; CI: 1.26–3.69), being single (aOR: 1.60; CI: 1.01–2.52), having a chronic illness (aOR: 2.32; CI: 1.43–3.78), facing food insecurity (aOR: 2.12; CI: 1.40–3.22) and participants' region of origin. Persons born in African and Eastern Mediterranean regions showed levels of depression comparable to those of French participants (30–33%) but higher than migrants from European countries (14%). Reduced rates of depression were observed amongst participants aged 30–49 (aOR: 0.60; CI: 0.38–0.95) and over 50 (aOR: 0.28; CI: 0.13–0.64), compared to 18–29–year–olds. Conclusions: Our results indicate high levels of depression among homeless persons during the COVID–19 pandemic. The value of these findings extends beyond the health crisis, as predicted future instability and economic repercussions could particularly impact the mental health of this vulnerable group.

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Leveraging Twitter Using Artificial Intelligence to Explore Mental Health Insights in the UK During the COVID-19 Pandemic (Preprint)

10.2196/preprints.32449 ◽

2021 ◽

Author(s):

Christopher Marshall ◽

Kate Lanyi ◽

Rhiannon Green ◽

Georgie Wilkins ◽

Fiona Pearson ◽

...

Keyword(s):

Mental Health ◽

Artificial Intelligence ◽

Language Processing ◽

Mental Health Problems ◽

Well Being ◽

Research Activity ◽

Health Crisis ◽

Key Topics ◽

The Uk ◽

The Impact

BACKGROUND There is increasing need to explore the value of soft-intelligence, leveraged using the latest artificial intelligence (AI) and natural language processing (NLP) techniques, as a source of analysed evidence to support public health research activity and decision-making. OBJECTIVE The aim of this study was to further explore the value of soft-intelligence analysed using AI through a case study, which examined a large collection of UK tweets relating to mental health during the COVID-19 pandemic. METHODS A search strategy comprising a list of terms related to mental health, COVID-19, and lockdown restrictions was developed to prospectively collate relevant tweets via Twitter’s advanced search application programming interface over a 24-week period. We deployed a specialist NLP platform to explore tweet frequency and sentiment across the UK and identify key topics of discussion. A series of keyword filters were used to clean the initial data retrieved and also set up to track specific mental health problems. Qualitative document analysis was carried out to further explore and expand upon the results generated by the NLP platform. All collated tweets were anonymised RESULTS We identified and analysed 286,902 tweets posted from UK user accounts from 23 July 2020 to 6 January 2021. The average sentiment score was 50%, suggesting overall neutral sentiment across all tweets over the study period. Major fluctuations in volume and sentiment appeared to coincide with key changes to any local and/or national social-distancing measures. Tweets around mental health were polarising, discussed with both positive and negative sentiment. Key topics of consistent discussion over the study period included the impact of the pandemic on people’s mental health (both positively and negatively), fear and anxiety over lockdowns, and anger and mistrust toward the government. CONCLUSIONS Through the primary use of an AI-based NLP platform, we were able to rapidly mine and analyse emerging health-related insights from UK tweets into how the pandemic may be impacting people’s mental health and well-being. This type of real-time analysed evidence could act as a useful intelligence source that agencies, local leaders, and health care decision makers can potentially draw from, particularly during a health crisis.

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407 - Living through the pandemic as an older person: Long-term psychological impacts in low- and middle-income countries

International Psychogeriatrics ◽

10.1017/s1041610221001666 ◽

2021 ◽

Vol 33 (S1) ◽

pp. 33-33

Author(s):

Clarissa Giebel ◽

Bwire Ivan ◽

Maria Isabel Zuluaga ◽

Suresh Kumar ◽

Mark Gabbay ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

Well Being ◽

Middle Income ◽

Middle Income Countries ◽

Health And Social Care ◽

The Impact ◽

Low And Middle Income

Background:The pandemic has put a huge strain on people’s mental health, with varying restrictions affecting people’s lives. Little is known how the pandemic affects older adults’ mental health, particularly those living in low- and middle-income countries (LMICs) where restrictions are affecting people’s access to basic necessities. Thus, the aim of this 3-country study was to understand the long- term impacts of the pandemic on the mental well-being of older adults with and without dementia in LMICs.Methods:We are collecting 30 baseline and 15 follow-up interviews with older adults (aged 60+), people with dementia, and family carers in Colombia, India, and Uganda, as well as a baseline and follow-up focus group with health and social are professionals in each country. Interviews are conducted remotely over the phone due to pandemic restrictions, with data collection taking place between March and July 2021. Transcripts are translated into English before being analysed using thematic analysis.Results:To date, we have completed close to 90 baseline interviews and 3 focus groups with health and social care professionals. Analysis is ongoing, but findings are capturing the detrimental second wave in India and follow-up interviews will capture the longitudinal impacts on mental health.Conclusions:Whilst vaccines are starting to be rolled out in LMICs, albeit at different rates, the virus will likely take much longer to be somewhat managed in LMICs. This leaves more room for people’s physical as well as mental health to be impacted by the restrictions, and with often limited mental health service coverage, it is all the more important o understand the impact of the pandemic on older people’s mental health.

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Coping With COVID-19: Mindfulness-Based Approaches for Mitigating Mental Health Crisis

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.563417 ◽

2021 ◽

Vol 12 ◽

Author(s):

Elena Antonova ◽

Karoly Schlosser ◽

Rakesh Pandey ◽

Veena Kumari

Keyword(s):

Mental Health ◽

Panic Attacks ◽

World Population ◽

Health Issues ◽

Health Crisis ◽

Social Distancing ◽

Compulsive Disorder ◽

Mental Health Issues ◽

The Impact

The novel coronavirus disease COVID-19 that first emerged in Wuhan, China, in Nov-Dec 2019 has already impacted a significant proportion of the world population. Governments of many countries imposed quarantines and social distancing measures in 2020, many of which remain in place, to mitigate the spread of the SARS-Cov-2 virus causing the COVID-19 disease. The direct impact of COVID-19 on people infected with the virus, their families and the health care workers, as well as the impact of the mitigation measures such as quarantine, social distancing, and self-isolation on the rest of the population have contributed to a global mental health pandemic, including anxiety, depression, panic attacks, posttraumatic stress symptoms, psychosis, addiction, obsessive-compulsive disorder, and suicidality. These effects are present acutely (for example, due to fear of contamination or losing loved ones, effects of quarantine/isolation, withdrawal of community and social services, etc.) and may continue long after the pandemic is over (for example, due to bereavement, unemployment, financial losses, etc). The COVID-19 pandemic has triggered mental health problems in people without previous history of mental illness, as well as worsened the symptoms in those with pre-existing psychiatric diagnosis. Therefore, the global effort is called for to deal with this mental health pandemic secondary to COVID-19 itself to address the emergence of new as well as the exacerbation of the existing mental health issues. Conversely, this global context provides an extraordinary opportunity for studying individual differences in response to and resilience in the face of physical and psychological threat, challenge to “normal” way of life, and long-term uncertainty. In this viewpoint article we outline the particular suitability of mindfulness, its skills and mechanisms, as an approach to the prevention and management of mental health issues, as well as to the promotion of well-being and building the foundations of adaptability and flexibility in dealing with the long-term uncertainty and profound changes to the social, economic, and possibly political systems as this pandemic continues to unfold.

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The Acute Impact of the COVID-19 Pandemic on Children’s Mental Health in Southwestern Ontario

10.31234/osf.io/5cwb4 ◽

2020 ◽

Cited By ~ 1

Author(s):

Alexandra Mactavish ◽

Carli Mastronardi ◽

Rosanne Menna ◽

Kimberley A. Babb ◽

Marco Battaglia ◽

...

Keyword(s):

Mental Health ◽

Social Support ◽

Psychological Distress ◽

Psychological Impact ◽

Well Being ◽

Children’S Mental Health ◽

Children's Mental Health ◽

Children And Parents ◽

The Impact

Objective: COVID-19 is an unprecedented global crisis. Research is critically needed to identify the acute and long-term impacts of the pandemic to children’s mental health including psychosocial factors that predict resilience, recovery, and persistent long-term distress. The present study collected data in June-July 2020 to enumerate the acute impact of the pandemic on children’s mental health, including the magnitude and nature of psychiatric and psychological distress in children, and to evaluate social support as a putative psychosocial correlate of children’s distress.Method: 190 families of children aged 8 to 13 from the Windsor-Essex region of Southwestern Ontario reported on the impact of the pandemic on children’s well-being (e.g., worry, happiness); irritability; social support; and symptoms of anxiety, depressive, and posttraumatic stress disorder at baseline assessment of an ongoing longitudinal study of the COVID-19 pandemic.Results: Children and parents reported worsened well-being and psychological distress during the pandemic compared to retrospective report of pre-pandemic well-being. Children and parents also reported higher depressive and anxiety symptoms, but fewer PTSD symptoms, compared to epidemiological samples that used the same measures prior to the pandemic. Finally, child-perceived social support from family and friends was associated with lower symptom severity.Conclusions: Study findings indicate broad psychological impact of the COVID-19 pandemic and are consistent with prior research that indicates a protective role of social support to mitigate the negative psychological impact of the pandemic.

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Exploring the impact of COVID-19-related fear, obsessions, anxiety and stress on psychological well-being among adults in Pakistan

The Journal of Mental Health Training Education and Practice ◽

10.1108/jmhtep-10-2020-0074 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Naeem Aslam ◽

Kanwal Shafique ◽

Ammar Ahmed

Keyword(s):

Mental Health ◽

Well Being ◽

Survey Method ◽

Health Issues ◽

Psychological Well Being ◽

Health Crisis ◽

Content Type ◽

Negatively Associated ◽

Mental Health Issues ◽

The Impact

Purpose Fear of COVID-19 is one of the pivotal components that have generated higher levels of stress, obsessions and anxiety among the adult population, thus creating numerous mental health issues. The purpose of this study was to evaluate psychological well-being based on COVID-19-related fear, obsessions and anxiety during the pandemic situation. Design/methodology/approach The current study aimed to evaluate the relationship between COVID-19-related fear, obsessions, anxiety, stress and well-being among adult populations. Additionally, the aim was to see the impact of COVID-19-related fear, obsessions, anxiety and stress on well-being. This was a cross-sectional study based on nonclinical sample of (n = 250) adults; data was obtained via online questionnaire survey method and analysis was performed by using the statistical package for social sciences (SPSS-22). Findings The authors’ findings based on descriptive statistics showed that COVID-19-related fear and obsessions were positively associated with COVID anxiety and stress and negatively associated with well-being. COVID anxiety was positively associated with stress and negatively associated with well-being. Moreover, perceived stress is negatively associated with well-being. The results additionally provide the outcome/conclusion that COVID-related anxiety significantly negatively predicted the psychological well-being. Overall the model explained 24% of the variance in psychological well-being. Females scored significantly high in COVID-19-related anxiety and obsessions as compared to males. Research limitations/implications A distinctive feature of this study is the understanding of COVID-19-related fear, obsessions, anxiety, stress and well-being among adult populations, and the findings are highlighting the need for psychological and social interventions for this specific population; therefore, immediate attention is needed by the clinical health professionals dealing with mental health issues. Originality/value There is a vital need to explore and develop psychological interventions aiming at the negative consequences being faced by the adult populations due to the COVID-19 pandemic and the impending second wave that will expose individuals to various mental health issues evolving because of the health crisis.

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Introduction: Mental Health and Human Rights: Social Policy and Sociological Perspectives

Social Policy and Society ◽

10.1017/s1474746408004739 ◽

2009 ◽

Vol 8 (2) ◽

pp. 211-214 ◽

Cited By ~ 3

Author(s):

Lydia Lewis

Keyword(s):

Mental Health ◽

Human Rights ◽

Social Policy ◽

Social Exclusion ◽

Social Cohesion ◽

Well Being ◽

World Health ◽

Health Crisis ◽

The Impact ◽

Health And Well Being

Recognition of the effects of social, economic, political and cultural conditions on mental health and the personal, social and economic costs of a growing global mental health crisis (WHO, 2001; EC, 2005) mean that mental health and well-being are a current feature of social policy agendas at UK, European and world levels, with debate increasingly becoming framed in human rights terms. In the UK, policy drives to address social exclusion and health inequalities as key social and economic rights issues have encompassed attention to mental health and distress (DoH, 2003; Social Exclusion Unit, 2004) and mental health has been identified as a priority area for the new Equality and Human Rights Commission (Diamond, 2007; DRC, 2007). At the European level too, rights-based social policy approaches to promoting social cohesion (European Committee for Social Cohesion, 2004) and policy directives on the ‘right to health’ (Commission of the European Communities, 2007) have been centrally concerned with mental health and well-being, and have been accompanied by a European strategy on mental health for the EU (EC, 2005). At a global level, the World Health Organisation has declared enjoyment of the highest attainable standard of health to be a fundamental human right (WHO, 2006). It has launched a new appeal on mental health which draws attention to the impact of human rights violations and cites social isolation, poor quality of life, stigma and discrimination as central issues for those with mental health needs (Dhanda and Narayan, 2007; Horton, 2007; WHO, 2007).

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Mental Health of Children and Adolescents Amidst COVID-19 and Past Pandemics: A Rapid Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073432 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3432

Author(s):

Salima Meherali ◽

Neelam Punjani ◽

Samantha Louie-Poon ◽

Komal Abdul Rahim ◽

Jai K. Das ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Children And Adolescents ◽

Behavioral Problems ◽

Well Being ◽

School Closure ◽

Social Distancing ◽

Psychosocial Services ◽

The Impact

Background: The COVID‑19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID‑19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children’s and adolescent’s mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children’s and adolescents’ mental health. Methodology: We conducted the systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included experimental randomized and nonrandomized controlled trials, observational studies, and qualitative studies. Results: Of the 5828 articles that we retrieved, 18 articles met the inclusion criteria. We thematically analyzed them and put the major findings under the thematic areas of impact of the pandemic on children’s and adolescents’ mental health. These studies reported that pandemics cause stress, worry, helplessness, and social and risky behavioral problems among children and adolescents (e.g., substance abuse, suicide, relationship problems, academic issues, and absenteeism from work). Interventions such as art-based programs, support services, and clinician-led mental health and psychosocial services effectively decrease mental health issues among children and adolescents. Conclusion: Children and adolescents are more likely to experience high rates of depression and anxiety during and after a pandemic. It is critical that future researchers explore effective mental health strategies that are tailored to the needs of children and adolescents. Explorations of effective channels regarding the development and delivery of evidenced-based, age-appropriate services are vital to lessen the effects and improve long-term capacities for mental health services for children and adolescents. Key Practitioner Message: The COVID-19 pandemic’s physical restrictions and social distancing measures have affected each and every domain of life. Although the number of children and adolescents affected by the disease is small, the disease and the containment measures such as social distancing, school closure, and isolation have negatively impacted the mental health and well-being of children and adolescents. The impact of COVID-19 on the mental health of children and adolescents is of great concern. Anxiety, depression, disturbances in sleep and appetite, as well as impairment in social interactions are the most common presentations. It has been indicated that compared to adults, this pandemic may continue to have increased long term adverse consequences on children’s and adolescents’ mental health. As the pandemic continues, it is important to monitor the impact on children’s and adolescents’ mental health status and how to help them to improve their mental health outcomes in the time of the current or future pandemics.

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The impact of the COVID-19 pandemic on mental health and well-being of people living with a long-term physical health condition: a qualitative study

BMC Public Health ◽

10.1186/s12889-021-11751-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

A. Fisher ◽

A. Roberts ◽

A. R. McKinlay ◽

D. Fancourt ◽

A. Burton

Keyword(s):

Mental Health ◽

Social Support ◽

Physical Health ◽

Well Being ◽

Severe Illness ◽

Health And Wellbeing ◽

Being There ◽

The Impact ◽

Health And Well Being

Abstract Background The COVID-19 pandemic and associated restrictions caused major global disruption. Individuals with long-term physical health conditions (LTCs) are at higher risk of severe illness and often subject to the strictest pandemic guidance, so may be disproportionally affected. The aim of this study was to qualitatively explore how living with a LTC during the COVID-19 pandemic affected people’s mental health and wellbeing. Methods Participants were people living with LTCs who participated in telephone/video call interviews based on a semi-structured topic guide. Key themes and subthemes were determined using deductive and inductive thematic analysis. Results The sample included 32 participants with LTCs (most commonly cancer, respiratory conditions or cardiovascular diseases), mean age 57 (SD 13) years, 66% female and 72% white British. There were four overarching themes specific to living with a LTC. These were 1) high levels of fear and anxiety related to perceived consequences of catching COVID-19, 2) impact of shielding/isolation on mental health and wellbeing, 3) experience of healthcare during the pandemic and 4) anxiety created by uncertainty about the future. Fourteen subthemes were identified, including concerns about accessing essential supplies and the importance of social support. Individuals who lived alone and were advised to shield could be profoundly negatively affected. Conclusions This study found that there were a number of aspects of living with a LTC during the pandemic that had a significant impact on mental health and well-being. There should be focus on how best to provide practical and social support to people with LTCs during a pandemic, particularly if they have to shield or isolate.

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Online Mindfulness May Target Psychological Distress and Mental Health during COVID-19

Global Advances in Health and Medicine ◽

10.1177/21649561211002461 ◽

2021 ◽

Vol 10 ◽

pp. 216495612110024

Author(s):

Suzan R Farris ◽

Licia Grazzi ◽

Miya Holley ◽

Anna Dorsett ◽

Kelly Xing ◽

...

Keyword(s):

Public Health ◽

Mental Health ◽

Psychological Distress ◽

Mindfulness Meditation ◽

Well Being ◽

Web Content ◽

Health Crisis ◽

Public Health Crisis ◽

Helping Others ◽

The Impact

Background The COVID-19 pandemic has dramatically affected mental health, creating an urgent need for convenient and safe interventions to improve well-being. Online mindfulness interventions show promise for improving depression, anxiety, and general well-being. Objective To assess: 1) the impact of online mindfulness on psychological distress, 2) altruistic efforts, and 3) the quantity, quality, and availability of online mindfulness resources during the COVID-19 pandemic. Methods 233 participants (203 U.S.; 20 international; 10 unknown) participated in this prospective, single-arm, non-randomized clinical trial of a single online mindfulness meditation session with pre- and post-surveys. Main Outcome Measures (a) Mindfulness session helpfulness, online platform effectiveness, and immediate pre- to post-session changes in momentary stress, anxiety, and COVID-19 concern; (b) qualitative themes representing how people are helping others during the pandemic; (c) absolute changes in quantity of mindfulness-oriented web content and free online mindfulness resource availability from May to August 2020. Results Most participants felt the online mindfulness session was helpful and the electronic platform effective for practicing mindfulness (89%, 95% CI: [82 to 93%]), with decreased momentary anxiety (76%; 95% CI: [69 to 83%]), stress (80%; [72 to 86%]), and COVID-19 concern (55%; [46 to 63%]), (p < 0.001 for each measure). Participants reported helping others in a variety of ways during the pandemic, including following public health guidelines, conducting acts of service and connection, and helping oneself in hopes of helping others. “Mindfulness + COVID” search results increased by 52% from May to August 2020. Most (73%) Academic Consortium for Integrative Medicine and Health member websites offer free online mindfulness resources. Conclusions Virtual mindfulness is an increasingly accessible intervention available world-wide that may reduce psychological distress during this isolating public health crisis. Kindness and altruism are being demonstrated during the pandemic. The consolidated online mindfulness resources provided may help guide clinicians and patients.

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