While the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the nervous system remain unclear, there is no doubt that the COVID-19 pandemic is bad for mental health. To alleviate the impact of both the virus and the measures taken to control its spread, we need high quality information about their immediate and long-term effects, and which countermeasures are most effective. The good news is that by October, 2020, mental health was top of the charts in terms of published papers and preprints on the effects of COVID-19.
For people with mental illness, database studies so far have produced contradictory findings: in South Korea, a history of mental illness was not associated with increased likelihood of testing positive for SARS-CoV-2, but patients with a history of severe mental illness had a slightly higher risk for severe clinical outcomes of COVID-19 than patients without such a history.
In the USA, a recent diagnosis of a mental disorder was associated with an increased risk for infection, which was exacerbated among African Americans and women,
and a higher frequency of some adverse outcomes of the infection. Taking a broader view on the pandemic as a whole, Holmes and colleagues asked, what is the effect of COVID-19 on risk of mental illness?
Rigorous, national surveillance systems are needed to provide the basis for
evidence-based services and prevention measures, because the economic consequences of the pandemic will be felt for many years. Rigorous,
national surveillance systems are needed to provide the basis for evidence-based services and prevention measures, because the economic consequences of the
pandemic will be felt for many years.
Holmes and colleagues also called for trials to determine the efficacy of mechanistically based digital and nondigital interventions and evaluate optimal models of implementation. Unfortunately, while many digital services have been introduced, few have been evaluated and too few seem to be mechanistically based. Similarly,
while many hospitals have provided psychological support for health-care staff, reports of these are mainly descriptive.
Hopefully, the other questions identified by Holmes and colleagues are being addressed, such as how best to deliver mental health services for vulnerable groups,
outreach methods to support those at risk of domestic abuse, how media consumption about COVID-19 influences mental health, and how to promote adherence to behavioral advice about COVID-19 while enabling mental wellbeing and minimizing distress.
Excerpt from: The Lancet Psychiatry