Abstract: With some 2.6 billion people around the world in lockdown, this is arguably the largest psychological experiment ever.
The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. There is an urgent need for research to address how mental health impacts can be mitigated under pandemic conditions, and on how to address the impact anxiety, stress and other mental health issues due to the repeated media consumption and health messaging around COVID-19.
Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuroscientific aspects of the pandemic are required.
The UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health have explored the psychological, social, and neuroscientific effects of COVID-19 and set out a set immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened in the first weeks of the pandemic in the UK in March 2020. Their surveys are reported online and the findings, combined with published scientific literature, informed the development of research priorities. To that end, they have now proposed a framework for the prioritization and coordination of essential, policy-relevant psychological, social, and neuroscientific research, to ensure that any research investment is efficiently targeted to answer the crucial mental health science questions as the pandemic unfolds.
Bazelet Health is part of a high-level International collaboration group working to ensure that these research priorities are addressed and will contribute to the new ones which will be identified over time.
Immediate research priorities include the monitoring and reporting of the rates of anxiety, depression, self-harm, suicide, and other mental health issues, and second to understand mechanisms that are crucial to inform interventions.
To optimize effectiveness of psychological treatments, healthcare providers need to be mechanistically informed—that is, targeting factors which are both causally associated with poor mental health and modifiable by an intervention.
The need for rigorous, peer-reviewed, ethically approved codeveloped research is fundamental. There is an urgent need for the discovery, evaluation, and refinement of mechanistically driven
interventions to address the psychological, social, and neuroscientific aspects of this pandemic. Bazelet Health will conduct experimental medicine studies to validate clinical biomarkers and repurpose new treatments.
Psychological and Social effects: It is already evident that the direct and indirect psychological and social effects of COVID-19 pandemic are pervasive which are affecting mental health now and will do so in the future.
The current COVID-19 lockdown will result in a secondary epidemic of burnouts and stress-related absenteeism in the latter half of 2020.
Perhaps unsurprisingly, people who are quarantined are very likely to develop a wide range of symptoms of psychological stress and disorder, including low mood, insomnia, stress, anxiety, anger, irritability, emotional exhaustion, depression and post-traumatic stress symptoms. According to a recent study1., low mood and irritability specifically stand out as being very common.
In cases where parents were quarantined with children, the mental health toll became even steeper. In one study, no less than 28% of quarantined parents warranted a diagnosis of “trauma-related mental health disorder”.
Among quarantined hospital staff, almost 10% reported “high depressive symptoms” up to three years after being quarantined2. Another study reporting on the long-term effects of SARS quarantine among healthcare workers found a long-term risk for alcohol abuse, self-medication and long-lasting “avoidance” behavior”. This means that years after being quarantined, some hospital workers still avoid being in close contact with patients by simply not showing up for work.
Reasons for stress abound in lockdowns and are very present in this current pandemic. Already there is a sharp increase in absenteeism in countries in lockdown. People are afraid to catch COVID-19 in the workplace and avoid work. Many professionals are expecting a second wave of this outbreak will occur in three to six months.
“Just when we need all able bodies to repair the economy, we can expect a sharp spike in absenteeism and burnout.” 2.
In general, we know the at-risk groups for long-term mental health issues will be the healthcare workers who are on the frontline, young people under 30, children, the elderly and those in precarious situations, such as those with existing mental illness, the disability and those living in poverty.
While the insights are not new, the sheer scale of these lockdowns is. This time, ground zero is not a quarantined village or town or region; a third of the global population is dealing with these intense stressors.
There is broad consensus among academics about the psychological care following disasters and major incidents.
Bazelet Health’s commitment: Here are ways Bazelet is working on psychological and social research that may be both adapted for, and integrated with, research efforts in other countries.
- Research self-help interventions that can address the needs of large affected populations with generalized anxiety disorders [GAD] and at-risk populations to help mitigate a secondary epidemic of burnouts and stress-related absenteeism.
- Research and Identify over the counter, non-prescription legal therapeutics to treat GAD, COVID-19 related anxieties.
- Launch of a multi-lingual online Interactive Patient Community (IPC) designed to help drive standards of patient safety and communications.
- Launch our online Learning Management System to provide essential education and learning opportunities for:
- Physicians and HCP’s: accredited and non-accredited online education.
- Patients and quarantined individuals that have developed symptoms of psychological stress: non-accredited online learning opportunities
- Investigating longer-term consequences of COVID-19 for at risk groups including healthcare workers, those with existing mental health conditions, and caregivers.