Consequences of Social Mitigation Strategies

BRIEF COMMUNICATION

Researchers found a significant drop in life expectancy from depression, alcohol dependence, suicidality, increased divorce rates, and childhood trauma that are a direct result of social distancing. A study published in European Psychiatry found 2.1% of the Swiss population will suffer from psychosocial stressors that arise from efforts to mitigate the spread of COVID-19. On average, their life expectancy will drop 9.79 years, say study authors Daniel S. Schechter, MD, and Dominik A. Moser, PhD, who discuss their study in this video.

Lead author, Dr Dominik Moser, observed, “On a population level, deteriorating psychosocial well-being and mental health tends to eventually manifest in reduced physical health and shortened life expectancy. Seeing the potential damage of COVID-19 confinement may be necessary to halt the spread of the virus.” However, the findings suggest COVID-19-related social distancing and confinement will take an enormous toll on mental health.

Dr Moser continues, “It is therefore crucial that governments invest heavily in mental health and front-line rather than side-line mental health workers, both during and following mass confinement. One could also interpret the study such that in confinement situations, there is an at-risk population that is particularly likely to suffer long-term health consequences from the psychosocial stress associated with confinement and isolation, similarly to how there is an at-risk group particularly likely to suffer from contracting the virus itself.”

Senior author, Dr. Daniel Schechter added, “This is the first study to focus on mental health implications of mitigation measures to fight the spread of COVID-19 using national public health data. Our study supports the importance of attention to mental health prevention and preventive intervention as an essential added dimension to public health policy from the outset.”

Dr Schechter stresses the importance of recognizing symptoms and signs, history and risk factors that would suggest that an individual is particularly vulnerable to the stress of quarantining, isolation, and social distancing. He points out that this is only one form of stress associated with the pandemic; the other is the stress resulting from fear of infection of self and loved ones, as well as illness and death directly related to COV-19. A third form of stress is linked to unemployment and financial instability as a result of the pandemic.

These tensions together necessitate recognition of and benefit from stress reduction, using techniques such as mindfulness/meditation or yoga, physical activity, and virtual group discussion, and creative outlets such as writing, music, blogging, and visual arts. Yet they also may necessitate or trigger the desire for mental health intervention.

Seeking help

For those who have never had contact with a mental health provider, finding one during confinement can be challenging. There are many resources online including from professional mental health associations such as the American Psychiatric Association, American Psychological Association, and the American Academy of Child & Adolescent Psychiatry. They can also contact community agencies that support individuals exposed to family violence, who feel otherwise unsafe as to what they themselves might do, and who have drug and alcohol abuse.

Internal and family medicine practitioners can often recommend an initial assessment. In the case of extreme distress, dysfunction, or sense of danger, hospital emergency services can be called or visited, without fear of increasing the risk for contracting COVID-19 if one takes appropriate precautions.

Staying well

For those who have had contact and ongoing care with a mental health provider, an essential question is how to maintain continuity or to reconnect to mental health help. Does your provider offer telehealth options for assessment and care?

Are you set up with all you need to make use of those options if available? Installing Zoom, WhatsApp, Whereby or Webex is very straightforward and you can find many aides online to setting up these tools. Once you have, you will find support groups, psychoeducation options, as well as consultation and treatment in many instances.

Concluding thoughts

Finally, Dr Schechter spoke about the challenges for families that may be living together in the context of all the stresses mentioned and who can be at increased risk for verbal, psychological, physical, and sexual violence and maltreatment. At-risk and affected individuals should not have to wait to get help until after the pandemic passes, even if they are afraid of reaching out for help because of a lack of privacy in their home. Many agencies provide discrete contact, encrypted confidential messaging, support and emergency services in instances of domestic violence and child maltreatment.

Just as it is important to diminish risk by acknowledging the problem and reaching out for help, it is also important to bolster resilience and maintain social support network virtually, by phone, or by social media. Let your children know if you are not your best because of stress and reassure them that together you will get better. Identify and mobilize your individual and collective family strengths. Pay attention to your mental health and your physical health. In so doing, your immunity, energy and stamina will increase. Mental and physical health work hand in hand. Each benefits the other! Keep routines, sleep hygiene, limit exposure to disturbing news, and model these health measures for your children and loved ones. Be safe and stay well!

Dr Schechter is Senior Attending, University Service of Child & Adolescent Psychiatry, Lausanne University Hospital, Switzerland, and Adjunct Associate Professor of Child & Adolescent Psychiatry, NYU Grossman School of Medicine. Dr Moser is Research Associate, University Service of Child & Adolescent Psychiatry, Lausanne University Hospital, and Institute of Psychology, University of Bern, Switzerland.

Reference

1. Moser DA, Glaus J. Frangou S, Schechter DS. Years of Life Lost Due to the Psychosocial Consequences of COVID-19 Mitigation Strategies Based on Swiss Data. Eur Psychiatry. 2020;63(1):e58.