The prevalence of mental health issues usually increases during times of crises and uncertainty and the current pandemic hasn’t proved otherwise. This article states that a Medline literature search was conducted in late September and this search resulted in over 23,000 articles related to COVID-19 with over 1,400 of the articles that addressed Health Psychology. Research related to stress and psychological distress has dominated the COVID-19 literature. Highlighted below are groups of the population that are most vulnerable to mental health consequences.
Pre-Existing Mental Illness
Even before COVID-19, mental health conditions were highly prevalent, accounting for about nearly 13% of the global burden of disease. Given this, those with pre-existing mental illness may be more vulnerable during times of crises and uncertainty as symptom severity may increase. This systematic review and meta-analysis of 15 studies regarding those with pre-existing mental illness sought to answer two questions:
- Do people with pre-existing mental illness experience an increase in mental health symptoms during a pandemic?
- Do people with pre-existing mental illness experience more hospitalizations during a pandemic?
The results found that those with pre-existing mental illness had significantly higher anxiety and depressive symptoms compared to the control group with pooled effect sizes (SMD) of 0.593 (95% confidence interval (CI) 0.46 to 0.72), 0.616 (95% CI 0.49 to 0.73) and 0.597 (95% CI 0.38 to 0.80) respectively. Voluntary hospitalizations, however, did not increase.
Health Care Workers and Mental Health
Health care workers during COVID-19 are exposed to high levels of stressful and traumatic events which may lead to increased mental health consequences. This study examined the psychological impact of COVID-19 by comparing the mental health effects on health care workers and non-healthcare workers in China. Through logistic regression analyses, the study found that health care workers’ continual worry about occupational exposure and hours spent in PPE had a significant effect (OR: 2.8, 95% CI 1.25 to 6.29; OR: 1.1, 95% CI 1.04 to 1.63) on anxiety and depression respectively. These effects were also correlated with location of the health care workers and regional differences in pandemic severity. Furthermore, this study found that the prevalence of psychological distress was high in health care workers and this was associated with certain risk factors such as young age, female gender, and inability to sleep.
College Students and Mental Health
Prior to the pandemic, mental health problems in college students were prevalent and rising and COVID-19 has only exacerbated this distress. Students’ social connections have been disrupted and they are trying to make the most out of a very unusual academic year. COVID-19 mitigation strategies that are in place by most institutes of higher education include quarantine and isolation and this puts students at an increased risk of experiencing mental health problems. A longitudinal study of Chinese college students examined three measures of psychological distress: acute stress, anxiety, and depression. The sample included 164,101 college students and 68,685 (41.9%) completed a follow-up. The study found that students, particularly seniors, who had COVID-19 worries or had positives cases in their community experienced greater psychological distress in all three areas. Certain risk factors such as decreased physical activity, lack of a social support system and a dysfunctional household exacerbated the mental health problems. An additional study emphasized the importance of psychological well-being of college medical students, stress counseling, and having enough resources available during the pandemic.
Unfortunately, the world has been woefully unprepared to handle the significant mental health consequences resulting from the pandemic. In order to mitigate the mental health impact of COVID-19, substantial unmet needs of societies must be addressed with a focus on the most vulnerable populations.