June 2020 | Meitheamh 2020

Special Journal Edition dedicated to the Mental Health Impact of COVID-19

Mon, 8 June 20 08:00

 

The College of Psychiatrists of Ireland have launched a special edition of its official scientific journal, Irish Journal of Psychological Medicine (IJPM), collating over 40 articles documenting the impact of COVID-19 on mental health in society and the delivery of mental health services since the pandemic took hold. This special edition has been edited by Professor Fiona McNicholas, UCD Full Professor of Child & Adolescent Psychiatry and Associate Professor Blánaid Gavin, UCD Associate Clinical Professor.  Covering perspectives from several countries across multiple disciplines and healthcare settings this unique edition has open access and is freely available to all.

Key areas covered include the mental health impact of COVID-19 on frontline healthcare and other workers, the extent of existing and new mental illness morbidity, and the mental health consequences of unemployment, lockdown and other COVID-19 restrictions. The journal covers the swift innovative response by services, including widespread adaptation of tele-psychiatry, what we have learnt from previous pandemics and the necessity to adequately plan for post pandemic mental health provision. Individual international personal perspective pieces are included from front line workers around the globe.

“As key experienced professionals and leaders in psychiatry and service provision for mental illness, this special edition with its richness of expertise, perspectives, and practical innovations, should be very useful to our policy and healthcare leaders as well as health professionals”

notes College President, Dr William Flannery.

“The wealth of invaluable and varied experiences, reflections and observations in one edition will serve many in Ireland from allied health professionals to policy makers, educators, government and the general public”

The mental health impact of this pandemic is as yet unknown, but the World Health Organisation has urged countries to prepare for the psychological and mental illness consequences which are expected to be substantial and long term. The College believe that this edition will be informative for developing and resourcing services and technologies as the mental health consequences of the pandemic become clearer.

IJPM editor, Dr John Lyne explains,

“The special issue brings a unique perspective to our understanding of how COVID-19 is impacting not only mental health services but also many other elements of our society.  There has been an overwhelming response from many mental health providers to contribute to this special edition with the desire for rapid innovation and service development clearly evident throughout.”

Commenting further he said,

“The potential to improve population mental health in the months and years ahead by adequately resourcing mental health service reform cannot be understated. It is essential that policymakers and healthcare leaders work collaboratively with frontline medical professionals along with patients and their families.”

Prof Fiona McNicholas guest editor highlights the disproportionate impact of COVID-19 on front line health care workers (HCW), currently representing 1/3 of all confirmed cases.

“Work-related stress disproportionally affects HCW linked to excessive workloads, working in emotionally charged environments and where demand outweighs capacity. COVID-19 represents a perfect storm where all of these factors coalesce, with the added surety that HCW are at risk of infection and transmission to others, not helped by an experience (at least initially) of reduced access to adequate PPE.’

Lessons from SARS highlight the risks to psychological wellbeing associated with social distancing, by virtue of infection control, quarantine, and deployment to new teams and having a family, both of which were more likely to lead to adverse outcomes.

Prof McNicholas acknowledges that

“Healthcare Workers experience a conflict between their duty of care to their patients and colleagues, and their role as parents or carers”.  By nature, Healthcare Workers cope by assuming more personal responsivity, prioritize work over other replenishing activities, and are less likely to seek supports.

Prof McNicholas added that 

‘”to ensure optimum service provision we must avoid a ‘second hit‘ to the health service brought about by HCW sick leave, and ensure that we prioritize their mental health wellbeing and offer robust and accessible mental health supports.’

Non clinical front line workers such as an Gardaí Siochana are also at increased risk and have played a consistently high profile role in this crisis. There is urgent need to develop an understanding of how we can assist front-line workers such as police and healthcare staff, and their families, who are potentially very vulnerable to mental health effects of COVID-19.

The College, and other stakeholders in Ireland have consistently called for not just the review of A Vision for Change to be published but sufficient budgets to be put in place which must now urgently take into account post Covid demands and requirements for mental health secondary and tertiary services and community supports. 

Dr Blánaid Gavin, guest editor, highlights the principle of reciprocity, the necessity of research and the targeting of much needed resources:

“The ethical principle of reciprocity holds that if a society demands that individuals withdraw their liberties for the common good, then individuals must be provided with adequate psychological support to discharge that obligation. Policymakers therefore must strongly support a coordinated national research programme to help us understand the psychological impact that the lockdown has had on vulnerable groups especially those with pre-existing psychiatric illness. Children and teenagers who fall within this cohort are especially vulnerable to the impact of prolonged lack of access to supports, school and social outlets.”

Dr Gavin added that:

“Given that we know from previous crises that most of the population will be resilient and emerge without long-term psychological consequences, it is imperative that resources are appropriately directed to those most likely to experience psychiatric morbidity arising from the pandemic. Much has been discussed and written in recent months about the need to ensure mental wellbeing during this crisis. The question is whether we as a society will respond to the mental illness consequences of this pandemic with parity of resources as for the other medical consequences. This is the true litmus test as to how we as a society view mental illness.

Online Special Edition link here.  A print version is planned for September.