The COVID-19 pandemic has necessitated the introduction of extreme measures that have served as attempts to restrict the spread of SARS-CoV-2 across the globe. These measures, such as national lockdowns, have dramatically altered people’s everyday lives: limiting social contact, affecting their ability to work and earn a living and reducing their ability to access services.
Indeed, studies have indicated a particular impact on employment, income, and significant personal debt accrual (Eberhardt et al., 2020). Whilst a substantial body of research has elucidated the physical health consequences of SARS-CoV-2, it would also be prudent to consider the potential mental health sequelae of the pandemic as a whole. Therefore, the following article will explore the pandemic’s impact on mental health.
Beginning with the first documented case in early December 2019, SARS-CoV-2 spread rapidly and became ubiquitous throughout many countries (Roberts, Rossman and Jarić, 2021). Many governments, advised by experts, implemented extreme mitigatory measures to protect public health to curb the spread of this novel, virulent pathogen. It was perhaps an inevitability that the introduction of strict quarantine measures and national lockdowns, along with the fear and uncertainty associated with a rapidly emerging health crisis, would have a profoundly detrimental effect on mental health. Now that the pandemic is well into its second year, scientists have gathered a colossal amount of data that shines a light on how this extraordinary situation has influenced people’s mental health.
Many cross-sectional online surveys regarding mental health and the COVID-19 pandemic have shown that many people report increased feelings of anxiety and depression (Psychiatry, 2021). More reliable and robust data has come through longitudinal studies, some of which have used pre-COVID data for comparison, which have shown that the pandemic has led to increases in feelings of mental distress among particular population demographics. For example, in the United Kingdom, Pierce and colleagues (2021) reported that reports of mental distress had increased, after adjusting for previous trends, in younger people aged 18-34 years, women, people living with young children and those who had a pre-existing psychiatric illness.
Researchers feared that the COVID-19 pandemic may lead to a rise in the suicide rate. The pressures of the pandemic and the consequences of lockdowns have meant that many people have been unable to support themselves financially. Many individuals and families have either lost or witnessed a dramatic drop in income.
Exposure to constant news coverage of the health crisis and barriers to community support and mental health treatment were also thought to be pertinent factors associated with suicide at the height of the outbreak (Reger, Stanley and Joiner, 2020). Fortunately, in high-income countries, the suicide rate does not seem to have increased (Psychiatry, 2021). Despite many newspapers reporting suicides in middle and low-income nations, no verifiable scientific data has been published.
Concerning self-harm, little data is available on whether the rate has increased due to the effects of the pandemic, at least in The United Kingdom, and the results from these data were in line with international trends in suicidal behaviour (John et al., 2020). Nevertheless, it is important to recognise some important caveats when considering rates of suicide and self-harm within the context of the COVID-19 pandemic. Firstly, this global health crisis is a rapidly evolving, fluid situation, so we may not yet have a clear picture of its complete and total effects on people’s wellbeing. Secondly, data on this topic are incredibly sparse and not static (Carr et al., 2021)
To prevent or curb the negative mental health consequences of the pandemic, people must have proper access to health and care services. It is thought that the pandemic has been responsible for an increase in reports of depression, anxiety, post-traumatic stress and cognitive deficits, even in individuals who have no history of mental illness (Byrne, Barber and Lim, 2021).
At the height of the outbreak, when quarantine restrictions were in place across many nations, providing adequate access to treatment services would have clearly posed a considerable challenge. Indeed, a study by Topriceanu and colleagues (2021) that evaluated access to healthcare services during the pandemic showed that health inequalities that existed before the crisis were further deepened during periods of lockdown.
The impact was predominantly felt by women, ethnic minorities and patients suffering from chronic illnesses. Furthermore, as a result of hospitals not operating as they would under normal circumstances, many patients have had operations cancelled and cancer treatments delayed, which has subsequently led to worse survival and quality of life outcomes for these patient populations (Kumar and Dey, 2020).
At this point in time, as the world is learning to live with COVID-19, access to key services for those with mental illness has improved. Clinics and counselling services and hospitals and doctors’ surgeries have allowed for more face-to-face appointments, and regular service has almost been resumed. Nevertheless, we must realise that the pandemic is far from being over, and the situation is liable to change from one period to the next. To avoid the deficits in care experienced during the beginning stages of the pandemic, economic efforts should be upscaled to deliver effective mental health care provided by a more robust and reliable service.
References
Byrne, A., Barber, R. and Lim, C.H. (2021). Impact of the COVID ‐19 pandemic – a mental health service perspective. Progress in Neurology and Psychiatry, 25(2), p.27. doi:10.1002/pnp.708.
Carr, M.J., Steeg, S., Webb, R.T., Kapur, N., Chew-Graham, C.A., Abel, K.M., Hope, H., Pierce, M. and Ashcroft, D.M. (2021). Effects of the COVID-19 pandemic on primary care-recorded mental illness and self-harm episodes in the UK: a population-based cohort study. The Lancet Public Health, [online] 6(2), pp.e124–e135. doi:10.1016/S2468-2667(20)30288-7.
Eberhardt, P., Flanagan, S., Scott, C., Wial, H. and Yee, D. (2020). Not the Great Equalizer: Which Neighborhoods are Most Economically Vulnerable to the Coronavirus Crisis? SSRN Electronic Journal. doi:10.2139/ssrn.3796465.
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John, A., Pirkis, J., Gunnell, D., Appleby, L. and Morrissey, J. (2020). Trends in suicide during the covid-19 pandemic. BMJ, 371(371), p.m4352. doi:10.1136/bmj.m4352.
Kumar, A. and Nayar, K.R. (2020). COVID 19 and its mental health consequences. Journal of Mental Health, [online] 30(1), pp.1–2. Doi:10.1080/09638237.2020.1757052.
Kumar, D. and Dey, T. (2020). Treatment delays in oncology patients during COVID-19 pandemic: A perspective. Journal of Global Health, 10(1). doi:10.7189/jogh.10.010367.
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Roberts, D.L., Rossman, J.S. and Jarić, I. (2021). Dating first cases of COVID-19. PLOS Pathogens, [online] 17(6), p.e1009620. doi:10.1371/journal.ppat.1009620.
Topriceanu, C.-C., Wong, A., Moon, J.C., Hughes, A.D., Bann, D., Chaturvedi, N., Patalay, P., Conti, G. and Captur, G. (2021). Evaluating access to health and care services during lockdown by the COVID-19 survey in five UK national longitudinal studies. BMJ Open, [online] 11(3). doi:10.1136/bmjopen-2020-045813.
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