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MENTAL HEALTH
CHALLENGES DUE TO
COVID-19 PANDEMIC
INTRODUCTION
• The dramatic outburst of Coronavirus disease (COVID-19) on
the global stage has amazed many people and left us feeling
vulnerable and helpless. It is believed to have originated in a
wet market of Wuhan, China, and then spread to infect the
entire world at an alarmingly fast rate., The first case of
COVID-19 in India, which was reported here on 30 January
2020.
• Presently, India has the most significant number of COVID-19
cases in Asia. As of 12 June 2021, in India 29.3 million testified
cases of COVID-19 contagion which was the second-largest
figure of definite COVID -19 cases in the world (after the
United States), as also the third-highest number of COVID-19
deaths (after the United States and Brazil) at 367,081 deaths.
• For the purpose of protection from the covid crisis, Several
countries have implemented a range of anti-epidemic
measures, like restricting journeys for foreign nationals,
shutting down public spaces, and closing down entire transit
system to contain transmission of highly communicable
infection from human to human in general population.
• These measures were drastically change there living hood, as
for a long stretch of time people were compelled to stay
indoors following repeated stretches of lockdowns during
which people were restricted from any outside visits. No
guidelines were framed and notified to protect people from
psychological trauma, even for the most susceptible individuals
• Researches exploring the mental health consequences of
COVID-19 in other countries also support the view that the
disease has been a psychological hazard. A general population
survey carried out in the UK found that the symptoms of
depression (PHQ9) and anxiety (GAD7) were more pronounced
than those typically attained in population surveys conducted
prior to the COVID-19 pandemic.
• A Chinese study conducted in Yunnan province, reported that
the rates of depression and anxiety between persons affected
and unaffected by quarantine measures, stated that those
quarantined reported significantly higher rates of depression as
well as anxiety.
• The COVID-19 pandemic has been a challenge for the covid-19
positive patients globally regarding their mental health, and the
situation prevailing in India is no different. Unfortunately, there
is a scarcity of data available regarding anxiety, mental health,
and stress levels being faced by covid-19 positive patients in
the country.
Covid 19 and mental health
PSYCHOLOGICAL IMPACT OF COVID-19 ON
HEALTH CARE PROFESSIONALS
• The widespread outbreak of COVID-19 virus has brought not
only the risk of death but also major psychological pressure
• Understandably, there has been much emphasis on the effect of
the pandemic on the health of the population, as well as the
consequences of the potential loss of life from overwhelmed
public health systems.
.
• The effects on frontline medical warriors have also been severe.
Healthcare workers are one of the most vulnerable groups and
the negative psychological effects of working on the frontline
of the pandemic have also been significant
• There are so many factor that adversely influence the mental
health of heath care workers
• Due to the increased risk of exposure to the virus, our frontline
doctors, nurses and healthcare workers fear that they may contract
COVID-19 themselves. • They worry about bringing the virus home
and passing it on to loved ones and family members - elderly
parents, new borns and immuno compromised relatives
• Healthcare staff report increased stress levels when dealing with
patients unwilling to cooperate or not adhering to safety instructions
• Feelings of helplessness when dealing with critically ill patients, in
the context of limited intensive care beds and resources.
• Healthcare staff report increased stress levels when dealing
with patients unwilling to cooperate or not adhering to safety
instructions • Feelings of helplessness when dealing with
critically ill patients, in the context of limited intensive care
beds and resources.
Covid 19 and mental health
• The use of protective equipment for long periods causes
difficulties in breathing and limited access to toilet and water,
resulting in subsequent physical and mental fatigue
• A very recent study among healthcare professionals in a tertiary
infectious disease hospital for COVID-19 in China, revealed a
high incidence of anxiety and stress disorders among frontline
medical staff , with nurses having a higher incidence of anxiety
than doctors.
Covid 19 and mental health
Covid 19 and mental health
• Healthcare workers from 5 major hospitals, involved in the care
for COVID-19 patients, in Singapore and India were invited to
participate in a study by performing a self-administered
questionnaire within the period of February 19 to April 17,
2020. • This questionnaire collected information on
demographics, medical history, symptom prevalence in the past
month, Depression Anxiety Stress Scales (DASS-21) and the
Impact of Events Scale-Revised (IES-R) instrument.
Psychological impact on healthcare professionals
•
• Out of the 906 healthcare workers who participated in the
survey, 48 (5.3%) screened positive for moderate to very-severe
depression, 79 (8.7%) for moderate to extremely-severe anxiety
, and 34 (3.8%) for moderate to severe levels of psychological
distress. • Participants who had experienced symptoms were
more likely to be older, have pre-existing co morbidities and a
positive screen for depression.
TAKING CARE OF MENTAL HEALTH IN
HEALTH CARE WORKERS IN COVID ERA
• Try to maintain regular rest periods
• Watch for sign of mental health impairment
• Encourage communication about your feeling and symptoms
with collogue, friend or relative.
• Seek medical care without stigma and hesitation
TAKE CARE OF BODY
• Maintain healthy diets, hygiene etiquettes, sleep( 6-7 hours at
least) and ensure adequate rest. Do indoor physical exercise or
Yoga for 30- 45 minutes at least
STAY SOCIALLY CONNECTED
• This can be the time to catch up with
• friends and relatives through phone or social media and also
lost or forgotten friends. It can also be good excuse to mend a
broken relationship.
• ▪Don’t hesitate to seek support from friends, relatives and
colleagues
FOLLOW DISTRACTION AND ENGAGEMENT
TECHNIQUES
• If anxiety and worry is more than usual, techniques like
listening to music at pleasant volume, reading, learning new
things at home. Take this as an opportunity to revive your
hobbies and memories.
DO RELAXATION EXERCISE
• Do relaxation exercise such as, pranayama, meditation,
• guided mindfulness relaxation, or
• deep breathing twice a day for 10-15 minutes at least. As
positive mood will improve your immunity and keep you stress
free.
AVOID USING UNHELPFUL COPING
STRATEGIES
• Avoid using unhelpful coping strategies such as tobacco,
alcohol, illicit drugs or self medication
IMPACT ON CHILDREN/ADOLESCENT
• Schools have been suspended nationwide in 188 countries.
Over 90% of enrolled learners (1·5 billion young
people)worldwide are now out of education.
• Children have been reported to be less susceptible to COVID-
19 infection. • Psychological implications- the shutting down
of schools and playgrounds, the restriction of outdoor activities
, parents' fears of contamination have been triggering
manifestations of anxiety, such as panic attacks and
psychosomatic symptoms. Impact on children/adolescent
• School routines are important coping mechanisms for young
people with mental health issues. • When schools are closed,
they lose an anchor in life and their symptoms could relapse.
Some lock themselves up inside their rooms for weeks ,
refusing to take showers, eat, or leave their beds.” (Hong Kong)
Impact on children/adolescent
• In a survey by the mental health charity Young Minds, which included
2111 participants up to age 25 years with a mental illness history in
the UK, 83% said the pandemic had made their conditions worse. •
26% said they were unable to access mental health support. • Peer
support groups and face to-face services have been cancelled , and
support by phone or online can be challenging for some young
people.
• • Children with special education needs- autism spectrum disorder,
are also at risk. • They can become frustrated and short-tempered
when their daily routines are disrupted, social skills groups
suspended. • With speech therapy sessions and social skills groups
suspended children with special needs might miss their chance to
develop essential skills. • Online speech and social skills training, are
needed to make up for the loss.
• Many countries are postponing or cancelling university /board
/entrance exams. • Uncertainties of whether the exams could be
delayed further stressful.
• THE TIMES OF INDIA,APRIL 20 The NGO, All India Council of
Human Rights, Liberties and Social Justice (AICHLS), has
claimed that there were increasing number of domestic
violence and child abuse incidents since the nation was put
under lockdown and sought an urgent intervention by the
court. The April 18 order from Delhi high court, uploaded
Sunday night, came on an NGO's plea seeking measures to
safeguard victims of domestic violence and child abuse amidst
the coronavirus or COVID-19 lockdown.
SUPPORTING YOUR CHILD’S
MENTAL HEALTH THROUGH
COVID-19
• • Keep your kid (and yourself) on a routine
• • Model responses you desire from your child
• • Involve your kids in serving other people
• Promote connectedness with friends, family through
technology
• • Busy is better for many kids
Covid 19 and mental health
IMPACT OF COVID-19 PANDEMIC ON PRE-
EXISTING MENTAL HEALTH PROBLEMS
• Most of the psychiatric disorders have an associating factor of
stress leading to increase in incidence and relapse rates. •
Research is sparse with regards to psychiatric disorders in viral
pandemics. • Most of the studies from this current COVID-19
and previous SARS epidemic in 2003 or corona influenza
epidemic in 2009 have shown anxiety, panic, depression to be
the predominant manifestation.
• COVID-19 pandemic and country-wide lockdown are likely to
increase the new onset of Illness Anxiety Disorder and to cause
exacerbation of symptoms in diagnosed cases. • Any simple flu
like symptom increases anxiety under present circumstances.
• Obsessive Compulsive Disorder patients, especially who have
checking, hoarding and washing compulsion, are at higher risk.
• Advice on improving personal hygiene measures might
increase the contamination obsessions and washing
compulsions.
• For Recurrent Depressive Disorder patients , GAD , chronic
insomnia lockdown is a major stress jeopardizing normal daily
routine, social rhythm →increasing stress levels-→escalate the
Cortisol level-→ vicious exacerbation of depressive symptoms
• Inability to join work, dwindling finances and the long term
impact on economy will have its effect on preexisting common
mental health disorders
• In a person with a previous psychiatric disorder, all these
problems can surface with renewed severity → PTSD or even
suicidal thoughts and attempts. • Anxiety → can precipitate
paranoia and nihilistic delusions
HIGH LEVELS OF EMOTIONAL DISTRESS,
SUBSTANCE ABUSE FROM COVID19
• Patients with bipolar disorder and schizophrenia are likely to
have relapses due to jeopardy in both the availability of regular
medication and medication compliance. • For substance use
disorder patients, this period could be lethal -non- availability
of substance or medicines→ severe withdrawal symptoms and
medical emergencies like delirium or seizures, which can be
life-threatening.
DEALING OF COVID-19 PANDEMIC IMPACT
ON PRE-EXISTING MENTAL HEALTH
PROBLEMS
• Doctors involved in emergency services must be more aware
about psychiatric emergencies so that appropriate and timely
referrals can be done. • There is need to bring in policy
changes which will ensure continuous availability of healthcare
services and essential drugs. • E-dispensing rules should be
relaxed, albeit under close monitoring. • Telemedicine
consultation should be practiced and policymakers should
focus on making doctors more aware and comfortable using
tele- consultation
IMPACT ON ELDERLY MENTAL HEALTH
• 15 percent of the first wave of deaths in China were aged above
60 years. • According to Chinese Centre for Disease Control
and Prevention, the mortality rate in age group 60-69 years is
3.6 percent which can reach up to 18 percent at 80 years and
above
WHAT MAKES THE ELDERLY AT-RISK
POPULATION
• COVID-19 induced pneumonia and risk of death is three times
higher in the older age-group. • The number of lung-lobes
involved, the need for mechanical ventilation, chance of blood-
gas abnormalities was all higher in the elderly . • Non-specific
organ involvement in the elderly. • Older people might have
cognitive and sensory deficits which make it difficult for them
to comprehend and follow precaution.
• Pandemics have significant psycho-social impact in elderly. • Social
distancing, is also a major cause of loneliness, particularly in settings
like nursing-care or old-age homes →independent risk factor for
depression, anxiety disorders and suicide.
• Most seniors are not comfortable with smart phones or the media
language, hence the precautions for a pandemic need to be
explained to them in their own simple terms. • Cognitive
impairment, wandering, irritability and psychotic symptoms can
worsen the panic and make it difficult for them to follow the
precautions of distancing and hand hygiene
TAKING CARE OF OLDER
ADULTS
• Taking care of Older adults, 65 years and older is essential as they
are at higher risk for severe illness. Let them spend less time
watching, listening or reading about corona outbreak, engage in
interactive activities/games with them, make sure they take their
medicines regularly.
• Break their difficult task into small tasks. They can be given easy and
interesting tasks they can work on. e.g. organizing old photos and
together, and enjoy the stories and happy memories they inspire.
SUPPORTING YOUR CHILD’S
MENTAL HEALTH THROUGH
COVID-19
• • Keep your kid (and yourself) on a routine
• • Model responses you desire from your child
• • Involve your kids in serving other people
• Promote connectedness with friends, family through
technology
• • Busy is better for many kids
THANK YOU

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Covid 19 and mental health

  • 1. MENTAL HEALTH CHALLENGES DUE TO COVID-19 PANDEMIC
  • 2. INTRODUCTION • The dramatic outburst of Coronavirus disease (COVID-19) on the global stage has amazed many people and left us feeling vulnerable and helpless. It is believed to have originated in a wet market of Wuhan, China, and then spread to infect the entire world at an alarmingly fast rate., The first case of COVID-19 in India, which was reported here on 30 January 2020.
  • 3. • Presently, India has the most significant number of COVID-19 cases in Asia. As of 12 June 2021, in India 29.3 million testified cases of COVID-19 contagion which was the second-largest figure of definite COVID -19 cases in the world (after the United States), as also the third-highest number of COVID-19 deaths (after the United States and Brazil) at 367,081 deaths.
  • 4. • For the purpose of protection from the covid crisis, Several countries have implemented a range of anti-epidemic measures, like restricting journeys for foreign nationals, shutting down public spaces, and closing down entire transit system to contain transmission of highly communicable infection from human to human in general population.
  • 5. • These measures were drastically change there living hood, as for a long stretch of time people were compelled to stay indoors following repeated stretches of lockdowns during which people were restricted from any outside visits. No guidelines were framed and notified to protect people from psychological trauma, even for the most susceptible individuals
  • 6. • Researches exploring the mental health consequences of COVID-19 in other countries also support the view that the disease has been a psychological hazard. A general population survey carried out in the UK found that the symptoms of depression (PHQ9) and anxiety (GAD7) were more pronounced than those typically attained in population surveys conducted prior to the COVID-19 pandemic.
  • 7. • A Chinese study conducted in Yunnan province, reported that the rates of depression and anxiety between persons affected and unaffected by quarantine measures, stated that those quarantined reported significantly higher rates of depression as well as anxiety.
  • 8. • The COVID-19 pandemic has been a challenge for the covid-19 positive patients globally regarding their mental health, and the situation prevailing in India is no different. Unfortunately, there is a scarcity of data available regarding anxiety, mental health, and stress levels being faced by covid-19 positive patients in the country.
  • 10. PSYCHOLOGICAL IMPACT OF COVID-19 ON HEALTH CARE PROFESSIONALS • The widespread outbreak of COVID-19 virus has brought not only the risk of death but also major psychological pressure • Understandably, there has been much emphasis on the effect of the pandemic on the health of the population, as well as the consequences of the potential loss of life from overwhelmed public health systems. .
  • 11. • The effects on frontline medical warriors have also been severe. Healthcare workers are one of the most vulnerable groups and the negative psychological effects of working on the frontline of the pandemic have also been significant • There are so many factor that adversely influence the mental health of heath care workers
  • 12. • Due to the increased risk of exposure to the virus, our frontline doctors, nurses and healthcare workers fear that they may contract COVID-19 themselves. • They worry about bringing the virus home and passing it on to loved ones and family members - elderly parents, new borns and immuno compromised relatives • Healthcare staff report increased stress levels when dealing with patients unwilling to cooperate or not adhering to safety instructions • Feelings of helplessness when dealing with critically ill patients, in the context of limited intensive care beds and resources.
  • 13. • Healthcare staff report increased stress levels when dealing with patients unwilling to cooperate or not adhering to safety instructions • Feelings of helplessness when dealing with critically ill patients, in the context of limited intensive care beds and resources.
  • 15. • The use of protective equipment for long periods causes difficulties in breathing and limited access to toilet and water, resulting in subsequent physical and mental fatigue • A very recent study among healthcare professionals in a tertiary infectious disease hospital for COVID-19 in China, revealed a high incidence of anxiety and stress disorders among frontline medical staff , with nurses having a higher incidence of anxiety than doctors.
  • 18. • Healthcare workers from 5 major hospitals, involved in the care for COVID-19 patients, in Singapore and India were invited to participate in a study by performing a self-administered questionnaire within the period of February 19 to April 17, 2020. • This questionnaire collected information on demographics, medical history, symptom prevalence in the past month, Depression Anxiety Stress Scales (DASS-21) and the Impact of Events Scale-Revised (IES-R) instrument. Psychological impact on healthcare professionals •
  • 19. • Out of the 906 healthcare workers who participated in the survey, 48 (5.3%) screened positive for moderate to very-severe depression, 79 (8.7%) for moderate to extremely-severe anxiety , and 34 (3.8%) for moderate to severe levels of psychological distress. • Participants who had experienced symptoms were more likely to be older, have pre-existing co morbidities and a positive screen for depression.
  • 20. TAKING CARE OF MENTAL HEALTH IN HEALTH CARE WORKERS IN COVID ERA • Try to maintain regular rest periods • Watch for sign of mental health impairment • Encourage communication about your feeling and symptoms with collogue, friend or relative. • Seek medical care without stigma and hesitation
  • 21. TAKE CARE OF BODY • Maintain healthy diets, hygiene etiquettes, sleep( 6-7 hours at least) and ensure adequate rest. Do indoor physical exercise or Yoga for 30- 45 minutes at least
  • 22. STAY SOCIALLY CONNECTED • This can be the time to catch up with • friends and relatives through phone or social media and also lost or forgotten friends. It can also be good excuse to mend a broken relationship. • ▪Don’t hesitate to seek support from friends, relatives and colleagues
  • 23. FOLLOW DISTRACTION AND ENGAGEMENT TECHNIQUES • If anxiety and worry is more than usual, techniques like listening to music at pleasant volume, reading, learning new things at home. Take this as an opportunity to revive your hobbies and memories.
  • 24. DO RELAXATION EXERCISE • Do relaxation exercise such as, pranayama, meditation, • guided mindfulness relaxation, or • deep breathing twice a day for 10-15 minutes at least. As positive mood will improve your immunity and keep you stress free.
  • 25. AVOID USING UNHELPFUL COPING STRATEGIES • Avoid using unhelpful coping strategies such as tobacco, alcohol, illicit drugs or self medication
  • 26. IMPACT ON CHILDREN/ADOLESCENT • Schools have been suspended nationwide in 188 countries. Over 90% of enrolled learners (1·5 billion young people)worldwide are now out of education. • Children have been reported to be less susceptible to COVID- 19 infection. • Psychological implications- the shutting down of schools and playgrounds, the restriction of outdoor activities , parents' fears of contamination have been triggering manifestations of anxiety, such as panic attacks and psychosomatic symptoms. Impact on children/adolescent
  • 27. • School routines are important coping mechanisms for young people with mental health issues. • When schools are closed, they lose an anchor in life and their symptoms could relapse. Some lock themselves up inside their rooms for weeks , refusing to take showers, eat, or leave their beds.” (Hong Kong) Impact on children/adolescent
  • 28. • In a survey by the mental health charity Young Minds, which included 2111 participants up to age 25 years with a mental illness history in the UK, 83% said the pandemic had made their conditions worse. • 26% said they were unable to access mental health support. • Peer support groups and face to-face services have been cancelled , and support by phone or online can be challenging for some young people.
  • 29. • • Children with special education needs- autism spectrum disorder, are also at risk. • They can become frustrated and short-tempered when their daily routines are disrupted, social skills groups suspended. • With speech therapy sessions and social skills groups suspended children with special needs might miss their chance to develop essential skills. • Online speech and social skills training, are needed to make up for the loss. • Many countries are postponing or cancelling university /board /entrance exams. • Uncertainties of whether the exams could be delayed further stressful.
  • 30. • THE TIMES OF INDIA,APRIL 20 The NGO, All India Council of Human Rights, Liberties and Social Justice (AICHLS), has claimed that there were increasing number of domestic violence and child abuse incidents since the nation was put under lockdown and sought an urgent intervention by the court. The April 18 order from Delhi high court, uploaded Sunday night, came on an NGO's plea seeking measures to safeguard victims of domestic violence and child abuse amidst the coronavirus or COVID-19 lockdown.
  • 31. SUPPORTING YOUR CHILD’S MENTAL HEALTH THROUGH COVID-19 • • Keep your kid (and yourself) on a routine • • Model responses you desire from your child • • Involve your kids in serving other people • Promote connectedness with friends, family through technology • • Busy is better for many kids
  • 33. IMPACT OF COVID-19 PANDEMIC ON PRE- EXISTING MENTAL HEALTH PROBLEMS • Most of the psychiatric disorders have an associating factor of stress leading to increase in incidence and relapse rates. • Research is sparse with regards to psychiatric disorders in viral pandemics. • Most of the studies from this current COVID-19 and previous SARS epidemic in 2003 or corona influenza epidemic in 2009 have shown anxiety, panic, depression to be the predominant manifestation.
  • 34. • COVID-19 pandemic and country-wide lockdown are likely to increase the new onset of Illness Anxiety Disorder and to cause exacerbation of symptoms in diagnosed cases. • Any simple flu like symptom increases anxiety under present circumstances. • Obsessive Compulsive Disorder patients, especially who have checking, hoarding and washing compulsion, are at higher risk. • Advice on improving personal hygiene measures might increase the contamination obsessions and washing compulsions.
  • 35. • For Recurrent Depressive Disorder patients , GAD , chronic insomnia lockdown is a major stress jeopardizing normal daily routine, social rhythm →increasing stress levels-→escalate the Cortisol level-→ vicious exacerbation of depressive symptoms • Inability to join work, dwindling finances and the long term impact on economy will have its effect on preexisting common mental health disorders
  • 36. • In a person with a previous psychiatric disorder, all these problems can surface with renewed severity → PTSD or even suicidal thoughts and attempts. • Anxiety → can precipitate paranoia and nihilistic delusions
  • 37. HIGH LEVELS OF EMOTIONAL DISTRESS, SUBSTANCE ABUSE FROM COVID19
  • 38. • Patients with bipolar disorder and schizophrenia are likely to have relapses due to jeopardy in both the availability of regular medication and medication compliance. • For substance use disorder patients, this period could be lethal -non- availability of substance or medicines→ severe withdrawal symptoms and medical emergencies like delirium or seizures, which can be life-threatening.
  • 39. DEALING OF COVID-19 PANDEMIC IMPACT ON PRE-EXISTING MENTAL HEALTH PROBLEMS • Doctors involved in emergency services must be more aware about psychiatric emergencies so that appropriate and timely referrals can be done. • There is need to bring in policy changes which will ensure continuous availability of healthcare services and essential drugs. • E-dispensing rules should be relaxed, albeit under close monitoring. • Telemedicine consultation should be practiced and policymakers should focus on making doctors more aware and comfortable using tele- consultation
  • 40. IMPACT ON ELDERLY MENTAL HEALTH • 15 percent of the first wave of deaths in China were aged above 60 years. • According to Chinese Centre for Disease Control and Prevention, the mortality rate in age group 60-69 years is 3.6 percent which can reach up to 18 percent at 80 years and above
  • 41. WHAT MAKES THE ELDERLY AT-RISK POPULATION • COVID-19 induced pneumonia and risk of death is three times higher in the older age-group. • The number of lung-lobes involved, the need for mechanical ventilation, chance of blood- gas abnormalities was all higher in the elderly . • Non-specific organ involvement in the elderly. • Older people might have cognitive and sensory deficits which make it difficult for them to comprehend and follow precaution.
  • 42. • Pandemics have significant psycho-social impact in elderly. • Social distancing, is also a major cause of loneliness, particularly in settings like nursing-care or old-age homes →independent risk factor for depression, anxiety disorders and suicide. • Most seniors are not comfortable with smart phones or the media language, hence the precautions for a pandemic need to be explained to them in their own simple terms. • Cognitive impairment, wandering, irritability and psychotic symptoms can worsen the panic and make it difficult for them to follow the precautions of distancing and hand hygiene
  • 43. TAKING CARE OF OLDER ADULTS • Taking care of Older adults, 65 years and older is essential as they are at higher risk for severe illness. Let them spend less time watching, listening or reading about corona outbreak, engage in interactive activities/games with them, make sure they take their medicines regularly. • Break their difficult task into small tasks. They can be given easy and interesting tasks they can work on. e.g. organizing old photos and together, and enjoy the stories and happy memories they inspire.
  • 44. SUPPORTING YOUR CHILD’S MENTAL HEALTH THROUGH COVID-19 • • Keep your kid (and yourself) on a routine • • Model responses you desire from your child • • Involve your kids in serving other people • Promote connectedness with friends, family through technology • • Busy is better for many kids