As of April 2022, there have been over 500 million confirmed cases of COVID-19, and over six million deaths due to the virus. The planet has collectively experienced a global pandemic for over two years. When the pandemic was declared in March of 2020, much of the focus was on mitigating the spread of COVID-19 and developing vaccines. Radical lockdowns and disruptions were created to slow the spread of the disease. However, these unprecedented responses have had a detrimental impact on mental health.
The World Health Organization (WHO) defines mental health as “A state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively, and is able to make a contribution to his or her community.” Mental health is fundamental to people as individuals and communities alike. The WHO recently published an approximate 25% increase in major depressive disorder and anxiety disorders worldwide in 2020 due to the COVID-19 pandemic. These numbers are shocking, but not surprising.
The COVID-19 pandemic and subsequent governmental responses including quarantine, social distancing, mask mandates, work from home implementation, online schooling, cancellation/postponement/modification of sports and recreational activities, etc., has disrupted the typical psychological and social development of children and adolescents. In turn, this has increased anxiety, anger, depression, irritability, and sleep disturbances in teenagers. Unfortunately, there are published studies documenting the increase in mental health issues and suicide in the adolescent population. The negative impact of COVID-19 and the new social paradigm has particularly impacted those who already have a high baseline risk of stress due to poverty, food insecurity, detrimental living situations, and medical disparities, among other risk factors. There is also a generalized stigma towards those affected with mental health issues, which is a barrier to seeking psychological and medical help.
One of the adaptations governments made was the switch from in-person activities and services to online activities and services, when appropriate or possible. For example, many schools switched to an online remote format. Medical facilities also ramped up telehealth services when a physical exam was not required. Given the improved access to online services, the use of social media increased during this same time. An Australian study reported 96% of their study population used social media daily, and two-thirds of participants reported an increased use in social media platforms. Social media has a mixed effect, as it may have a negative impact on face-to-face social interactions, the user’s daily activities, and be a place for hostility including cyberbullying and harassment. However, social media may also be a place where young people may seek (and provide) support for mental health issues including suicide.
Healthcare workers and laboratory personnel are uniquely susceptible to adverse mental health issues due to the COVID-19 pandemic. Healthcare facilities and laboratory medicine have been at the epicenter of the pandemic for over two years. New variants of COVID-19 are being discovered and there may be regional outbreaks. These factors may take a toll on the mental health of medical and laboratory employees. Administrators and managers in the medical and testing space may work extended hours, even nights and weekends, to keep up with the demand for patient care and testing. Labs may run 24/7, medical workers may have longer shifts, and work-life balance may be even more challenging than ever before.
The COVID-19 pandemic is a traumatic event, defined as a stressful incident(s) that is outside the normal human experience for almost anyone. The prolonged exposure to the stress may cause post-traumatic stress disorder (PTSD), which may result in anxiety and depression, substance abuse, disrupted relationships, and even self-harm including suicide. Burnout is caused by work-related stress that results in mental exhaustion, personal disconnect from the employee’s surroundings, and the feeling of lack of accomplishment (hopelessness). Burnout may increase employee turnover, medical errors, employee maladaptive coping mechanisms; and may lower productivity, quality of work, and patient care and satisfaction.
Clearly, new models are needed for mental health support, prevention, screening, and care. Social media provides a unique opportunity for assistance to those seeking help for mental health issues. Pediatricians should take special care to assess the mental health of their patients during all appointments, regardless of the indication for the consultation. Frontline workers should engage in self-care and reach out for help with mental health issues before they reach their “breaking point”. Additionally, managers and supervisors should create a work culture that is supportive to employees and reduce the stigmatization of asking for help. The number for the National Suicide Prevention Lifeline is 800-273-8255, and they even have a chat feature on their website. The American Society of Clinical Pathology (ASCP) has multiple resources for COVID-19, including a free course on burnout.
Nobody is really sure when the COVID-19 pandemic will end. New variants are being identified and there are novel surges around the globe, causing different governmental responses. Data is starting to be published regarding the mental health toll COVID-19 has had on the general population, healthcare workers, and laboratory personnel. Mechanisms for mental health services, mental health screening, self-care, and healthy coping processes are extremely important for personal well-being, as well as to successfully combat the pandemic. Individuals need to care for themselves, their family members, and co-workers to mitigate mental health issues. Likewise, community resources, health systems, and workplace culture must adjust to the mental health strain that comes with living in an unprecedented global pandemic.
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WHO Coronavirus (COVID-19) Dashboard. https://covid19.who.int/
WHO Mental health: Strengthening our responses. https://www.who.int/en/news-room/fact-sheets/detail/mental-health-strengthening-our-response
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