May is Mental Health Month – and month 6 of a global pandemic

In Wuhan, China, late December 2019 saw many cases of a pneumonia that proved fatal quickly for an alarming number of those who were sick. Chinese researchers soon after identified a new virus that caused the disease. Named initially “2019-nCoV” that indicated that this is a novel (n) corona (Co) virus (V) identified in 2019, the condition came to be known as COVID-19 (corona virus disease).

By now “COVID-19” has penetrated nearly every aspect of life. Escalating numbers of cases, hospitalizations, death, along with media saturation, social distancing, and economic dislocation have affected a wide swath of life and lives in the US and the world.

In addition to the toll on physical health, the pandemic increasingly challenges the mental health of virtually everyone. Persons with pre-existing mental health issues such as depression or anxiety are at particular risk of increased distress. One primary care advocacy non-profit projects that “deaths of despair” resulting from this pandemic could be equal to the number of deaths from COVID-19.[i] A recent commentary in The Lancet Psychiatry drew on experiences from the 2003 SARS outbreak to call on clinical care givers to be aware of psychological trauma visited on clinical staff, people who have COVID-19, their contacts and families as well as the population at large.[ii] Everyone is at risk.

Fear, uncertainty, stigmatization, isolation, unemployment, financial stresses, conflicting data points, and sensational conspiracy theories all sow seeds of mental distress. IH providers can help themselves, their patients and their communities by following suggestions from the WHO[iii], the CDC[iv] and other organizations on how we can communicate with each other and with our patients to moderate the stressful effects that stretch out from the pandemic. Some suggestions:

  • When referring to people with COVID-19, do not attach the disease to any particular ethnicity or nationality.
  • Do not refer to patients as “COVID-19 cases”, “victims” “COVID-19 families” or “the diseased”. These are “people who have COVID-19”, “people who are being treated for COVID-19”, or “people who are recovering from COVID-19”. It is important to separate a person from having an identity defined by COVID-19, in order to reduce stigma.
  • Minimize watching, reading or listening to news about COVID-19 especially if that causes anxiety or distress.
  • Seek information only from trusted sources and mainly so that you can take practical steps to prepare your plans and protect yourself, your patients, and loved ones. Get the facts; not rumors and misinformation. Facts can help to minimize fears. The near-constant stream of news reports about this outbreak can cause anyone to feel worried.
  • Seek information updates at specific times during the day, once or twice only.
  • Protect yourself and be supportive of others in their time of need. This can benefit both the person receiving support and the helper as well. Check by telephone on neighbors and others who may need some extra assistance. Working together as one community can help to create solidarity in addressing COVID-19 together.
  • Find opportunities to amplify positive and hopeful stories and positive images of local people who have experienced COVID-19. For example, stories of people who have recovered or who have supported a loved one and are willing to share their experience.
  • Honor care givers and healthcare workers who are supporting people affected with COVID-19 in your community. Acknowledge the role they play in saving lives and keeping loved ones safe.

Data and guidelines for IH treatment of COVID-19 are beginning to emerge.[v] [vi] [vii] However implementing effective evidence based communication strategies can and should be accomplished immediately.


 

[i] Petterson, S et al. “Projected Deaths of Despair During the Coronavirus Recession,” Well Being Trust. May 8, 2020. WellBeingTrust.org.

[ii] Yu-Tao Xiang, Yuan Yang, Wen Li, Ling Zhang, Qinge Zhang, Teris Cheung, Chee H Ng.  Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed www.thelancet.com/psychiatry Vol 7 March 2020.

[iii] World Health Organization. Mental health and psychosocial considerations during the COVID-19 outbreak. https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf?sfvrsn=6d3578af_10

[iv] Center fro Disease Control and Prevention. COVD-19 Stress and Coping.

https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress anxiety.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fprepare%2Fmanaging-stress-anxiety.html

[v] Society for Acupuncture Research. https://www.acupunctureresearch.org/assets/WFAS-COVID19-2.pdf

[vi] National University of Naturopathic Medicine. https://nunm.edu/?s=covid-19

[vii] Johnson C, et al. Response of Chiropractic Organizations to the COVID-19 Pandemic: A Descriptive Report. JMPT April 20, 2020 (in press). https://www.jmptonline.org/article/S0161-4754(20)30120-2/fulltext