How Can COVID-19 Response Include Mental Health Considerations?

Pandemic preparedness and response plans should integrate public mental health interventions.

A public mental health crisis emerged as coronavirus disease 2019 (COVID-19) outbreak began to spread in Wuhan, China, underscoring the need for mental health interventions to be integrated into pandemic preparedness and response plans.

Published in Emerging Infectious Diseases by the US Centers for Disease Control and Prevention, a new research letter examines emergency psychological crisis interventions implemented in China and the challenges to such efforts.

The letter was authored by Lu Dong, PhD, an associate behavioral scientist and licensed clinical psychologist at RAND Corp., and Jennifer Bouey, PhD, a senior policy researcher and the Tang Chair in China Policy Studies at RAND Corp.

“Given lessons learned from past outbreaks in China and other parts of the world, public mental health interventions should be formally integrated into public health preparedness and emergency response plans to effectively curb all outbreaks,” the authors wrote, noting that the World Health Organization hasn’t addressed mental health in its pandemic plans.

Contributing to the mental health crisis in China were fears based on the 2003 outbreak of severe acute respiratory syndrome, the relatively high rates of transmissibility and mortality of the SARS-CoV-2 virus, uncertainty about asymptomatic transmission, lack of public trust in government after initial downplaying of the disease, the isolation caused by large-scale quarantine measures, shortages of medical supplies, and an overabundance of information and misinformation on social media.

The National Health Commission of China provided guiding principles for emergency psychological crisis interventions on January 26th, with differentiated efforts targeting confirmed patients, persons under investigation for COVID-19, health care workers, persons in immediate contact with patients, ill persons who refuse to seek care, and the general public.

The National Health Commission guidance lacked information on directing the mobilization of specific resources, who should deliver specific interventions to specific groups, and how they should be delivered. A shortage of mental health workers also hindered efforts.

The letter recommended telemedicine, shifting some tasks to other workers, and seeking collaborations with international mental health officials.

“As the virus spreads globally, governments must address public mental health needs by developing and implementing well-coordinated strategic plans to meet these needs during the COVID-19 pandemic,” the authors wrote.

One of the groups targeted for mental health interventions in China is mental health workers, as they face greater exposure, extreme workloads, moral dilemmas, and other challenges throughout the pandemic. A recent viewpoint focused on the need to understand health care workers’ sources of anxiety and fear.

Another viewpoint addressed the need for health care organizations to protect workers during the pandemic from the overwhelming burden of illness stressing capacities along with risk of infection and other adverse effects on health care workers. It highlighted measures such as providing adequate personal protective equipment and providing adequate time off to care for loved ones.