THE MENTAL HEALTH TOLL OF COVID-19
Number of the elderly seeking help on rise after cocooning
REPORTS of panic attacks, eating disorders and psychotic episodes are on the rise as people emerge from lockdown.
A new survey of consultant psychiatrists, carried out by the College of Psychiatrists of Ireland, shows that the lockdown has seen an increase in referrals for a range of mental illnesses.
They include anxiety, depression, panic attacks, self-harm, suicidal ideation and eating disorders.
It also found depressed older people are presenting to mental health services for the first time ever following serious self-harm after months of isolation.
The majority of the 200 consultants surveyed, 72%, reported an increase in the number of new referrals to secondary mental health services in the past month compared to the first month of lockdown. Two thirds, 64%, say they saw an increase in the number of patients experiencing a relapse of mental illness compared to the first month of lockdown.
As expected, 68% of respondents saw an initial lull in referrals to mental health services immediately after the lockdown began, with a subsequent increase in the second month of lockdown.
A significant majority, 81%, felt that social isolation was contributing to a relapse in mental illness or new onset of depressive episodes.
One respondent said: ‘I believe we are now seeing the “aftermath” of the initial Covid response.
‘People are feeling depressed and anxious and some [are] developing psychotic symptoms as a result of stressors associated with the Covid-19 pandemic.’
A predicted surge in mental illness looks increasingly likely as the survey found the lockdown has led to an increase in anxiety and depression. It also reported an increase in ‘self harm with depression’.
The majority of consultants identified an increase in the number of referrals for generalised anxiety, 79%, new onset depression, 57%, and relapse of depression, 49%, compared to the first month of the lockdown.
They also noted an increase in the number of referrals for panic attacks, 54%, and for psychotic depression, 35%, compared to March. The results of the survey show that the lockdown has ‘particularly impacted’ older people, many of whom have been cocooning since March.
The survey noted: ‘Older people [have been] particularly impacted and some first presentations of depressed older people presenting following serious self-harm’ [were noted]. Three quarters, 78%, of consultants believed the lockdown was leading to patients experiencing thoughts of self-harm and suicidal ideation.
An increase in the number of cases of self-harm or attempted suicide compared to before the lockdown was noted by almost half of consultants, 46%.
A number of consultants, 14%, felt more lethal methods were being used in acts of self-harm.
Multiple factors of the lockdown were believed to be contributing to emergency mental health presentations.
These were primarily believed to be due to increased isolation, 81%, and reduced access to face-to-face mental health support, 79%, including counselling, 68%.
Other factors attributed the decline in mental health to abuse and neglect at home, 38%, and almost half, 47%, pointed to an increased reliance on drugs or alcohol during the lockdown.
The survey also noted the ‘striking’ effect that the virus itself was having on patients’ mental health. It reported an increase in ‘obsessional ideas either about handwashing or being a vector for Covid’.
Compared to the first month of the lockdown, 72% of consultants identified an increase in health anxiety and 81% had experienced a patient who incorporated Covid-19 into health anxiety.
Almost half, 49%, of consultants had a patient incorporate Covid-19 into a delusional belief system, and 18% had seen a Covid-19 related neuropsychiatric presentation such as delirium or encephalopathy. Lockdown seems to have triggered an increase in referrals across a range of other mental health disorders as well.
Consultants identified an increase in referrals for eating disorders, 21%, new onset psychotic disorders, 23%, and relapse of psychotic disorders, 40%, compared to the first month of the lockdown.
Over half, 59%, of survey respondents felt the demand for inpatient beds had increased in the past month compared to the first month of the lockdown.
There was also an increase of 23% in the number of healthcare workers referred to mental health services showing the potential stressful impact of working through a pandemic.
Many professionals believe this is just the first wave of the mental health crisis, with 73% of consultant psychiatrists saying they felt their workload would further increase in the coming months.
This comes as a new national mental health policy, Sharing the Vision, was published yesterday by the Department of Health as a roadmap for the provision of mental health services in Ireland over the next ten years.
The new policy focuses on mental health promotion, recovery, the prevention of mental ill health and early intervention, service access, coordination and continuity of care, social inclusion, accountability and continuous improvement.
Mental Health Ireland says it is ‘refreshing’ that the new policy is focused on the individual experiencing mental health challenges and their needs rather than service models.
Martin Rogan CEO said: ‘Having properly funded mental health services which can respond in a timely and empathetic manner is a vital element, but is just one component of achieving better mental health for every member of our community.
‘We welcome the positive and inclusive tone, the core principles and the practical sense of urgency struck in this new mental health policy,’ he said.
‘People feel depressed’
Obsessive ideas on handwashing