The extended research-based suggested solutions for governments, local authorities, EU:
- make sure self-help interventions are in place that can address the needs of large affected populations;
- provide and promote a unique website with a quick tool (perhaps simple tests) to identify the scalable solutions that may work for each visitor. Make sure the tool can easily redirect people to different types of psychotherapy (online or offline). Offer a human resources database, psychotherapy centers and specialists grouped on a map or available online. Make sure there is an easy telephone option for some people (for instance elderly people);
- make sure digital interventions are widely accessible, sometimes looking beyond digital interventions (for the people that still have no access to them), and ascertain what other mechanistically based psychological interventions are effective and for whom is important;
- promote all the solutions suggested here. One of the ways could be by payed promotion on tv, youtube, online news sites, or any place where we may find the people that may need the solutions offered – according to data and specialists experience. Cooperation may be key here; Perhaps promotion should be done in cooperation with psychologists and advertising professionals so we make sure we reach different groups of people at risks;
- make sure there are psychologists involved in mass communication and authority decisions during the crisis, in order for decisions to be properly perceived by the people and not induce psychological distress;
- offer and promote a state-paid psychotherapy and/or emotional intelligence package and therefore free for all people in need;
- provide psychological counseling services for public health workers, decision makers, all people involved in managing the crisis, people that may experience more stress than usual. Establish a contingency plan and strategies for dealing with more serious psychiatric symptoms in any institution involved in managing the crisis. In some institutions training may be needed in fields like stress management, trauma, depression and risk behavior protocols;
- provide and promote a unique site with tools and resources for children and harmonious child-parent relationships;
- run smart campaigns aimed to inform people of the importance of managing one’s emotions and stress, simple evidence-based methods of improving emotional intelligence and it’s benefits for self and loved ones, expert advice like why and how to avoid excessively news exposure, excessive drinking, provide evidence-based ways to deal with attempts of exposure to conspiracy theories and ways to help the people already exposed to feel accepted, etc;
- make sure we do all we can to help people understand that a psychological reaction is normal; Provide the tools to help educate people about the expected psychological impact and reactions to toxic stress or trauma, and do it in ways that are appealing and easy to understand by most of the people at risk. Provide psycho-education, education about available solutions for anxiety, depression, OCD and other mental health issues .
- monitor and report rates of anxiety, depression, self-harm, suicide and other mental health issues both to understand mechanisms and crucially to inform interventions;
- apply evidence-based actions that can help reduce the stress for the general population or categories of affected people. For example: emphasize the altruistic choice of self-isolating;
- create and promote simple to implement, evidence-based programs to help companies and employees and educate them on the huge benefits of improved mental health and stress management abilities for them and the loved ones or colleagues;
- ensure adequate resources and infrastructure for mental health services. Offer training and simple technological solutions for mental health professionals. Offer help in organizing support groups or other scalable interventions (when applicable);
- consider and respect cultural factors in the implementation of public policies;
- continuously encourage scientific research also in the field of mental health;
- monitor and rebut fake news – with a widely accessible emphasis on the scientific reasons why we need to avoid them;
Other suggested solutions:
| Government actions: | |
| – Encourage the participation of multidisciplinary mental health teams at national, state and municipal levels | – Provide official channels for updated information to the public |
| – Training in stress management, trauma, depression and risk behavior protocols | – Provide alternative service channels (apps, websites, telephone); |
| – Standardize psychotropic medications and make them available | – Monitor and rebut fake news |
| – Ensure adequate resources and infrastructure for mental health services | – Continuously encourage scientific research |
| – Ensure that clinical and mental health care are accessible to the population | – Consider and respect cultural factors in the implementation of public policies |
| – Develop psychoeducational materials that are easily accessible to the population | – Collect epidemiological data that can support future prevention and mental health care policies |
| Individual recommendations: | |
| – Take care of yourself and others, keeping in touch with friends and family and finding time for leisure activities | – Limit exposure to pandemic-related news, since too much information can trigger anxiety disorders |
| – Follow WHO and government health agency recommendations | – Tell someone when you experience symptoms of sadness or anxiety |
| – Pay attention to your own needs, feelings and thoughts | – Assist, as much as possible, people in risk groups |
| – Limit physical contact with other people while avoiding emotional distance | – Share contamination prevention information and instructions |
| – Monitor dysphoric mental states such as irritability and aggression | – Understand that stress and fear are normal in unknown situations |
| – Develop a feeling of belonging to the collective care process | – Avoid confusing the solitude of preventive confinement with abandonment, rejection or helplessness |
| – Consider the collective impact of your actions | – Establish a support network (even if it is a virtual one) |
| – Consider the impact of social actions on stopping or decelerating the disease | – Do not discriminate or blame groups or individuals for the contamination process |
| – Do not disseminate information from unofficial sources | – Maintain adequate sleep, nutrition and exercise patterns |
| – Practice meditation (mindfulness) | |
| – Maintain normal use of prescription medications | – Use positive psychiatry/psychology techniques |
| Care for special groups: | |
| Children: Maintain family and leisure activities (games). Explain the phenomenon in clear and accessible language; try to maintain the routine (insofar as possible), be available to answer any questions and understand that in such times children may be more irritable, sensitive, attention-demanding and regressive (e.g. bedwetting). It is important not to blame them for these behaviors: use a kind and reassuring approach. Teach them to express disturbing feelings, such as fear, in a positive way. Control the amount of information they are exposed to so that they do not become even more frightened. In case of quarantine, be creative, inventing games (especially involving physical activity) to avoid tedium. | At-risk populations requiring quarantine (the immunodepressed, older adults, etc.) and psychiatric patients: Help protect these populations from contact with the pathogen, especially the most vulnerable; pay special attention to them through phone/video calls and social networks. Be available to help with tasks that must be carried out in places of risk (e.g., shopping at the supermarket). Maintain greater vigilance regarding symptoms and guarantee every possible comfort when they are in isolation. Help them adhere to clinical and psychiatric medication regimens and provide emotional support. |
| Hospitals and health care referral centers: | |
| – Establish a contingency plan and strategies for dealing with more serious psychiatric symptoms | |
| – Establish a relationship of transparency and trust with employees that prioritizes equity and well-being | |
| – Ensure adequate training for teams and provide support or supervision, which can be done in group settings | |
| – Provide quality clinical and psychological assistance for teams exposed to risk situations | |
| – Maintain an empathetic and flexible posture when facing the fears, stress and changes in routine common to such situations | |
| – Ensure mental health care for the family members of people who may be affected by the pathogen | |
| – Inform everyone that feelings such as fear, anxiety and sadness are normal at times like this and guide those who are seeking help whenever necessary | |
| – Ensure a healthy climate of communication and collaboration between professionals and teams, in addition to providing expert intervention in interpersonal problems that may arise | |
| – Constantly value the work of those who are exposing themselves to risk for the social good | |
Source: https://www.scielo.br/scielo.php?pid=S1516-44462020005008201&script=sci_arttext
“What we’re looking at right now is scaling up programs that can be done online and on the phone,” she said of the immediate need, noting one such program managed by the association, called BounceBack, provides online support for adults and youth over 15 to deal with mild to moderate depression, anxiety and stress. She said it has recently received more funding in British Columbia and Manitoba.
A major adverse consequence of the COVID-19 pandemic is likely to be increased social isolation and loneliness (as reflected in our surveys),4 which are strongly associated with anxiety, depression, self-harm, and suicide attempts across the lifespan.24, 25 Tracking loneliness and intervening early are important priorities. Crucially, reducing sustained feelings of loneliness and promoting belongingness are candidate mechanisms to protect against suicide, self-harm, and emotional problems.26, 27 Social isolation and loneliness are distinct and might represent different risk pathways.
The immediate research priorities are to monitor and report rates of anxiety, depression, self-harm, suicide, and other mental health issues both to understand mechanisms and crucially to inform interventions. This should be adopted across the general population and vulnerable groups, including front-line workers. Monitoring must go beyond NHS record linkage to capture the real incidence in the community, because self-harm might become more hidden. We must harness existing datasets and ongoing longitudinal studies, and establish new cohorts with new ways of recording including detailed psychological factors.26, 31Techniques assessing moment to moment changes in psychological risk factors should be embraced.
Looking beyond digital interventions (as not everyone has access to them), and ascertaining what other mechanistically based psychological interventions are effective and for whom is important.31, 43 Risks and buffers for loneliness should be a focal target in interventions to protect wellbeing. The longer-term consequences of COVID-19 for the younger and older generations (and other groups at high risk, including workers, those with existing mental health conditions, and caregivers) are also unknown and must be a priority.
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159850/
Psychoeducation of the patients and families,
debunking misinformation about the pandemic,
facilitating tele-consults and online psychotherapy,
It is vital to explain the context and circumstances of washing and help people realize what is ‘out of proportion’ and OCD related.
Similarly, any unnecessary hoarding needs to be minimized.
We need to be prepared for the likely surge of obsessive-compulsive disorders, especially in the next 3-6 months. Primary health-care workers at various sites need to be trained to identify OC complaints and the necessary referrals. Both the psychiatrists and allied specialties need to be sensitized about uncontrolled obsessions and compulsions, that they can lead to dermatological conditions, chronic stress, insomnia and high risk for suicide. More so, when the overall panic and fear of a pandemic is looming large. Lack of inhibitory control in OCD can run into a vicious loop thus bringing in a chronic sense of vulnerability to the infection, hence increased thought of contamination and increased washing.
Mental stress: As described above, during the COVID-19 outbreak many patients have suffered from extraordinary stress as they often endured long periods of quarantine and extreme uncertainty and witnessed the death of close family members and fellow patients. It is imperative to provide psychological counseling and long-term support to help these patients recover from the stress and return to normal life 66.
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7098028/
There is broad consensus among academics about the psychological care following disasters and major incidents. Here are a few rules of thumb:
- Make sure self-help interventions are in place that can address the needs of large affected populations;
- Educate people about the expected psychological impact and reactions to trauma if they are interested in receiving it. Make sure people understand that a psychological reaction is normal;
- Launch a specific website to address psychosocial issues;
- Make sure that people with acute issues can find the help that they need
Date: 9 April 2020
… Of 3166 papers found, 24 are included in this Review …
Boredom and isolation will cause distress; people who are quarantined should be advised about what they can do to stave off boredom and provided with practical advice on coping and stress management techniques.
…
Activating your social network, albeit remotely, is not just a key priority, but an inability to do so is associated not just with immediate anxiety, but longer- term distress.2, 42 One study21 suggested that having a telephone support line, staffed by psychiatric nurses, set up specifically for those in quarantine could be effective in terms of providing them with a social network. The ability to communicate with one’s family and friends is also essential. Particularly, social media could play an important part in communication with those far away, allowing people who are quarantined to update their loved ones about their situation and reassure them that they are well. Therefore, providing those quarantined with mobile phones, cords and outlets for charging devices, and robust WiFi networks with internet access to allow them to communicate directly with loved ones could reduce feelings of isolation, stress, and panic.2 Although this is possible to achieve in enforced quarantine, it could be more difficult to do in the case of widespread home quarantine; countries imposing censors on social media and messaging applications could also present difficulties in ensuring lines of communication between those quarantined and their loved ones.
…
There is evidence to suggest that support groups specifically for people who were quarantined at home during disease outbreaks can be helpful. One study23 found that having such a group and feeling connected to others who had been through the same situation could be a validating, empowering experience and can provide people with the support they might find they are not receiving from other people….
During infectious disease outbreaks, organisational support has been found to be protective of mental health for health-care staff in general39 and managers should take steps to ensure their staff members are supportive of their colleagues who are quarantined.
…
Reinforcing that quarantine is helping to keep others safe, including those particularly vulnerable (such as those who are very young, old, or with pre-existing serious medical conditions), and that health authorities are genuinely grateful to them, can only help to reduce the mental health effect and adherence in those quarantined.19, 33 Notably, altruism has its limits if people are being asked to quarantine without adequate information on how to keep the people they live with safe. It is unacceptable to ask people to self-quarantine for the benefit of the community’s health, when while doing so they might be putting their loved ones at risk.
Date: 2020
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30460-8/fulltext
- Most of the adverse effects come from the imposition of a restriction of liberty; voluntary quarantine is associated with less distress and fewer long-term complications
- Public health officials should emphasise the altruistic choice of self-isolating
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30460-8/fulltext#seccestitle40
WHO about Scalable psychological interventions
https://www.who.int/mental_health/management/scalable_psychological_interventions/en/
Examples of investing in the field:
https://dailyhive.com/vancouver/bc-government-mental-health-support-coronavirus
https://globalnews.ca/news/6764078/coronavirus-saskatchewan-mental-health-investment/
… say psychiatrists and psychologists who are calling for urgent research.
Writing in The Lancet Psychiatry, they say smartphones should be used to monitor mental health in real time.
And support would need to be tailored to specific groups, such as children and front-line health workers.
Who are the most vulnerable groups?
The paper lists eight groups that might experience the pandemic differently from the general population:
- children, young people and families (school closures, domestic violence, no free school meals)
- older adults and those with underlying health issues (isolation, loneliness, bereavement)
- people with existing mental-health issues (disruption to services and relapses)
- front-line healthcare workers (fears of contamination, work stress)
- people with learning difficulties (changes to routines and support)
- people on low incomes (job and financial insecurity)
- prisoners, the homeless and refugees (social exclusion)
- society in general might experience increased health inequality and a rise in use of food banks
Source: https://acmedsci.ac.uk/file-download/99436893
What we can do for companies
https://www.weforum.org/agenda/2019/05/4-ways-to-keep-mental-health-momentum-rolling
Expert tips about mental health:
https://www.weforum.org/agenda/2020/03/covid19-coronavirus-mental-health-expert-insights
What peope can do:
Other very good suggestions:
https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2764227
https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf
https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html
https://www.sciencedirect.com/science/article/pii/S2215036620301681
More on the efficacity of emotional intelligence training and programs in preventing or improving mental health:
Raise awareness about how emotional intelligence can help both personally and professionally and provide access to good emotional intelligence training programs.
”
The results of regression analysis showed that there is a significant impact of EI in controlling work stress as 24% of variation in work stress could be explained by the variation in EI.
Multivariate Analysis of Variance (MANOVA) revealed that students with high scores on well-being or emotionality EI dimensions tend to be higher in social functioning; while those with high scores in self-control or high in sociability EI dimensions tend to report fewer somatic and depressive symptoms, respectively. Post-hoc tests following MANOVA indicated that well-being and sociability EI dimensions interacted to reduce depressive symptoms, while well-being, emotionality, and sociability EI dimensions interacted to reduce both anxiety and depression. Well-being, self-control, emotionality, and sociability dimensions of EI appear significant for the mental health of first-year university students.
https://www.tandfonline.com/doi/abs/10.1080/14330237.2018.1540229?journalCode=rpia20
In other words, people with low emotional intelligence suffer from mental disorders, lack of empathy, anxiety, anger, weak defense mechanisms, and have problems in administration of their emotions more than others.15,16
Anxiety, obsessive-compulsive, aggression, phobia, hypochondria disorders, and emotional intelligence were the most significant predictors of Internet addiction. Moreover, there were significant correlations between these variables and Internet addiction disorder (P < 0.001).
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3905545/
Results from Pearson correlation coefficient test showed a significant relationship between emotional intelligence and mental health for different field. Findings showed that there is significant relationship between emotional intelligence and components of mental health of student in deferent field.
”
A bit more on the need of education programs about the way our minds work and how it can help:
The problem is not necessarily that we use the emotive part of our brain more than the rational in decision making, but that we are self-delusional. Even experts are prone to biases and these mean costly mistakes are made, and irrational prejudices are systemic in organisations where people believe themselves to be non-racist, non-sexist and to hold the positions they do through skill rather than luck.
Source: https://www.bbc.com/future/article/20200505-why-its-so-hard-to-be-rational-about-covid-19
Source: https://www.bbc.com/future/article/20160608-the-true-impact-of-tiny-microaggressions