Translating science into policy: mental health challenges during the COVID-19 pandemic

Abstract

Several stressors associated with the coronavirus disease 2019 (COVID-19) are expected to affect the mental health of global populations: the effects of physical distancing, quarantine, and social isolation; the emotional suffering of health and other frontline workers; neuropsychiatric sequelae in those affected by the virus; the impact to families of lives lost to the disease; differential effects for those with severe mental disorders; and the consequences of social and economic deterioration. In this context, we sought: to form a panel of Brazilian experts on child and adolescent health, neurodevelopment, health services, and adult and elderly mental health; and to compile evidence-based interventions to support suggested policy changes in Brazil to mitigate the expected increase in mental health disorders during the pandemic and its mental health consequences. The following actions are recommended: 1) invest in prevention programs for the safe return of students to schools; 2) adopt evidence-based psychosocial interventions to maintain an adequate environment for child and adolescent development; 3) target socially vulnerable populations and those experiencing discrimination; 4) train primary care teams to solve common mental health problems, provide needs-based assessments, and manage long-term, at-home care for older patients; 5) invest in technological advancements (e.g., telemedicine, e-Health, and web-based algorithms) to promote coordinated care; 6) increase access to and literacy in the use of computers and mobile phones, especially among older adults; 7) expand protocols for remote, brief psychotherapy interventions and psychoeducation to manage common mental health problems.

Associations of Sociodemographic Factors and Health Behaviors with the Emotional Well-Being of Adolescents during the COVID-19 Pandemic in Brazil

“…The findings of this study showed adolescents from disadvantaged families are more likely to have emotional problems, probably due to uncertainty and anxiety among adolescents regarding their families' financial difficulties [44]. The negative emotional consequences indicate the need to intensify mental health protection actions, giving priority to the most vulnerable families [43].…”

“…During the period of social restraint measures, low-income families had more difficulties in facing the pandemic [40]. In Brazil, there was a greater reduction in family income among the poorest sections of the population, while informal workers were left without work, raising concerns about family maintenance and food insecurity [41][42][43]. The findings of this study showed adolescents from disadvantaged families are more likely to have emotional problems, probably due to uncertainty and anxiety among adolescents regarding their families' financial difficulties [44].…”

Lessons Learned or Forgotten? Impacts of COVID-19 on the Future Direction of Global (e-)Mental Health Care

“…Accordingly, people with this diagnosis during a pandemic should have received more care and attention. Unfortunately, it did not happen—patients had difficulty getting in touch with a doctor let alone accessing better care and prevention [ 11 ].…”

“…Global consensus and national policies have emphasized deinstitutionalization, or a shift in providing mental health care from institutional to community settings. The integration of psychiatry with somatic medicine and the development of a community psychiatry requires the organization and creation of a complex and coordinated care system, including primary care, specialized mental health care, crisis management services, housing programs, inpatient units, and centers running a specialized treatment program and supervising this system and consulting them clinical academic centers [ 11 ]. This creates great opportunities to introduce innovative technologies in the form of telemedicine systems coordinating the operation of a multi-module care system.…”

“…Such a telemedicine system may include other mobile medical applications that enable screening diagnosis, early diagnosis, cognitive training, video education, and digital forms of treatment with the use of virtual reality, augmented reality, and applications for relaxation or phonotherapy [ 39 , 40 ]. Such systems can automatically accelerate patient care by monitoring symptoms and processing them through algorithms that prioritize patients with more severe mental health problems [ 11 , 41 ].…”