Principles of mental health care during the COVID-19 pandemic

Abstract

We describe the basic principles of mental health care during the COVID-19 pandemic that should be endorsed by the mental health professional associations and incorporated in the health strategies for the management of the COVID-19 pandemic. The main principle is that there should be no substantial differences in the provision of health care for COVID-19 between persons with pre-existing mental health disorders and the ones without previous disorders. Subsequently, the organization of the health care should reflect that as well. These principles should (a) prevent the possible effects of stigmatizing attitudes toward mental health issues, possibly leading to potentially deleterious situations, such as psychiatric patients being treated (even temporarily) separately from other patients, in psychiatric facilities, where the staff is not equipped and trained adequately for the management of COVID-19; (b) highlight the fact that patients with mental health disorders are at greater risk for developing serious complications of COVID-19 infection due to other factors—they often smoke and have comorbidities such as hypertension, diabetes, all associated with higher morbidity and mortality from COVID-19 infection; (c) highlight that measures should be taken to minimize the risk of the spread of infection in psychiatric wards/institutions; (d) provide a general framework for the reorganization of mental health services toward the provision of services for persons in need, including frontline medical workers and patients with COVID-19 without previous mental health problems as well as for persons with pre-existing mental health problems under new circumstances of pandemic.

Effects of the lockdown on the mental health of the general population during the COVID-19 pandemic in Italy: Results from the COMET collaborative network

“…Given the high level of contagiousness, as well as the lack of appropriate treatments and vaccines, almost all countries have adopted confinement measures, including lockdown, home isolation and physical distancing [5]. While most of the clinical and research efforts have been directed to reduce the effects of the virus on physical health [6][7][8], its short-and long-term effects on mental health are causing a second wave of pandemic, which has been mostly neglected [9][10][11]. Furthermore, the pandemic represents a traumatic event which has differential effects at individual and population levels.…”

Reduction in hospitalizations and emergency psychiatric care due to social distancing measures during the COVID-19 pandemic

“…The restriction of hospitalization criteria and the consequent decrease in the hospitalized population is one of the main recommendations for preventing COVID-19 infection in psychiatric hospitals 6 . This strategy is internationally recommended, together with the adoption of others that can mitigate the possible negative effects of this restraint on access to specialized services 7 . In Fortaleza, the recommendation was adopted for professionals to be more judicious when indicating psychiatric hospitalizations, besides having been suspended at the evaluated hospital voluntary hospitalization of patients with problems related to drug addiction, as already stated.…”

“…The study was conducted at Professor Frota Pinto Mental Health Hospital, the only public service to attend psychiatric emergencies in the city. To face the COVID-19 health crisis, the service developed a contingency plan, adapting international recommendations to the local context 6,7 . These measures include greater rigor in the criteria for hospitalization, allocation of space for quarantine for newly admitted patients and a separate place for those with mild flu-like syndromes.…”

One year after the COVID-19: What have we learnt, what shall we do next?

“…Three articles of this collection listed advices and recommendations to protect and defend the rights of patients with severe mental disorders in the circumstances of a pandemic [7], to organize basic principles of mental healthcare during the COVID-19 pandemic [8], and to help the general population to reduce stress and cope with related aspects such as confinement and lockdown [9].…”