The Impact of Wearing a Face Mask on the Psychiatric Interview: a National Survey During the COVID-19 Pandemic

Abstract

The COVID-19 pandemic has forced to rapidly encourage the use of face masks during medical consultations, with significant implication for psychiatry. This study examined the opinions and attitudes of psychiatrists toward the impact of wearing a face mask on the psychiatric interview. 513 psychiatrists and trainee psychiatrists completed an electronic survey about the impact of wearing a face mask on the psychiatric interview. Less efficiency in capturing clinical signs/symptoms, emergence of false inferences in patients and altered patient-clinician interactions were commonly reported negative impacts of face mask (66-96%). The quality of the therapeutic alliance was reported as affected by the mask by 47% of the sample. Results were mixed on the use of telepsychiatry as a potential solution to mask-related inconvenience. The use of face masks has significant negative effects on the psychiatric interview. Providing specific training to clinicians could be a potential solution for masks-induced biases. Supplementary Information The online version contains supplementary material available at 10.1007/s11126-021-09962-3.

Perceived empowerment and the impact of negative effects of the COVID-19 pandemic on the quality of life of persons with severe mental illness

“…Overall, our study results confirm the hypothesis shared by many researchers that the negative consequences of the COVID-19 pandemic on people with mental disorders go far beyond the physical health impairments potentially caused by a SARS CoV-II infection [16,18,19,[21][22][23][24][25][26][27]. We found direct effects of a SARS CoV-II infection only for perceived negative effects on physical well-being and on mobility.…”

“…Among other vulnerable groups, persons with severe mental illness (SMI) have been expected by many experts to become particularly affected by the psychological distress caused by fear of infection, increasing social isolation, and restricted access to mental health care services [15][16][17][18][19][20][21][22][23][24][25][26][27]. However, most of the studies on the impact the COVID-19 pandemic on psychopathological symptoms suggested that the majority of patients with mental illness seemed to have adapted to the challenges of the pandemic after the first wave as well as people without pre-existing mental health problems [6,16,17,[28][29][30][31][32][33][34][35][36][37][38][39].…”

Patient and provider experiences of telemental health during the COVID-19 pandemic in a New York City academic medical center

“…General telehealth studies have found that both patients and providers have high levels of satisfaction with the use of telehealth and are willing to use it in the future, finding it to be comparable in quality of care delivery, with increased flexibility and lower cost ( Andrews et al, 2020 ; Malouff et al, 2021 ). Within psychiatry specifically, TMH offers an opportunity to exchange verbal and non-verbal communication without masks, which have been reported to negatively impact the quality of the psychiatric evaluation( Dondé et al, 2021 ).…”

It is time to abandon mask mandates in psychiatric facilities

“…But while we support research that interrogates core constructs, mechanisms and processes, we caution against inferring from studies that use broad approaches and examine more general concepts, and as such perhaps lack the necessary specificity. In this study, 1 for example, major depressive disorder (MDD) is widely recognized as a heterogeneous illness, and this would be even more likely in the patients described, given the naturalistic recruitment from treatment centres. Irritability itself, as we have pointed out 2 and the authors acknowledge, is variably characterized and in need of precise definition.…”

“…It has been well established that facial coverings significantly impact the quality and ease of psychiatric assessments. 1 Interviews conducted by clinicians whose mouths are hidden can create false inferences and beliefs in patients, worsen communication barriers, and erode therapeutic rapport. Facial coverings also hide micro-expressions and impede non-verbal expressions of empathy and active listening.…”