COVID-19 & Mental Health

On Thursday, April 23, 2020, MDedge Psychiatry hosted a Twitter conversation at #MDedgeChats on COVID-19 and mental health.

Two psychiatrists affiliated with Johns Hopkins University, Dinah Miller, MD (@shrinkrapdinah), and Elizabeth Ryznar, MD (@RyznarMD), hosted the conversation. Throughout the conversation several themes emerged. One is that COVID-19 illustrates the connections between housing and health, and another is that stigma tied to being COVID positive is leading to suicidality, particularly in Haiti. The discussants also talked about the importance of self-care.

Questions asked during the Twitter chat:

1. How are your pre-pandemic patients doing during this crisis?
2. How has COVID-19 affected inpatient and outpatient care for you?
3. How are our most vulnerable populations being affected by COVID-19?
4. How are you doing personally and professionally as medical professionals during the pandemic?
5. What psychiatric manifestations are you seeing in your patients who have had COVID-19?

The following is an edited version of the discussion. For the full experience, visit our Twitter archive, you can still join the conversation.

Some experts are predicting that the magnitude of the mental health fallout from the COVID-19 pandemic will be profound. They also have concerns that physical distancing and increased unemployment forced by the pandemic will lead to a rise in suicide risk, particularly for at-risk populations.¹

For psychiatric patients, COVID-19 is expected to leave behind higher levels of anxiety, depression, and insomnia.²

And for health care workers on the front lines, the mental health toll could lead to stress, burnout, and worse.

Clinicians are also dealing with shortages of PPE and medical equipment, worrying about their safety and that of their families, while trying to save lives amid great uncertainty about SARS-CoV-2, the coronavirus that causes COVID-19.

Most recently an emergency department physician in New York who was recovering from COVID-19 herself reportedly recently ended her own life, according to her father, who is a physician.

As Dr. Sarah Candler said in a previous twitter chat with MDedge Internal Medicine, “Good doctors take care of themselves, too.” Be kind to yourself during this global crisis.

The National Suicide Prevention Lifeline is always available at 1-800-273-TALK (8255).

Resources

• Mental health and the COVID-19 pandemic
• Brief examines the COVID-19 crisis’ implications for Americans’ mental health
• COVID-19: Helping health care workers on the front lines
• Overcoming COVID-related stress
• Confessions of an outpatient psychiatrist during the pandemic
• Psychiatric patients may be among the hardest hit
• Experts hasten to head off mental health crisis
• Podcast: Physician Suicide

¹Lancet Psychiatry. 2020 Apr 21. doi: 10.1016/S2215-0366(20):30171-1.

²Brain, Behav Immun. 2020 Apr 27. doi: 10.10116/j.bbi.2020.04.069).

Kclark@mdedge.com
ghenderson@mdedge.com