In the wake of the huge social upheavals brought about by the Covid-19 pandemic, every aspect of health care has had to adapt to the challenges and changing circumstances. The fields of mental health and psychiatric care are no exception.
Increased and prolonged social isolation, fear of illness, and economic insecurity are only some of the factors that have affected people. Loneliness, increased dependence on food or alcohol, reliance on gambling and other distraction methods can all lead to problems even in individuals with no previous history of mental illness.
To cope with these challenges, the way we approach psychiatric care for our patients has been steadily evolving. Below we look at some of the ways the response to Covid -19 is transforming the way we support our patients.
Impact of social distancing
The need for socially distanced interaction has led to a move away from possibly crowded treatment centers to home-based solutions, whenever practical. The need for in-patient care is often being re-assessed, and the length of any stay is kept to a minimum. In-home hospitalization, with phone and IT monitoring support from professionals, is becoming an option of choice. This not only lowers the risk of Covid-19 infection for both staff and patients, but it can also be helpful for patients and their families that they remain in their home environment.
With greater emphasis on technology to support the delivery of mental health care, the use of telemedicine and video medicine will likely continue to grow. Over the past 12 months, many people have become accustomed to communicating via video calls, which allow face-to-face communication between doctor and patient, and also enables the professionals within a care team to communicate rapidly and efficiently. However, it should be noted that his approach, also raises certain issues. First is patient confidentiality and data protection. Another is that of equity – how will this delivery option be made available to patients without the financial means to access the technology?
With patients unable to attend in-person appointments, phone-in prescribing has become increasingly acceptable. The use of long-acting injectables may be preferred, when possible. Given the physical distance between doctor and patient, there’s likely to be more emphasis on the patient’s own assessment of side effects, with the increasing use of biometric monitoring to provide valuable additional data. Overall acceptance of user input into designing care plans and shared decision-making is only likely to increase.
Emphasis on self-care
Given the widespread awareness of the impact of COVID-19 on mental health, there has been an increased focus on public mental health education. The importance of self-care strategies to avoid problems such as depression, or alcoholism is likely to be highlighted. Individual coping strategies, such as CBT and mindfulness practices; healthy lifestyles including adequate exercise, good nutrition, and fresh air; and the importance of family support have all been emphasized over the past 12 months.
Increasingly, peer groups on social media, volunteer organizations, and local health providers are creating networks to which people can turn when they find themselves in need of support for their mental and emotional health.