Since 1949, the month of May has traditionally been observed in the United States as Mental Health Month. This year, May also has the unfortunate distinction of having seen the highest number of COVID-19 cases and deaths nationwide.
On a broader level, the two events are inextricably tied — how can a population living through a pandemic not suffer from trauma, loss, stress and uncertainty, all hallmark contributors for mental health issues? Some have even termed the coronavirus outbreak a national grief.
Traumatic stress and traumatic experiences are felt in this pandemic by everyone from patients to frontline providers. Even the “worried well” feel an impact, facing a fear of contracting the illness even without exposure, or potentially knowing anyone who has had it or lost someone to it.
In fact, the majority of the country’s adults — 56% — report that “worry or stress related to the pandemic has caused them to experience at least one negative effect on their mental health and wellbeing” (this includes issues with sleeping or eating, increased alcohol use or worsening chronic conditions).
What contributes to these stressors? And what role does healthcare play in mitigating them? Let’s take a closer look.
Changes to routine bring concerns along with them
From county-specific restrictions to statewide lockdowns, governments at all levels have taken action to make social distancing easier and more effective. But these measures can often come at a cost to mental health.
One survey found that, as of last week, nearly half (48%) of those surveyed felt that, in the United States, the worst is yet to come. To help prevent this, many Americans have changed their behaviors, including:
- Avoiding public events and gatherings (81%)
- Avoiding going out to restaurants or bars (81%)
- Spending almost all of their time in their house or apartment (74%)
- Going to the grocery store or supermarket less often (73%)
Changes in routine like this can lead to anxiety and stress on their own merit, however, in addition to the stress brought on by living through a pandemic. The CDC offers suggestions for ways to cope with these types of feelings during a global public health emergency like COVID-19. But isolation and anxiety can often remain.
Healthcare anxiety is increasing
In addition to unease brought about by changes in routine, healthcare anxiety is increasing. One survey found that 70% are worried there won’t be room in hospitals or available doctors if they get COVID-19. Younger people are concerned about their ability to visit with a sick family member.
And it’s not just the current outbreak that has people worried — 49% are concerned about a "second wave" of COVID-19 once the country starts to reopen. All of these things contribute to unprecedented behaviors and stress.
Don’t discount financial concerns
Above and beyond the social and medical aspects of the outbreak are very real concerns about paying for treatment and other bills at a time when many have lost their jobs.
On this front:
- 29% indicated concern over being unable to afford an emergency medical expense
- 47% are worried about the economy falling into a recession
- 25% are worried about falling behind on bills
These aren’t just hypothetical concerns. In fact, 29% have already fallen behind in paying bills or had difficulty affording household expenses like food or health insurance coverage since February due to the pandemic.
So what role can healthcare play?
First, consider what health looks like, whether before, during or after a pandemic. We’re used to thinking of health as the opposite of illness, but the World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
Pandemic or not, then, it is incumbent on providers and health systems to view a patient as a whole person, with all the potential concerns, worries and stressors that might entail and extend support beyond just tracking traditional signs and symptoms. Considerations include:
- Is isolation preventing the patient from getting groceries and other important supplies?
- Do concerns about the health of friends and family manifest themselves as sleepless nights?
- Does the patient have income to cover copays? Are they cancelling elective procedures out of financial concern?
In light of these worries, the clinical is just one piece of the puzzle. Assessment and treatment of patients must go beyond clinical guidance and protocols, incorporating things like behavioral health factors, social determinants and psychosocial circumstances to support a whole-person approach to care.
This is where digital technology has a role to play
Resources can be made available through tools that reach, educate, calm and assess the holistic health of individuals. The GetWell Loop COVID-19 care plans, for example, incorporate breathing exercises as well as stress management and mindfulness videos from Learn to Live, a digital Cognitive Behavioral Therapy provider with a complementary whole-person, social approach. In addition, the care plans provide windows into research on vaccines and treatment to provide a sense of hope and control.
The GetWell Loop digital care management software also has built-in trigger alerts to drive patients to the right resources during crisis moments. We are thinking creatively about how technology can be used to work alongside a patient’s humanity — after all, that’s the common bond tying individuals together during this pandemic.
The bottom line
There’s a lot of advice to offer — use an empathetic tone and accessible literacy level to educate. Treat individuals as more than just patients, more than just medical charts. Seek to understand the full picture, whether that’s by gaining insight into the patient’s social distancing behaviors, feeling of connectedness or daily stressors.
Seek to mitigate these anxieties and concerns with the kind of authoritative support that healthcare is best suited to provide. From centering exercises to expectation setting, identifying unmet needs, alerting care teams and highlighting relevant resources and programs, automated technology can help you put the “human” first, before the “patient.”