Developmental psychology researchers largely founded that learned experiences through environmental factors during early childhood engender the fundamentals for lifetime behavior and success as it is a crucial phase for cognitive, emotional and psychosocial skill development.  Closing of schools, parks, and playgrounds will disrupt children’s usual lifestyle and can potentially promote distress and confusion. Children are likely to become more demanding, having to cope up with these changes, and may exhibit impatience, annoyance and hostility, which in turn may cause them suffering from physical and mental violence by overly pressurized parents

Children

 older adults and people with serious comorbidities are particularly vulnerable to worse outcomes from COVID-19 can create considerable fear amongst the elderly.   Older adults with cognitive decline may become much more anxious, agitated, and socially withdrawn, thus their specific needs demand specific attention

Old Age

 Members at home may feel it emotionally difficult if they cannot visit their sick relatives in the hospital due to strict lockdown situations. On the other hand, family members coming to hospitals for their critically ill relatives/significant others who require emergency care and admission may have feelings of helplessness and vulnerability in fear of violating the social restriction rules, setting an example of “learned helplessness”

Domestic Caregivers

Majority of international migrant workers in the public health structures are already overstretched and live in areas with high incidence of Covid-19.  These people are more likely to be discriminated against.  Furthermore, immigrants and refugees may even have to bear with the stigma of remaining as a speculated source of outbreak in a community where home-quarantine has been implemented. Considering the lethal communicability of this disease, migrants, refugees and slum-dwellers are at heightened risk of contracting and spreading the infection

Marginalized community- migrants, prisoners, slum dwellers and daily wagers

- higher risk of SARS-CoV-2 infection for those with pre-existing mental health disorders
- Difficulty in following safety measures due to entenuating circumstances
- increased symptoms, relapse, and poorer access to services and supports

Potential consequences of COVID-19 for mental health for people with pre-existing mental health disorders

- Clinically stable people discharged from hospital after recovering from COVID-19 have reported high rates of post-traumatic symptoms 
- Mental disorders such as PTSD, depression and anxiety were prevalent in people who survived severe coronavirus infections 
- People who have had COVID-19 can experience post-intensive-care syndrome, and those who have been admitted into ICUs may experience dysexecutive syndrome 
- There have been reports of a post-viral syndrome that resembles depression

Potential consequences of COVID-19 for mental health for people who have or had COVID-19

Potential consequences of COVID-19 for mental health for the General Public

The stress of exposure and fear of infecting themselves or their loved ones associated with working as a health-care worker is related to adverse mental health effects such as depression, anxiety, insomnia, distress. Common risk factors included a lack of social support and communication, maladaptive coping strategies, and a lack of (usually disaster) training. Moral injury is also a subject of concern in health-care workers, especially those who had worked in the over-stressed ICUs where they had to make tough decisions about how to prioritize scant or inadequate resources, potentially resulting in deaths that might be avoidable under normal circumstances

Health-care workers


Since COVID-19’s inception in December 2019, healthcare workers (HCW) have been the primary persons involved in the screening and treatment of the disease. However, HCW are not immune to its psychological effects. Various reasons exist for these adverse outcomes which include: high infection rates among HCW, excessive workload, inadequate PPE, an oversaturated media presence, and the feeling of insufficient support. Reasons specific to the disease itself include its rapid spread, mode of transmission, an undefined protocol of treatment, and lack of vaccine. Compared to doctors, nurses have higher rates of depressive and anxiety symptoms. Thus, it is important to consider mental health evaluation in the regular screening of HCW, followed with implementation of mental health teams.

Psychological Effects of COVID-19 on Healthcare Workers

- People with IDD had higher prevalence of specific co-morbidities associated with poorer COVID-19 outcomes such as hypertension, heart disease, respiratory disease, and diabetes
- Overall case-fatality rates similar for those with IDD (5.1%) and those without
- Within 18–74 years age range, case-fatality rate higher for IDD population(4.5%) compared to those without IDD (2.7%), and also in the 0–17 years age group, but not among those 75 years and older
- Not enough data on people with IDD even though they have higher risk of identified co-morbidities 
- Case-fatality rates in this study were similar for people with and without IDD when not accounting for age, but considerably different when accounting for age

People with Intellectual and Developmental Disabilities and COVID-19 Outcomes 

- Children

- Domestic caregivers

- Old age

- Marginalized community

- General public

- People who have or had COVID-19

- People with pre-existing mental health disorders

- Health-care workers

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- Cognitive Impacts
- Creating New Measurements
- Long-term prognosis and psychological impacts
- Mental Health focuses
- Psychosocial impact 
- Strategies to combat the psychological impact of COVID-19
- Substance use issues
- Relationship conflict and sexual behavior

Focuses of the Psychological effects of COVID-19 pandemic

- Potential consequences of COVID-19 for mental health
- Mental health service responses to COVID-19
- Sustainable adaptations of mental health delivery
- Assessment of mental health outcomes in clinical practice

Topics of How mental health care should change as a consequence of the COVID-19 pandemic

Dubey, S., Biswas, P., Ghosh, R., Chatterjee, S., Dubey, M., Chatterjee, S., . . . Lavie, C. (2020, May 27). Psychosocial impact of COVID-19. Retrieved July 23, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255207/

Psychosocial impact of Covid-19

Moreno, C., Wykes, T., Galderisi, S., Nordentoft, M., Crossley, N., Jones, N., Cannon, M., Correll, C., Byrne, L., Carr, S., Chen, E., Gorwood, P., Johnson, S., Kärkkäinen, H., Krystal, J., Lee, J., Lieberman, J., López-Jaramillo, C., Männikkö, M., Phillips, M., Uchida, H., Vieta, E., Vita, A. and Arango, C., 2020. How mental health care should change as a consequence of the COVID-19 pandemic. The Lancet Psychiatry. DOI:https://doi.org/10.1016/S2215-0366(20)30307-2

How mental health care should change as a consequence of the COVID-19 pandemic

Due to the large life and routine changes caused by the COVID-19 Pandemic,  substance use issues are arising and increasingly relevant public health problems that needs to be addressed.

Substance Use Issues Associated with the COVID-19 Pandemic

COVID-19 patients have reported mental fatigue and loss of concentration.  Severe cognitive impairment is reported by people with secondary illnesses.  Encephalopathy (damage to brain) is observed after extubation.  This could be because of sedation or mechanical ventilation.  Damage to the brain can occur from bacteria during ventilation. 
 



Cognitive impacts of COVID-19

Many reports show that most patients can return to their roles and recover fully but some survivors will have lasting disability.  Sedation affects recall which is why those patients won't necessarily have a long lasting trauma but patients who are conscious may experience anxiety especially when they are physically disabled or dependent due to the virus.  Risk of depression increases when the patients are separated from their families for a prolonged period of time.  Loss of independence is experience and many have to go through outpatient psychotherapy.

Long-term prognosis and psychological impacts

The impact the pandemic has on the psychological state of the people is something many psychologists are interested to investigate, and as such, new measurements specific to the pandemic is needed

Creating New Measurements for Psychology during COVID-19 Pandemic

Psychological Effects of COVID-19 on different sections of society

- Mental Disorders
- Mental Health and psychological distress
- Mental Health Care
- Mental Health Consequences and physical distancing
- Mental Health Risk Factors
- Students mental health

Mental health focuses (COVID-19)

- Accurate dissemination of health and related information to the public
- Addition of psychologists and psychiatrists to the COVID-19 task force
- Have HCPs take a bigger role in mental health care of patients
- Identification of high-risk groups (psychologically)
- Improved screening of psychiatric morbidities
- Integration of hospital and community resources
- Psycho-education (preventative)
- Psychological interventions and psychosocial support
- Psychological support for frontline workers



Strategies to Combat Psychological Impact of COVID-19

- COVID-19 pandemic causes: disruptions of daily routines, anxiety of the pandemic, lack of physical activity, absence of outside social outlets, lack of access to unperson therapy, and reduced physical contact (e.g. hugging..)
- All may contribute to romantic relationship conflict 
- Previous study showed married couple experienced greater negative impact on mental well-being than unmarried couple during the pandemic 
- Psychological stress impact sexual desire and sexual function; sexual desire and orgasm are known to be supported by a lower-stress environment 
- Life-threatening event and Intense financial stress and economic hardship may lead to relationship conflict


Romantic Relationship Conflict Due to the COVID-19 Pandemic: Background stress and Changes in Intimate and Sexual Behaviors 


- Psychosocial impact on general public
- Psychosocial impact on healthcare workers
- Psychosocial burden of quarantine and isolation

Psychosocial impact of COVID-19 on different levels

- Public mental health responses and community outreach
- Mental health-care settings
- Mental health needs of special populations

Mental health service responses to COVID-19

- Ethics-driven and rights-driven considerations
- Service user knowledge and involvement
- Longer-term mental health needs
- Remote therapy
- Ways of working

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