Mental health problems in COVID-19 and the need for reliable data

The effects of the coronavirus disease 2019 (COVID-19) pandemic on both physical and mental health are significant. While preventive measures against the spread of the novel coronavirus and the treatment of people with COVID-19 has been in the focus of health systems worldwide, the need for mental health care for patients and health professionals affected by the pandemic has been less well addressed. Mental health problems associated with the pandemic include the possibility of delirium in the acute stage of COVID-19, while depression, anxiety, fatigue and posttraumatic stress disorder may be found in the longer term. People with severe mental illness are at high risk during the COVID-19 pandemic and may be among the most vulnerable populations. In addition to an exacerbation of their mental condition, these individuals may show an increased susceptibility to COVID-19 infection and increased mortality rates, due primarily to high rates of overweight, obesity, smoking and bad diet. COVID-19 related mental health problems are not confined to those infected with the virus. Measures taken to slow the spread of the virus, such as physical distancing and business and school closures, which lead to greater isolation and potential financial distress, may result in disturbances of mental health in non-infected people. Social isolation and the uncertainties surrounding the novel coronavirus may lead to loneliness, despair, anxiety and depressive thoughts. As a consequence, psychiatric symptoms may emerge in individuals with no history of mental disorders, and pre-existing mental conditions may worsen.Given previous experiences with large-scale disasters and the SARS epidemic of 2003, the COVID-19 pandemic is likely to increase the prevalence of anxiety, depression, substance use, self-harm and domestic violence in the general population. Moreover, school closures may result in an increase in child abuse. At present, there is no epidemiological data on either the psychiatric morbidity of those diagnosed with COVID-19 or mental health problems of their health care providers. Data on the mental health effects related to the pandemic in the general population is also lacking.Public mental health interventions are needed during the COVID-19 pandemic in order to address the anticipated increases in the prevalence of mental disorders and poor mental health across populations. In this context, systematic information on the immediate psychosocial problems caused by the pandemic is important. Reliable data will also be required to measure the growing effects of COVID-19 on mental health and substance use. The increase in the need for mental health services may become a long-term issue even though new cases and deaths due to COVID-19 are declining.In summary, the implications of the COVID-19 pandemic for mental health call for a greater focus on the needs of those with mental disorders and on mental health issues affecting health care workers and the general population. However, little is known concerning the nature, extent, duration and distribution of the effects of the COVID-19 pandemic on mental health. The need to collect high-quality data on the mental health effects of COVID-19 on both vulnerable groups and whole populations is therefore pressing. Longitudinal data will be needed to track the prevalence of mental health problems and the associated need for treatment and public health measures. Reliable information, which can be gained only by random sampling from the entire population, is needed in order to reduce the risk of bias and erroneous conclusions and to avoid potentially damaging interventions