Effects of lockdown and of Covid-19 itself could be deep and long-term, say researchers

Rapid and rigorous research into the impact of Covid-19 on mental health is needed to limit the impact of the pandemic, researchers have said.

Experts say newly conducted polls and emerging studies into Covid-19 together with lessons from past outbreaks suggest that the pandemic could have profound and potentially long-term impacts on mental health.

The team say it is now crucial to begin a thorough and coordinated programme of research to delve into the impact of the coronavirus itself, as well as policies like lockdown..

Prof Ed Bullmore, head of the department of psychiatry at the University of Cambridge and a co-author of the new report, said research conducted so far has been small-scale and fragmented.

“Our key message is that Covid is likely to have major impacts on mental health now and into the future and we need to start thinking about that immediately,” he said.

Writing in the journal Lancet Psychiatry, Bullmore and a team of colleagues in mental health sciences brought together by the charity MQ and the UK Academy of Medical Sciences, say that among key priorities is the need for real-time monitoring of mental health issues, both across the general population and at-risk groups, as well as healthcare professionals.

“The pandemic is clearly having a major social and psychological impact on the whole population, increasing unemployment, separating families and various other changes in the way that we live that we know are generally major psychological risk factors for anxiety, depression and self-harm,” said Bullmore.

The team say there is also a need to look at the impact of policies to manage the pandemic on unemployment and poverty, which play a role in mental health problems.

They add that among other priorities, it is important to explore ways people have found to cope with the pandemic, and urgently find ways to support mental wellbeing, particularly in vulnerable groups as well as healthcare workers..

They also flag a need to understand the impact of repeatedly looking at news and other media around Covid-19

And the researchers say more investigations are needed into the possible impact of the coronavirus on the brain, noting recent research from China which found that of 214 patients in hospitals in Wuhan with Covid-19, 78 reported neurological symptoms.

“We think it is also possible that there will be an impact on mental health more specifically in Covid patients in ways that are linked to the brain and the body’s response to viral infection,” said Bullmore.

The team stress that the research programme could not only provide insights into how to tackle outbreaks and ramifications of Covid-19 in the future, but could help in the short-term – for example in finding the best way to communicate public health measures and change behaviours without triggering distress, and repurposing digital therapies that can be rapidly scaled up and delivered to those in need.

Prof Rory O’Connor, from the University of Glasgow, a co-author of the study, said that while it is too early to say for certain what the mental health impact of Covid-19 will be, there are lessons to learn from the past.

“If we look at the Sars outbreak in 2003, we know there is evidence there that there were increased rates of anxiety, increased rates of depression and post-traumatic stress and, in some groups, there were also increased rates of suicide,” he said.

The team also reveal results from two online surveys, covering more than 3,000 people in total, conducted in the UK in the week the lockdown began. One focused largely on people who had experience of mental health problems while the other involved the UK general public.

The team say the surveys flagged widespread concerns among participants about the impact of the coronavirus on mental health, from access to support services to concerns around social isolation and increases in anxiety and other problems.

While Bullmore added that it was understandable that the physical health impacts of Covid-19 had received significant funding, it was also important to prepare for the mental health aspects.

“When we are thinking about this as a health crisis we need to keep thinking about mental and physical health together and not apart,” he said.

Prof Wendy Burn, president of the Royal College of Psychiatrists, welcomed the team’s call for action, adding that mental health research is significantly underfunded, lagging behind funding for illnesses such as cancer.

“The long-term mental health impacts of this unprecedented pandemic – on people with existing mental illness and other vulnerable groups, on the health and social care workforce, and on the healthy population – are not yet fully known but they may be equally unprecedented,” she said.

• In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Other international suicide helplines can be found at www.befrienders.org