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‘Covid-19 and its psychological consequences’ by Dr Teresa Mulhern

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July 2020 marks the additional easement of physical distancing restrictions put in place to battle the current COVID pandemic.  It seems as though we have weathered these restrictions as a nation, however, what legacy has this period of physical and social isolation and this global pandemic taken on the mental health and psychological wellbeing of the Irish population, and the world more broadly?

There is some evidence to suggest that the early stages of the COVID pandemic and social isolation had negative psychological consequences for the general public. Wang and colleagues (2020) surveyed 1210 respondents across 194 cities in China from the 31st of January to the 2nd of February 2020 and found that 53.8% of their participants rated the psychological impact of the COVID pandemic as moderate or severe, with 16.5% of respondents rating their depressive symptoms as moderate to severe, 28.8% rated their anxiety symptoms as moderate to severe, and 8.1% of participants reported moderate to severe stress levels. Interestingly, the researchers found that there were specific participant characteristics that were associated with greater psychological vulnerability – specifically, participants who had poor self-rated health status and were considered as “vulnerable” reported higher levels of stress, anxiety and depression coinciding with the outbreak. Furthermore, this outcome was more prevalent amongst females and the student population. The findings of this study indicate the extreme psychological impact on the general public, even at the early stages of the virus, suggesting that it may have been wise to ensure that services and resources were allocated towards monitoring the mental health of various nations and intervening where necessary and appropriate.

In a recent review conducted by Hossain and colleagues (2020) a number of negative mental health outcomes were linked with quarantine and isolation including depression, post-traumatic stress disorder, anxiety, mood disorders, insomnia, and a lack of self-control (which I can also verify given my frequent trips to the kitchen and fridge). Although the studies cited within this article were conducted across a number of different contexts and were not related to COVID, these findings are applicable to the current global crisis and suggest the need to invest in mental health services and reconsider policies and mental health infrastructures that are suitable during periods of physical isolation, given the potential for a second wave or possible future pandemics. For example, Sprang and Silman (2013) assessed the mental health and wellbeing of 398 parents of children placed in isolation or quarantine and found that 30% of children and 25% of parents met the criteria for post-traumatic stress disorder. Given the additional stresses placed upon parents during this time to work from home, educate their children and run a household on a potentially reduced budget, we may expect similar experiences and outcomes of stress. Additional studies have indicated a high prevalence of anxiety as a result of quarantine and isolation (Abad, Fearday, & Safdar, 2010; Gammon, Hunt & Musselwhite, 2019; Sharma et al., 2020), with further studies indicating increases in depression (Pursell, Gould & Chudleigh, 2020), anger and irritability (Brooks et al., 2020; Morgan, Diekema, Sepkowitz & Perencevich, 2009). Given the prolonged period of isolation experienced globally, it is probable that such manifestations of anxiety and mood disorders may occur as a result of this isolation. As such, it is paramount that resources are put into place to offset such potential outcomes.

Of major concern to me as both a psychologist and a lecturer, is the mental health of college students. Recent research indicates that this period of isolation, coupled with the continued barrage of information regarding the dangers of COVID has had a significant negative impact on the manifestation of anxiety amongst college students. For example, a recent study published by Cao and colleagues in 2020 examined the feelings of anxiety amongst over 7,000 college students from Changzhi medical college and found that 21.3% of those sampled were experiencing mild anxiety, 2.7% experienced moderate anxiety, while 0.9% of respondents experienced severe anxiety as a result of the current pandemic. Interestingly, the researchers found that students who lived in an urban area were somewhat protected against these feelings of anxiety. Although Ireland has become increasingly urbanised in the last two to three decades, it is still a predominantly rural country, and the finding put forward by Cao and colleagues is a worrying one for the student population of Ireland who found themselves displaced to more remote and rural regions. Students within this study also cited that delays in academic activities and economic stresses during this time period were more likely to result in increases in feelings of anxiety, however, the presence of social support for these students was associated with decreases in anxiety. Given the information generated from this research, it provides us with considerations of how best to support the mental health and well-being of students who may have some reservations regarding the currently trepidatious reality of  entering higher level education.

Although the body of research examining the impact of social and physical isolation in the context of a global pandemic has yet to be conducted, the preliminary research does suggest a considerable psychological fallout on a national and global level. The onus is now on us to ensure that resources are allocated towards services so as to bolster an already overwhelmed mental health system and prevent the malevolent undercurrent of the pandemic – that of psychological suffering.

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