Mental health professionals are concerned about the psychological consequences of confinement, which several countries affected by the coronavirus pandemic have extended this week.
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“Extension of containment expected, but news will deeply disappoint many,” said Linda Bauld, professor of public health at the University of Edinburgh, after the three-week lockdown extension was announced on Thursday ” in Great Britain. “The indirect consequences are piling up,” she continued, noting that “recent studies show a worrying increase in anxiety and depression” in the general population.
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Psychological distress
The observation is repeated in all the countries subjected to this drastic measure, forgotten for decades in our modern societies. In France, a consortium of research units, including the School of Advanced Studies in Public Health, launched CoConel (coronavirus and containment), “longitudinal study” (over time) of a panel of a thousand people, carried out by Ifop.
If the situation persists, it could favor the occurrence of severe psychiatric pathologies
At the end of the second wave, released on April 8, before the announcement of the one-month extension of the confinement in force since March 17 in France, “overall 37% of those surveyed show signs of psychological distress”, with no notable variation with the first wave published in March.
“Comparison with the latest data collected in the general population in 2017 suggests a deterioration in mental health during confinement. If this situation continues for several weeks, it could favor the occurrence of severe psychiatric pathologies, and a rebound in demand for care in lifting containment, which should be prepared, “warn the researchers.
Seriously affected
Same concern in the United States, where “more than a third of Americans (36%) say that the coronavirus seriously affects their mental health” pointed out the American psychiatric association (APA) in a letter addressed to Congress leaders on April 13 .
Warning of the risk of seeing “even more Americans in need of psychiatric care”, the APA called for investments for immediate needs “and for the recovery period”, notably in teleconsultations and access to care.
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“Call to action” also in Britain, signed Thursday by 24 professionals in the journal Lancet Psychiatry, the morning of the announcement of the extension of confinement in the country. In particular, they call for reinforced surveillance of the psychiatric consequences of the epidemic, also relying on opinion surveys revealing a stronger fear of the psycho-social impacts of the epidemic than of falling sick oneself.
“Increased social isolation, loneliness, health concerns, stress and economic plunge: the conditions are there to harm well-being and mental health,” summarized one of the signatories, Rory O’Connor of the University of Glasgow in a conference call.
The problem is too important to ignore, both in human terms and in terms of broader social impact. ”
In fact, practitioners “are already starting to see an impact, on patients already followed or new”, abounds Professor Antoine Pelissolo, head of the psychiatry department at CHU Henri-Mondor, in the Paris region. “And we are going to have other complications, as well as the psycho-social consequences of the crisis that will follow, necessarily creating distress.”
Hallucinations
And it is therefore access to professional help that is going to be one of the challenges of coming out of the crisis. With the brakes already identified, starting with the image of mental disorders in the public, quickly sent back “crazy”.
“Destigmatization is crucial,” said Anne Giersch, director of the cognitive neuropsychology unit at Inserm at the University of Strasbourg. “For example, there is a link between isolation and hallucinations, but you still have to be able to ask these taboo questions. When you have certain symptoms, it seems normal to go and consult for a heart attack, why not in psychiatry?”
“Get the message out that it can affect everyone, and that it’s okay. But there are things we can do”
Still need to have easy access to care, second pitfall. As of March 23, the Syndicate of French Psychiatrists (SPF) thus asked “that the necessary means be deployed (to) ensure prevention as well as continuity of care”.
The crisis could thus be “an opportunity to try to see how we can restart differently, without having to wait months for an appointment,” hopes its president, Maurice Bensoussan. The SPF is already trying to “establish a closer link with city medicine, develop collaborative practices” in order to be “available to respond to new requests” and “prepare for the post-Covid “.
With the aim in mind that Professor Pelissolo sums up: “Spread the message that it can concern everyone, and that it is normal. But that there are things that we can do”.
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