Mental Health and Related Challenges in COVID-19 Era. A Mini Review Volume 46 - Issue 2

Ammara Ghaffar¹, Muhammad Sohail Mushtaq², Keron Akintola Ayodele Blair³, Salma Yusuf⁴, Tai Donovan⁵, Ayesha riaz⁶, Nadeem Iqbal⁷* and Anab Rehan Taseer⁸

• ¹King Edward Medical University, Pakistan
• ²(ELAM) Latin American School of Medicine Cuba, Cuba
• ³American International School of Medicine, Guyana
• ⁴Windsor University School of Medicine, Saint Kitts and Nevis
• ⁵Windsor University School of Medicine, Saint Kitts and Nevis
• ⁶Avecenna Medical College, Pakistan
• ⁷Department of Urology and Kidney Transplant, Pakistan Kidney and Liver Institute Lahore, Pakistan
• ⁸Department of Pulmonology, Lady Reading Hospital Peshawar, Pakistan

Received: September 09, 2022;   Published: September 16, 2022

*Corresponding author: Nadeem Iqbal, Department of Urology and Kidney Transplant, Pakistan Kidney and Liver Institute Lahore, Pakistan

DOI: 10.26717/BJSTR.2022.46.007317

Abstract PDF

Mental health is an important aspect of human life. COVID era was full of the stress of the fear of catching the virus and the loneliness caused by the lockdowns and social distancing measures. It has affected all categories of age and professions, mother, and the children alike. Health care workers were also facing challenges of being over worked and lack of social support. In this mini review, we wanted to summarize the effects of the COVID era on the mental health of different kinds of people.

Keywords: COVID-19; Pandemic; Healthcare Workers; Stress; Depression; Telemedicine Clinic

Mental health is an important aspect of human life. There is extensive literature on the psychological aftermaths of exposure to trauma that showed two risk factors that are most strongly predictive of long-term mental health status including lack of posttrauma social support and exposure to stressors during recovery from trauma [1]. These stressors may be in the form of trauma, such as the death of a close family member or colleague, or attributable to the crisis, such as relationship issues [1-3]. COVID era was full of the stress of the fear of catching the virus and the loneliness caused by the lockdowns and social distancing measures. It has affected all categories of age and professions, mother, and the children alike. Health care workers were also facing challenges of being over worked and lack of social support. In this mini review, we wanted to summarize the effects of the COVID era on the mental health of different kinds of people.

We searched PubMed, and Medline database publications using: COVID-19, Mental health, pandemic. The publications included were special communications, reviews, books, and research studies regarding the subject matter over the last three years.

The COVID-19 pandemic has transformed people’s lifestyles which are attributable to confined movements; rising unemployment; new ways of working from home; absence of physical contact with family members, friends, and colleagues [4]. The most important factor causing this loneliness was the fear of contracting the disease. Other factors that had effects on mental health included the stressful life events, hopelessness, home quarantine, social distancing, wearing face masks and heightened exposure to social media. Good mental health is cardinal to overall health and well-being [3,4]. Hence, it is vital to properly manage mental health problems during the COVID-19 pandemic. During lockdowns children and mothers may be more vulnerable to mental health problems. Mothers living in chaotic households, indicated by disorder, noise, and crowding, acquire inadequate sleep and are more prone to gain obesity [5].

Stress can affect behaviors. The main causes for generating stress are less physical activity, parenting practices, and less duration of sleep [6-8]. There is a need to focus on strategies such as reducing stress and promoting routines [9], with the aim of mothers achieving adequate physical activity and sleep. Regrettably, many households were disrupted during the times of Coronavirus Disease-19 (COVID-19) as inhabitants followed social distancing, which forced them to stay within the confines of their home and limited social meetings [10]. Such changes in routine at individual and community levels may lead to more household chaos and potentially poor mental and physical health. There are both direct and indirect impacts of the pandemic on mothers’ everyday lives. Mothers living in high-income countries have faced disruptions in childcare and heightened domestic demands, and mothers of all countries had to face disproportional job loss compared to fathers. In China, it was noted that having grandparents as caregivers alleviated the stress and was protective against the risk of poor mental health [8-10].

COVID-19 has also affected the adolescents. Adolescence is a transitory phase from childhood into adulthood. According to the United Nation definition, adolescence is the period between 10 and 19 years of age [11,12]. It is a period to develop self-identity, self-esteem, and independence. Therefore, the adolescence period comprises biological and psychosocial factors. Owing to the brain hormonal changes in this period affect cognitive abilities, and emotional and self-control capacities of this age group. Consequently, adolescents experience an excessive sense of selfesteem, self-importance, and uniqueness but at the same time, they might have feelings such as self-criticism, sadness, and anger [12,13]. Adolescents may experience several challenges such as need for self-independence, pressures of academic competence, and uncertainty of future directions of professional career. Such challenges lead to interpersonal conflicts that can lower threshold of the vulnerability to depression, fear, and anxiety.

Thus, being a teenager is quite difficult, and it is thought that the COVID-19 pandemic has made it even worse. For example, to gain the psychosocial strength to support their mental well-being, adolescents may need to stay for a longer time with their peers, participate in outdoor activities and utilize more time at school to support their cognitive development and life skills [12-14]. Therefore, staying at home during the pandemic means students cannot access their school due to the lockdowns, they might lose fervor in every aspect of their lives. A possible remedy for this is tele-education which can maintain adolescents’ daily activities and keep them connected to their peers. Additionally, supportive psychotherapy and psychoeducation for parents, adolescents, and other family members can be arranged through telepsychiatry services during the lockdowns in the pandemic [13,14].

Healthcare workers also faced challenging times during the COVID-19 era. Throughout the COVID-19 pandemic, most healthcare providers have worked diligently for long hours in highpressure environments. Additionally, they may have been exposed to moral dilemmas relating to high demands and the need for accuracy in the delivery of high-quality care. Other challenges they faced were the lack of experience or preparedness or lower staff availability. Another challenge to the frontline healthcare workers was of being isolated and quarantined after duty days, and hence they were more affected psychologically. Inadequate social support arising from isolation and stigmatization added fuel to previous or current psychiatric illnesses among health care workers. There were also disgraceful reports on doctor assaults after the deaths of COVID-19 patients. Such incidents may trigger psychological problems among health care workers during the combat against the pandemic. It is essential to take care of mental health of the health care staff. Switching to a flexible working hour may help mitigate the work-induced distress and therefore alleviate mental health symptoms induced by the COVID-19 pandemic. Local psychiatric teams can be made at an institutional base, which can identify risky staff regularly using simple and survey-based scales. Health care workers should be encouraged to utilize tele psychiatric services whenever they need them. This will result in enhanced efficiency among the health care workers during high pressure times [15-20].

During the COVID-19 pandemic, many mothers experienced poor sleep that led to stress. Moreover, adolescents had their own psychological challenges made worse by the social distancing and lockdowns. Health care workers were challenged due to over exhaustion and consistent exposure to COVID patients. Such problems underscore the need of social support and utilization of telepsychiatry services whenever needed by anyone.

1. Brooks SK, Rebecca Dunn, Richard Amlôt, Gideon James Rubin, Neil Greenberg (2018) A systematic, thematic review of social and occupational factors associated with psychological outcomes in healthcare employees during an infectious disease outbreak. J Occ Environ Med60(3): 248-257.
2. Greenberg N, Mary Docherty, Sam Gnanapragasam, Simon Wessely (2020) Managing mental health challenges faced by healthcare workers during covid-19 pandemic. Br Med J 368: m1211.
3. Brooks SK, R Amlôt, GJ Rubin, N Greenberg (2020) Psychological resilience and post-traumatic growth in disaster-exposed organisations: overview of the literature. BMJ Mil Health166(1): 52-56.
4. Milligan Saville JS, Leona Tan, Aimée Gayed, Caryl Barnes, Ira Madan, et al. (2017) Workplace mental health training for managers and its effect on sick leave in employees: a cluster randomised controlled trial. Lancet Psychiatry4(11): 850-858.
5. Marsh S, Dobson R, Maddison R (2020) The relationship between household chaos and child, parent, and family outcomes: a systematic scoping review. BMC Public Health 20: 513.
6. McQuillan ME, Bates JE, Staples AD, Kirby Deater-Deckard (2019) Maternal stress, sleep, and parenting. J Fam Psychol 33(3): 349-359.
7. Slavish DC, Asbee J, Veeramachaneni K, Brett A Messman, Bella Scott, et al. (2020) The cycle of daily stress and sleep: sleep measurement matters. Ann Behav Med 55(5): 413-423.
8. Dunton GF, Ke W, Dzubur E, Sydney G O'Connor, Nanette V Lopez, et al. (2019) Within-subject effects of stress on weight-related parenting practices in mothers: an ecological momentary assessment study. Ann Behav Med 53(5): 415-425.
9. Carroll N, Sadowski A, Laila A, Valerie Hruska, Madeline Nixon, et al. (2020) The impact of COVID-19 on health behavior, stress, financial and food security among middle to high income Canadian families with young children. Nutrients 12(8): 2353.
10. Kotlar B, Gerson E, Petrillo S, Ana Langer, Henning Tiemeier (2021) The impact of the COVID-19 pandemic on maternal and perinatal health: A scoping review. Reprod Health 18: 10.
11. Bahn GH (2020) Coronavirus Disease 2019, School Closures, and Children's Mental Health. Soa Chongsonyon Chongsin Uihak 31(2): 74-79.
12. Sawyer SM, Azzopardi PS, Wickremarathne D, Patton GC (2018) The age of adolescence. Lancet Child Adolesc Health 2(3): 223-228.
13. Chen WC, Huang AS, Chuang JH, Chiu CC, Kuo HS (2011) Social and economic impact of school closure resulting from pandemic influenza A/H1N1. J Infect 62(3): 200-203.
14. Fegert JM, Vitiello B, Plener PL, Clemens V (2020) Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child Adolesc Psychiatry Ment Health 14: 20.
15. Robertson E, Hershenfield K, Grace SL, Stewart DE (2004) The psychosocial effects of being quarantined following exposure to SARS: a qualitative study of Toronto health care workers. Can J Psychiatry 49: 403-407.
16. Chen Q, Liang M, Li Y, Guo J, Fei D, et al. (2020) Mental health care for medical staff in China during the COVID-19 outbreak. Lancet Psychiatry 7: e15-e16.
17. Zhou Y, Ding H, Zhang Y, Zhang B, Guo Y, et al. (2021) Prevalence of poor psychiatric status and sleep quality among frontline healthcare workers during and after the COVID-19 outbreak: a longitudinal study. Transl Psychiatry 11: 223.
18. Yıldırım M, Solmaz F (2020) COVID-19 burnout, COVID-19 stress and resilience: Initial psychometric properties of COVID-19 Burnout Scale. Death Stud.
19. Şahin MK, Aker S, Şahin G, Karabekiroğlu A (2020) Prevalence of depression, anxiety, distress and insomnia and related factors in healthcare workers during COVID-19 pandemic in Turkey. J Community Health 45(6): 1168-1177.
20. Amna Khan, Oluwasegun Afolabi Shoewu, Ahmed Abdullah, et al. (2022) Geriatric Care and Related Challenges in Covid Era-Mini Review Article. Biomed J Sci & Tech Res 45(3).