On March 11, World Health Organization  Director General Tedros Adhanom officially declared the novel coronavirus disease, COVID-19, a global pandemic.  Since then, governments around the world, including the Quebec government, have dramatically escalated isolation protocols, ordering schools closed, closing borders, and asking employees to work from home. While isolation measures are deemed necessary to protect people’s physical health, governments must note the impact of these measures on individuals’ mental health, and act accordingly. Coronavirus presents not only a public health crisis in physical health, but also a potential crisis in mental health. This will present new challenges for national, provincial, and community public health organizations.

While self-isolation of individuals experiencing confirmed or suspected COVID-19 symptoms already presents mental health challenges for those affected, the recent push for broader social distancing even among the currently healthy extends potential mental health repercussions across society. Take, for example, the most recent social distancing measures imposed by the Quebec government: a ban on all gatherings of crowds larger than 250, and the closure of all academic institutions and daycares. These two measures alone result in substantially decreased social interaction for a large percentage of the province’s population. In addition to government-imposed isolation, many individuals are voluntarily staying home to do their part in “flattening the curve,” working remotely and avoiding all large crowds.

According to the World Health Organization (WHO),  the prevalence of common mental disorders such as depression and anxiety is expected to more than double in a humanitarian crisis.” This is in part due to the extra stress and loss of routine that come with sudden crises. While mental health can deteriorate in any public emergency, the global response to COVID-19 poses an unprecedented challenge due to the unique widespread imposition of self-isolation protocols. 

The WHO has produced general guidelines outlining how to effectively integrate mental health support into emergency response protocols. Current best practice highlights the importance of community and social support, the integration of health services into existing community institutions, and first-line mental health first aid by health professionals. 

The vast majority of these recommendations rely on two key assumptions: first, that responders can interact face-to-face with affected community members; and second, that some level of existing community support can be mobilized. Isolation protocols drastically reduce the extent to which these two pillars can be mobilized.

This is very likely to result in dramatic increases of distress among individuals in isolation. There is a large body of research that links loneliness and social isolation with consequences such as increased release of stress hormones, functional decline and mortality among seniors, and diagnoses of post-traumatic stress disorder in adults and children. These negative health effects may be further compounded by the 24-hour news cycle and the contagion of misinformation, leaving individuals at risk of extreme psychological distress. If isolation is necessary, it is also necessary that provincial and federal public health agencies ensure they are providing the population with as much support as possible.

One important measure governments should take is providing reliable, consistent information to the citizenry.  According to a recent academic review of the psychological consequences of quarantine, providing adequate estimates about the isolation timelines, helping the population understand the reasons behind the decisions being made, and providing consistent updates across multiple mediums have all been proven to significantly decrease stress and fear. 

Further, facilitating online communication between community members and promoting electronic mental health services are paramount, particularly in populations of increased risk (for example elderly individuals) to prevent the compounding consequences of loneliness. One study even demonstrated that creating a support group for individuals in quarantine provided participants with therapeutic benefits. 

While we wait on governments to take the necessary action to address mental health in this crisis, many have taken matters into their own hands. One example is a series of Facebook groups that have been affectionately coined “caremongering” by the Toronto founders. These community groups have popped up all over Facebook and are spaces in which individuals can either offer services/supplies they have available, or ask their community for help with food delivery, prescription refills, and dog-walking among countless others. 

Such examples of group altruism and compassion can do wonders to combate sentiments of hopelessness and fear. In addition to developing mental health infrastructure to see society through the COVID-19 peak, public health officials can encourage and further facilitate such community-driven action.

There is no script to follow in this public health crisis. From a epidemiological perspective the province’s diligence in implementing isolation strategies is likely to dramatically decrease the large-scale spread of the COVID-19 virus. However, these practices will undoubtedly be associated with unintended mental health consequences for Quebec citizens. 

As isolation strategies are likely to escalate in the coming weeks, it is imperative that the Quebec Health Ministry accompany these protocols with as many preventative mental health strategies and resources as possible. In a period of such extreme uncertainty, public health officials face a challenge beyond that of controlling COVID-19; they must find ways to guard citizens’ mental wellbeing while protecting their physical health.

Olivia Frank is the Students’ Society of McGill University Mental Health Commissioner and is finishing her undergraduate degree in psychology. She will be pursuing a Master in Public Health at Columbia University in September 2020.

Edited by Catharina O’Donnell

The opinions expressed in this article are solely those of the author and they do not reflect the position of the McGill Journal of Political Studies or the Political Science Students’ Association. 

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