Dearth of mental health support during pandemic for those with chronic health problems

A new scoping review found that those with chronic health concerns, such as diabetes, heart disease, cancer, and autoimmune conditions, are not only at a higher risk of severe COVID-19 infection, they are also more likely to experience anxiety, depression or substance use during the COVID-19 pandemic.

The aim of the review was to address knowledge gaps related to the prevention and management of mental health responses among those with chronic conditions. The findings, recently published in the International Journal of Environmental Research and Public Health, were based on a comprehensive review of 67 Chinese and English-language studies.

"Levels of anxiety, depression, and substance use tended to be more prevalent among those with physical health concerns, and these mental health impacts also interfered with their treatment plans," says first author Karen Davison, Canada Research Chair at Kwantlen Polytechnic University.

Physical and mental health problems often occur together, possibly due to factors such as shared underlying inflammatory responses and the psychosocial effects of living with a health condition, say the study's authors. Economic instability, social isolation, and reduced access to health and social care services also increased the likelihood of mental health concerns among those with a chronic physical health condition.

"These circumstances, which became more prevalent during the pandemic, likely impact an individual's ability to cope," says co-author Professor Simon Carroll from the University of Victoria's Sociology department.

Rapidly spreading misinformation during the pandemic may have also influenced reactions that can worsen mental health.

"Lower levels of health literacy have been associated with poorer physical and mental health," says Brandon Hey, Policy and Research Analyst, COVID 19 Policy, Programs and Priorities at the Mental Health Commission of Canada. "This needs to be addressed by the public health community who can educate and support social and conventional media to accurately deliver information."

The findings and practice recommendations from this review have the potential to inform the work of policy-makers, practitioners, and researchers looking to provide better mental health supports for those with chronic illness.

"Several promising practices include screening for mental health issues, addressing factors such as income support, using digital resources to provide care, and providing services such as patient navigation, group online visits, peer support, and social prescribing," says co-author University of British Columbia Nursing Professor Maura MacPhee.

University of Toronto Social Work Professor, Esme Fuller-Thomson, who is also Director of the Institute for Life Course and Aging, says we now have the opportunity to shape policies, programs, and other efforts to strengthen people's mental health. "Multi-integrated interventions can help provide the supports that are needed to address the complex needs of different populations and foster resilience in times of public health crises," she says.