The potential impact of COVID-19 on mental health outcomes and the implications for service solutions

An evidence review of how infectious disease outbreaks – requiring community or population-level quarantine and / or social isolation – affect the prevalence of mental health conditions within the general population and healthcare workers, and the community and population-level approaches to prevent and address mental health conditions following such outbreaks.

In the context of infectious disease outbreaks requiring community or population-level quarantine and / or social isolation, the researchers aimed to answer the following:

1. What is the impact of such outbreaks on the prevalence of mental health conditions within the general population and across healthcare workers?
2. What community and population-level approaches have been taken to prevent and address the increased levels of mental health conditions following such outbreaks?

Overview of findings

All conclusions should be interpreted cautiously due to contextual factors, methodological differences, mental health outcomes assessed, and the lack of effectiveness data for the second research question.

For the first research question:

• The evidence suggests that an increase in the prevalence of mental health conditions is likely during, and immediately after, the COVID-19 outbreak. However, amongst the general population, this increase subsided after quarantine measures are lifted.
• Healthcare workers are at greater risk of adverse mental health outcomes, particularly those who are frontline staff, who in “high-risk” units, or have been re-deployed to “high-risk” units from other departments.
• Several other groups also appear at risk:
  • those with chronic physical and mental health conditions
  • children and parents
  • those who have lost a family member
  • those with lower levels of education
  • those who perceive themselves to be at risk
  • those who live in outbreak hot spots

For the second research question:

• The general public may automatically adopt behaviours which are protective of their mental health. For example, seeking peer, family and community support.
• Efforts should be taken to avoid / reduce COVID-related stigma – for those who have contracted the virus and for healthcare workers.
• Screening should be used, initially targeted at groups thought to be at greater risk, to determine the tier of support required.
• Most recommendations point towards the use of online, or remote, services and resources (such as hotlines, apps, accurate and up-to-date information) to support at-risk groups and the general population.
• A specific set of recommendations are provided for the prevention and treatment of mental health conditions in healthcare workers.

Citing this report

This report should be cited as:

Nobles, J., Martin, F., Dawson, S., Moran, P. and Savovic, J. The potential impact of COVID-19 on mental health outcomes and the implications for service solutions. 15 April 2020. Available from: https://arc-w.nihr.ac.uk/research-and-implementation/covid-19-response/potential-impact-of-covid-19-on-mental-health-outcomes-and-the-implications-for-service-solutions/