Behavioral Health in the ED

Coronavirus, or COVID-19, has been making headlines worldwide for the past few months. While our understanding of this virus is still incomplete, it does have strong parallels with the 2003 severe acute respiratory syndrome (SARS) outbreak and has been declared a pandemic by the World Health Organization. The continuing outbreak and the quick spread of this virus are concerning and our response as healthcare providers can make all the difference.

Epidemics Take a Toll on Mental Health

Like other high-stress situations we have covered, epidemics like COVID-19 and SARS affect more than people’s physical health. They take a large toll on society, causing disruptions and stress that can worsen mental health issues and cause new issues to occur in previously mentally well patients.

Paul Gionfriddo, President and CEO of Mental Health America stated in an open letter “For the general public, the mental health effects of COVID-19 are as important to address as the physical health effects. And for the one in five who already have mental health conditions – or the one in two who are at risk of developing them – we need to take personal, professional, and policy measures now to address them.”

Every day new restrictions are being put in place to help enforce public safety and control the spread of the virus. While in the best interest of public health, these new enforcements can cause anxiety and fear.

Unlike in 2003, today’s 24/7 media coverage poses a unique threat in that people worldwide are inundated with information, both heightening alarm through fearmongering and misinformation and providing valuable tools for encouraging precautions and prevention. Over the past few weeks, we have already seen some of the consequences of this fear as people begin to hoard food and medical supplies.

Fear in the face of the unknown is understandable and can lead to increasing levels of stress and anxiety. Those with mental illness are especially vulnerable to the effects of widespread panic and threats. Severe anxiety can lead to a relapse of substance abuse or depression. Even those without previous symptoms can be at risk of developing a psychiatric condition due to the increase in stress, as we have learned from past outbreaks.

In the early stages of the SARS outbreak, patients experienced a multitude of psychiatric conditions, including depression, anxiety, panic attacks, delirium, and even suicide. With COVID-19, the public is also facing fears of quarantine and the boredom and loneliness that come with it.

Healthcare workers are vulnerable to mental health issues as they face a higher threat of infection and many fear spreading the contagion to their family and friends. During the SARS outbreak, 10% of healthcare workers in Beijing experienced high levels of post-traumatic stress. Those who underwent quarantine were 2 to 3 times more likely to have high post-traumatic stress symptoms.

How telepsychiatry can help

Psychiatrists are uniquely qualified to help with the psychological impact of COVID-19. As we learned in previous posts, fewer than 24% of emergency medicine training programs provide any psychiatric training. Health professionals are now expected to work in isolation units in highly stressful situations with patients who are potentially fighting for their lives and are fearful, anxiety-ridden, and likely cut off from contact with their family and friends.

Understandably, both patients and providers benefit from specialized psychiatric care at times like these. So far, mental health for patients and healthcare professionals affected by COVID-19 has been under-addressed. Multidisciplinary teams can work together to provide support and care for both the physical ailments as well as the mental challenges these patients and providers are facing.

MindCare’s industry-leading telepsychiatry platform enables us to bring this specialized care to hospitals when and where it is needed. We offer 24/7 access to board-trained psychiatrists and behavioral health specialists who are well versed in behavioral health patient care and standard operating procedures in emergency departments. All members of our team work to streamline communication and coordination between health professionals on the scene and our team.

Telepsychiatry is also exceptionally suited to help in high-risk infection situations. Virtual visits allow patients in quarantine to receive access to the mental health care they need, without the risk of spreading the contagion. MindCare’s system has been designed to be quickly and seamlessly integrated and complement in-house medical teams.

As we face this new outbreak, society is better equipped because of the technology available to us. Telepsychiatry makes it possible to provide mental health support that is not restrained by location and provides enduring care to help patients return to a normal, healthy life.