Depression & Mental Health Issues Re: Covid 19

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Depression & Mental Health Issues Re: Covid 19

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WHO and partner organizations call for massive scale-up in investment in mental health

8/28/20

https://www.news-medical.net/news/20200 ... ealth.aspx

Mental health is one of the most neglected areas of public health. Close to 1 billion people are living with a mental disorder, 3 million people die every year from the harmful use of alcohol and one person dies every 40 seconds by suicide.

And now, billions of people around the world have been affected by the COVID-19 pandemic, which is having a further impact on people's mental health.

Yet, relatively few people around the world have access to quality mental health services. In low- and middle-income countries, more than 75% of people with mental, neurological and substance use disorders receive no treatment for their condition at all.

Furthermore, stigma, discrimination, punitive legislation and human rights abuses are still widespread.

The limited access to quality, affordable mental health care in the world before the pandemic, and particularly in humanitarian emergencies and conflict settings, has been further diminished due to COVID-19 as the pandemic has disrupted health services around the world.

Primary causes have been infection and the risk of infection in long-stay facilities such as care homes and psychiatric institutions; barriers to meeting people face-to-face; mental health staff being infected with the virus; and the closing of mental health facilities to convert them into care facilities for people with COVID-19.

Move for mental health: Let's invest

That's why, for this year's World Mental Health Day, WHO, together with partner organizations, United for Global Mental Health and the World Federation for Mental Health, is calling for a massive scale-up in investment in mental health.

To encourage public action around the world, a World Mental Health Day campaign, Move for mental health: let's invest will kick off in September.

" World Mental Health Day is an opportunity for the world to come together and begin redressing the historic neglect of mental health."

-Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization

"We are already seeing the consequences of the COVID-19 pandemic on people's mental well-being, and this is just the beginning. Unless we make serious commitments to scale up investment in mental health right now, the health, social and economic consequences will be far-reaching."

During the past few months, the World Health Organization has issued, in collaboration with partners, guidance and advice on mental health for health workers and other frontline workers, managers of health facilities, and people of all ages whose lives have changed considerably as a result of the pandemic.

With the disruption in health services, countries are finding innovative ways to provide mental health care, and initiatives to strengthen psychosocial support have sprung up. Yet, because of the scale of the problem, the vast majority of mental health needs remain unaddressed.

The response is hampered by chronic under-investment in mental health promotion, prevention and care for many years before the pandemic.

Countries spend just 2% of their health budgets on mental health


Countries spend on average only 2% of their health budgets on mental health. Despite some increases in recent years, international development assistance for mental health has never exceeded 1% of all development assistance for health.

This is despite the fact that for every US$ 1 invested in scaled-up treatment for common mental disorders such as depression and anxiety, there is a return of US$ 5 in improved health and productivity.

World Mental Health Day: An opportunity to commit

The World Mental Health Day campaign will offer opportunities, primarily online given the continuing pandemic, for all of us to do something life-affirming: as individuals, to take concrete actions in support of our own mental health, and to support friends and family who are struggling; as employers, to take steps towards putting in place employee wellness programmes; as governments, to commit to establishing or scaling-up mental health services; and as journalists, to explain what more can and must be done to make mental health care a reality for everyone.

"It is nearly 30 years since the first World Mental Health Day was launched by the World Federation for Mental Health," said Dr Ingrid Daniels, President of the World Federation for Mental Health.

"During that time, we have seen an increasing openness to talk about mental health in many countries of the world. But now we must turn words into actions. We need to see concerted efforts being made to build mental health systems that are appropriate and relevant for today's – and tomorrow's - world.

"With so many people lacking access to good quality, appropriate mental health services, investment is needed now more than ever," said Elisha London, Founder and CEO of United for Global Mental Health. "Everyone, everywhere can participate in this year's campaign.

Whether you have struggled with your own mental health, know someone who has been affected, are a mental health expert, or if you simply believe that investing in mental health is the right thing to do, move for mental health, and help make mental health care and support accessible for everyone."

Key events

United for Global Mental Health: The 24-hour march for mental health


On 9 October, people from around the world will be encouraged to participate in a virtual march. A 24-hour livestream will feature people with lived experience, mental health leaders and influencers from the civil society groups already active in 19 countries through the Speak Your Mind campaign.

In addition, global partner organizations that are leading and coordinating work on mental health are organizing hour-long sessions on specific themes, including mental health and young people, mental health and older people, and mental health and the LGBTQ+ community. Confirmed partners include Human Rights Watch and Alzheimer's Disease International.

The March will help increase awareness of mental health issues, break down stigma and bring about policy change. Members of the public will be urged to "add their voice" and join the March using online filters to be released in the lead-up to the event.

WHO: The big event for mental health

On World Mental Health Day, 10 October, the World Health Organization will, for the first time ever, host a global online advocacy Event on mental health. At this event - the Big Event for Mental Health - WHO will showcase the work that its staff are doing around the world to reduce mental illness and the harmful use of alcohol and drugs.

World leaders and mental health experts will join the WHO Director-General to talk about their commitment to mental health and what more must be done. World-renowned musicians who have spoken out about the importance of mental health will talk about their motivation and perform.

Sportsmen and women whose lives have been affected by mental ill health will share their experiences and how they have dealt with conditions such as depression and anxiety.

During the Event, a Special Prize for a mental health film, a newly-created category of WHO's inaugural Health for All Film Festival, will be awarded.

World Federation for Mental Health: education and awareness raising

The Federation's campaign kicks off on 1 September, with the Federation's President launching the 2020 World Mental Health Day Campaign Educational Material "Mental Health for All: Greater Investment - Greater Access" under the Royal Patronage of HRH Princess Iman Afzan Al-Sultan Abdullah of Malaysia.

This includes a Call to Action 2020 from Pamela Y. Collins and Deepa Rao, and will be followed by 45 days of awareness-raising activities led by the Federation's youth section, including a global online discussion forum and art exhibition.
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Re: Depression & Mental Health Issues Re: Covid 19

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Older adults experienced mental health problems during COVID-19 pandemic

8/27/20

https://www.news-medical.net/news/20200 ... demic.aspx

Older adults experienced greater depression and loneliness during the COVID-19 pandemic, according to a new study by Indiana University researchers, and relationship strength (perceived closeness to network members) moderated the relationship between loneliness and depression.

The study, published in The Journal of Gerontology: Series B, was authored by Anne Krendl, associate professor in the College of Arts and Sciences' Department of Psychological and Brain Sciences and Brea Perry, professor in the Department to Sociology at IU Bloomington.

" What we found is the pandemic was associated with worse mental health outcomes for many older adults. However, for some, having close social networks seemed to serve as a protector against negative mental health outcomes."

-Anne Krendl, Associate Professor, College of Arts and Sciences' Department of Psychological and Brain Sciences

Krendl and Perry's study examined whether social isolation due to the COVID-19 shelter-in-place orders was associated with greater loneliness and greater depression for older adults, and, if so, whether declines in social engagement or relationship strength moderated that relationship. Researchers compared personal social networks, subjective loneliness and depression of 93 older adults in the Bloomington community, six to nine months prior to the pandemic and from late April to late May when most people were under stay-at-home orders.

Two-thirds (68 percent) of older adults reported spending less time than before with people they loved, according to the study, and 79 percent felt like their social life decreased or was negatively affected by COVID-19. However, 60 percent reported spending somewhat or much more time reconnecting or catching up with people they cared about and 78 percent were using some form of internet technology to keep in touch during the pandemic. On average, older adults reported spending about 76 minutes socializing virtually or over the phone each day.

"Although prior research has shown that people in this age group are not avid users of social media, the pandemic seems to have moved the needle, with more older people relying on social media to try to stay connected," Krendl said.

Research has shown that loneliness is associated with a number of negative outcomes for older adults, including higher rates of depression and higher mortality, while closeness to individuals in their networks can result in greater emotional well-being .

"Although older adults were relatively adaptable in staying connected during the pandemic, we found that adults who felt less close to their social network during the pandemic experienced increased depression. However, for older adults who felt closer to their social networks during the pandemic, depression only increased markedly for those who also had experienced a large increase in loneliness."

It is important, Krendl said, to fully understand the short-term impact the pandemic has had on older adults' mental health well-being so resources and services can be available to those who need it. Furthermore, Krendl will continue to follow up with those who took part in the survey, to see if changes in their mental health remain short-term or lead to permanent changes.

"One period of increased mental health problems does not necessarily mean a permanent change," she said. "But certainly, periods of mental health distress can have longer term implications for health and well-being. Characterizing those shifts will be important for understanding the full impact of the pandemic on older adults' mental and social wellbeing."

The study was conducted with support from the IU Office of the Vice President for Research.
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Re: Depression & Mental Health Issues Re: Covid 19

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Study shows potential of digital mental healthcare to help people during COVID-19 pandemic

8/31/20

https://www.news-medical.net/news/20200 ... demic.aspx

The COVID-19 pandemic has caused worldwide fear, uncertainty and restriction of movement. The physical distancing, socio-economic consequences of quarantine measures, and the loss of social support are a grave threat to public mental health. One way to help counter and resolve some of these issues is the spread of digital mental health. A study published today by the research group of Professor Claudi Bockting (Centre for Urban Mental Health, University of Amsterdam) shows that digital psychological interventions can effectively diminish the symptoms of mental disorders including depression and substance use, even in low and middle income countries.

With large proportions of worldwide populations living with the consequences of quarantine measures, mental health fallout from the pandemic has been mounting. Digital psychological interventions can be a useful tool to reach those affected by mental health problem who otherwise have limited human contact.

" Our study can help to further encourage digital psychological help for those experiencing mental health problems, during and after the COVID pandemic."

-Professor Claudi Bockting, Centre for Urban Mental Health, University of Amsterdam

Digital technology has, of course, reshaped our life globally, including in the field of psychotherapy. Digital mental health is widely applied in the care settings in Western countries. But nearly 80% of the worldwide population lives in low and middle-income countries, where they face a drastic shortage of mental health professionals. Psychotherapy adapted into a digital format is emerging as a promising compliment to standard in-person care. And this applies more than ever during a global health emergency such as COVID-19.

For the first time, researchers have been able to demonstrate the potential of digital mental healthcare in low and middle-income countries. On aggregate, based on 22 randomized controlled trials globally, digital psychological interventions effectively diminished the symptoms of mental disorders, including depression and addiction. The meta-analyses has been published in Lancet Psychiatry.

One of the researchers, ZhongfangFu, explains: 'Our meta-analysis demonstrated that internet interventions as delivered by, for instance, a website or a smartphone app have robust effects in treating mental health conditions in low and middle income countries. Thanks to these interventions, in addition to growing internet coverage and expansion of smartphone use, more people suffering from mental health problems can be reached. In particular young people who are familiar with digital technology can easily be reached.'
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Re: Depression & Mental Health Issues Re: Covid 19

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Research project to understand the psychological aspects of COVID-19

9/1/20

https://www.news-medical.net/news/20200 ... ID-19.aspx

SMU Office of Research and Tech Transfer - In response to the rapidly evolving COVID-19 pandemic, the Psychological Science Accelerator (PSA) issued a call on March 13th for rapid and impactful proposals to understand the psychological and behavioral aspects of the pandemic. Singapore Management University (SMU) Assistant Professor of Psychology (Education) Andree Hartanto was invited to participate in the project.

"My contribution was to comment on the research proposal before the study began, do pilot testing on the study with researchers from other labs, and run the actual study in Singapore," Professor Hartanto told the Office of Research and Tech Transfer.

The PSA is a globally distributed network of over 500 psychological science laboratories, representing over 70 countries on all six continents, that coordinates data collection for democratically selected studies. Its mission is to accelerate the accumulation of reliable and generalizable evidence in psychological science, reducing the gap between truth about human behavior and mental processes and our current understanding.

Accepted for publication

The research project broadly aims to provide suggestions on how to best ensure compliance with health-promoting behaviors and manage negative feelings associated with the pandemic, as the mitigation of a pandemic depends on how the population, as a whole, engage in behaviors that limit the spread of the virus.

While the study is due to be completed later this year, it has already been accepted for publication in principle by Nature Human Behaviour, an online-only monthly journal dedicated to the best research into human behavior from across the social and natural sciences.

"The remarkable part about this project is that the proposal was accepted as a registered report at Nature Human Behaviour, meaning that regardless of whether the results are positive or negative, it will still be published there," Professor Hartanto enthuses.

Professor Hartanto appointed Nadyanna Majeed, a fourth-year SMU undergraduate in Psychology and his former independent study student, as the lead investigator for the project at SMU. "I believe it will provide a unique and important learning opportunity for Nadya as an undergraduate, and as she fast tracks to graduate school in August this year."

As the lead investigator, Nadya tells the Office of Research & Tech Transfer that she is responsible for all aspects of the study in Singapore, where SMU is the only participating institution. "It includes roles such as recruiting participants, running the actual study, and also administrative tasks such as making sure the participants receive their remuneration."

The study


Apart from the research team at SMU, there are over 100 other labs from various countries collaborating on data collection for this project. The project is made up of three sub-studies, each focusing on a different aspect.

The first sub-study draws on insights from behavioral science and public health, and seeks to understand if message framing in terms of gains (e.g. protecting others) versus losses (e.g. endangering others) can improve policy support, information seeking, and intentions to engage in preventative behavior related to COVID-19.

The second sub-study is related to coping with negative emotions, as negative emotions triggered by the COVID-19 outbreak can have detrimental effects on people's health and well-being. One way in which people cope with negative emotions is by employing emotion-regulation strategies that alter the strength of their emotional responses. This sub-study compares the effectiveness of various coping strategies related to distressing information about the pandemic, such as photographs of sick people in the news.

The last sub-study aims to test the effectiveness of different types of messages encouraging social distancing.

" Specifically, we compare the effectiveness of an autonomy-supportive message, which strives to take the person's perspective and provide rationale and structure for the desired behavior, versus a controlling message, which uses more pressuring, prescriptive language, versus no specific message where the objective or factual information is presented in a neutral tone, without any extra affirmation."

-Nadyanna Majeed, a fourth-year SMU undergraduate in Psychology

Methodology

Research studies in SMU are normally conducted in the psychology lab, but due to COVID-19, the team is unable to carry out their study in person. Instead, the study is conducted online. Participants are recruited through SMU's subject pool system and are assigned to a bundle of sub-studies randomly and within each sub-study, they are also randomly assigned to a condition as the study uses a within-subjects design.

"Participants are assigned to one of two bundles: the message-framing bundle which comprises two sub-studies, or the emotion-regulation bundle," Nadya clarifies. "To complete all three sub-studies would not be feasible as it would take up too much time for each participant."

In the first sub-study in the message-framing bundle, participants are randomly assigned to either a gain condition where behaviors are framed as protecting others, or a loss condition where the behaviors are framed as endangering others. Participants are shown messages that are framed accordingly. Then, they are asked about their attitudes and opinions about relevant health policies and their desire to seek more information related to the pandemic, and their intentions to engage in preventative behaviors against COVID-19.

In the second sub-study, participants are randomly assigned to read either a supportive message, a controlling message, or a neutral message. The supportive message stresses the rationale behind and structure of the desired behavior of social distancing, and takes on a more understanding and sympathetic tone, whereas with the controlling message, pressurising language is used to coerce people into complying. After viewing their assigned message, participants report whether they would or would not comply with the social distancing measures.

In the emotion-regulation bundle, participants are randomly assigned to and taught a coping strategy, which they will then use throughout the experiment. They are shown a series of distressing photographs of COVID-19 taken from news agencies around the world, and are asked to use their assigned coping strategy to regulate their emotions.

Benefits of the study

Nadya believes that the way a message is framed and how we choose to cope in a crisis is important because it can have impacts on how relevant organizations may choose to enact their policies. Governments or health authorities can use the knowledge from the study to better address their citizens or patients by creating effective messages in their press releases, infographics, and information on their websites, so as to increase compliance with important behaviors such as social distancing and wearing masks. Ultimately, these measures are important in helping to slow the spread of the virus.

"Virus transmission cannot be addressed alone. We've seen during this pandemic that the whole population must work together to reduce the spread. Ensuring that messages are effective is important in preventing even more people from getting sick and losing their lives, as even one individual choosing not to cooperate can endanger their whole community," Nadya argues.

She adds: "The results from the emotion-regulation study can be used by mental health professionals such as counselors, psychologists, and social workers to help individuals cope with distressing events. Not just with regard to this pandemic, but also in general. From this study, we can see which strategies are more effective than others. It's important that we find effective coping strategies so that people can find the best ways to cope."
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Re: Depression & Mental Health Issues Re: Covid 19

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New emergency program provides mental health care across Colorado

9/2/20

https://www.news-medical.net/news/20200 ... orado.aspx

The COVID-19 pandemic's effects run deep - far beyond the virus's immediate infections. From loss of livelihoods to drastic decreases in social connection, people across the country are suffering ongoing emotional strain. And that has psychological health researchers, like Colorado State University's Deborah Essert, worried.

Essert is the director of the Psychological Services Center, operated through the psychology department in the College of Natural Sciences, which serves members of the greater Fort Collins community.

" As the state moved to a stay-at-home order in the spring, I saw the need for it from a community medical health perspective. At the same time, my heart ached knowing how much the isolation, increased stress, and economic upheaval would negatively impact the emotional well-being and physical safety of so many in Colorado."

-Deborah Essert, Psychological Health Researcher, Colorado State University.

So she, along with Brad Conner, who directs the addiction counseling master's program in the department, have created an initiative to provide an emergency expansion of mental health care across the state, with a focus on suicide prevention during the pandemic.

The program is being supported by a grant of almost $800,000 from the U.S. Department of Health and Human Services' Substance Abuse and Mental Health Services Administration (SAMHSA).

The state of Colorado already had the seventh highest number of deaths by suicide in the country before the pandemic. For example, in 2017, the latest year for which CDC data is available, more people in Colorado died by suicide than from diabetes or drug overdoses.

The pandemic threatens to make that worse.

"When we are faced with an unknown threat, it is easy to become myopic," Essert says. She feels that with so much attention on the virus itself, the mental health impacts of the pandemic have been neglected.

"This is why the Federal Aviation Administration requires two crew members in the cockpit at all times - while one is focusing on a new immediate problem, the other can keep the plane in the air," she explains. "When we went to stay-at-home orders for COVID-19, as a mental health provider, I felt locked out of the cockpit."

With the new statewide suicide prevention program, she hopes she and the team can help more people stay aloft in this turbulent time.

Stopping the spread of the novel coronavirus has, understandably, been a top priority, as the death toll continues to increase. But, notes, Essert, "many of the safety measures taken to slow the spread of COVID-19 and their repercussions are associated with higher suicidality - including isolation, strained family relationships, financial insecurity, and marital distress," she says.

"And when you take increased feelings of loneliness, fear, and confusion, add to it the possibility of using substances to cope with the sudden uptick in sustained stress, and then drastically reduce and complicate access to mental and behavioral health care, it is like a perfect storm for increased mental health symptoms and suicidality."

The new emergency program will focus, in particular, on communities and individuals at highest risk, including rural and agricultural areas, the uninsured, and people with substance-use disorders.

Others in the community who might be assumed to be well-situated to get help they might need are also going unnoticed. Frontline health care workers, particularly in the middle of a pandemic, often don't have their mental health needs recognized, Essert notes, which is why support for this group also will be a focus in the new program.

Also at considerable risk are those experiencing domestic violence and their children, as increased isolation is associated with a greater threat to physical safety and suicidality.

This group that was "nearly invisible and voiceless before the pandemic now has even fewer eyes on them, which means less access to support," Essert says. "For some of the most vulnerable and desperate in our community, the motto that families are 'safer at home' is horribly untrue."

While the pandemic has added strain to most everyone's lives, Essert has seen from their work at the Psychological Services Center that it has pushed many people who were already struggling to manage daily life into much higher risk for self-harm.

"Part of the aim of this project is to bring to light that, for some, there are dangers more powerful, and more proximal, than the threat posed by COVID-19," Essert says. "For some, the more imminent danger is the one waiting for them at home, or the threat they pose to themselves when they are home alone."

The new SAMHSA grant will enable Essert and Conner and their team (which also includes Lorann Stallones, a professor in the psychology department and director of the Colorado Injury Control Research Center, Paula Yuma, an assistant professor of social work in the College of Health and Human Sciences, and Heather Schatten of Brown University) to immediately begin training more providers throughout the state in evidence-based practices put forth by the U.S. Centers for Disease Control and Prevention.

"We aim to reduce suicidality by reducing risk factors and promoting protective factors within the individual - and in the systems around them," Essert explains.

The project, which is a collaboration among the psychology department's Counseling Psychology and Masters in Addiction Counseling programs, the School of Social Work, and the Colorado School of Public Health, will partner with agencies in the area and across the state, including the University of Colorado Health system, Crossroads Safehouse, La Familia, Sandstone Care, and the 17th Judicial District Diversion Program.

This is just the beginning of their new network. They plan to add more groups and agencies in the near future (with a priority to those who serve rural communities, underserved groups, and people experiencing domestic violence).

In fact, when they put out a call for partners earlier this year, Essert says, "the response and support from across the state was actually overwhelming. It seems everyone feels the need to strengthen the links around mental health right now."

At the CSU-based Psychological Services Center, the grant will allow the team to deploy an Integrated Suicide Treatment Team that will be able to see at least 60 new clients.

The grant officially began at the end of July, and Essert, Conner, and the group have been hiring and training additional staff. "We plan to be offering services and training to the community by September," she says.

And that can't come too soon.

"We are all being stretched to understand and manage a new normal," Essert says. "While that can bring about some solidarity and resilience, it can also leave us feeling depleted and susceptible to feelings of depression, anxiety, and other emotional struggles."

Soon there will be more life-saving resources for people to turn to across the state.
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Re: Depression & Mental Health Issues Re: Covid 19

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Depression symptoms have tripled during COVID-19 pandemic, finds study

9/2/20

https://www.news-medical.net/news/20200 ... study.aspx

A first-of-its-kind study from the Boston University School of Public Health (BUSPH) finds 27.8% of U.S. adults had depression symptoms as of mid-April, compared to 8.5% before the COVID-19 pandemic.

Published in the journal JAMA Network Open, the study also found that income and savings are the most dramatic predictors of depression symptoms in the time of COVID.

"Depression in the general population after prior large scale traumatic events has been observed to, at most, double," says study senior author Dr. Sandro Galea, Dean and Robert A. Knox Professor at BUSPH, citing examples such as September 11, the Ebola outbreak, and civil unrest in Hong Kong.

"We were surprised to see these results at first, but other studies since conducted suggest similar-scale mental health consequences," Galea says. These studies have mainly been conducted in Asia and focused on specific populations such as healthcare workers and college students (one such study found depression symptoms among half of Chinese healthcare workers who had treated COVID patients).

But the new BUSPH study is the first nationally-representative study in the U.S. to assess the change in depression prevalence before and during COVID using the Patient Health Questionnaire-9 (PHQ 9), the leading self-administered depression screening tool.

The researchers used data from 5,065 respondents to the 2017-2018 National Health and Nutrition Examination Survey (NHANES), and 1,441 respondents from the COVID-19 Life Stressors Impact on Mental Health and Well-Being (CLIMB) study, which was conducted from March 31 to April 13, 2020, when 96% of the U.S. population was under stay-at-home advisories or shelter-in-place policies.

Both surveys used the PHQ 9 to assess depression symptoms and gathered the same demographic data, and the 2020 survey also gathered data on COVID-related stressors including job loss, the death of a friend or loved one from COVID, and financial problems.

Across the board, the researchers found an increase in depression symptoms among all demographic groups. Not surprisingly, experiencing more COVID-related stressors was a major predictor of depression symptoms.

However, the biggest demographic difference came down to money. After adjusting for all other demographics, the researchers found that, during COVID, someone with less than $5,000 in savings was 50% more likely to have depression symptoms than someone with more than $5,000.

Persons who were already at risk before COVID-19, with fewer social and economic resources, were more likely to report probable depression, suggesting that inequity may increase during this time and that health gaps may widen.

" We would hope that these findings promote creating a society where a robust safety net exists, where people have fair wages, where equitable policies and practices exist, and where families can not only live on their income but can also save money towards the future."

-Catherine Ettman, study lead author, doctoral student at the Brown University School of Public Health and director of strategic development in the Office of the Dean at BUSPH

As COVID continues to grip the country, Ettman says, "There may be steps that policymakers can take now to help reduce the impact of COVID-19 stressors on depression, such as eviction moratoria, providing universal health insurance that is not tied to employment, and helping people return to work safely for those able to do so."

At the same time, Ettman says she and her colleagues hope the study findings will also help those who are experiencing depression in this incredibly difficult time see that they are not alone: On the contrary, one in four U.S. adults is probably going through the same thing.
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Re: Depression & Mental Health Issues Re: Covid 19

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Caring for newly diagnosed dementia patients associated with increase in depressive symptoms

9/2/20

https://www.news-medical.net/news/20200 ... ptoms.aspx

Caring for a partner or spouse with a new diagnosis of Alzheimer's or related dementia is associated with a 30% increase in depressive symptoms, compared to older adults who don't have a spouse with dementia--and these symptoms are sustained over time, a new University of Michigan study found.

This sustained depression over time is important because partners are often caregivers for many years, said Melissa Harris, a doctoral student in the U-M School of Nursing and the study's lead author.

Research suggests that depression can spike after a traumatic event--cancer diagnosis, accident, death, etc.--but that most people often return to their previous emotional health. That didn't happen with the dementia caregivers.

Harris and U-M nursing professors Geoffrey Hoffman and Marita Titler analyzed Health and Retirement Study data from 16,650 older adults--those without a partner diagnosis of dementia, those with a partner whose diagnosis was within the past two years and those with a partner whose diagnosis was older than two years.

The U-M study differs from previous studies in a couple of important ways, Harris says. She and her colleagues looked at depressive symptoms over time (rather than a snapshot in time) and at the number of reported depressive symptoms, as opposed to only diagnoses of major depression--a threshold that's rarely met. Depression can range from severe and persistent to mild and temporary, but even the latter can significantly reduce quality of life.

The average number of depressive symptoms reported by older adults with partners without dementia was 1.2. People whose partners were diagnosed within the last two years reported an additional .31 symptoms (27% increase) and those with partners diagnosed more than two years ago reported an additional .38 symptoms (33% increase). Researchers adjusted for sociodemographic, health and health behavior differences in partners.

" This may not seem like a huge increase in depressive symptoms, but think about feeling depressed or feeling restless everyday. That can mean a lot in the life of a caregiver."

-Melissa Harris, Doctoral Student, U-M School of Nursing

The increase in symptoms is also important because previous research conducted by Hoffman, assistant professor of nursing and senior author on the current study, found that similar changes in depressive symptoms was associated with a 30% increase of fall risk.

"We know that falls are another common debilitating outcome for this group, so the change in depressive symptoms we saw could also imply changes in a caregiver's physical and functional health," Harris said.

"Whether it's carers protecting family members from injury, as we found in prior work, or a spouse's dementia status affecting the carer, as we found in this study, we have seen that family members deeply affect each other's health, so clinical and supportive care must orient more around the needs of the family," Hoffman said.

The social isolation caused by the pandemic only adds to the caregiver's burden.

"The pandemic is adversely affecting family caregivers because of social isolation, and also because resources have been canceled or now have limited access," Harris said. "Many caregivers have said they already felt socially isolated and that the pandemic has just amplified those feelings."

Most people in the early stages of dementia still live at home and are cared for by unpaid family members, primarily partners and spouses, Harris said.

The takeaway for caregivers?

"It's so important to ask for advice and support early on," Harris said. "We saw these increases within two years and they were sustained for two years and beyond. Caregivers should remember that their health is just as important as their partner's and substantially impacts the health of the person with dementia.
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Re: Depression & Mental Health Issues Re: Covid 19

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Remote delivery of mental health care across the U.S. has increased dramatically

9/3/20

https://www.news-medical.net/news/20200 ... cally.aspx

The COVID-19 pandemic has spurred a remarkable number of psychologists across the United States to shift to delivering mental health care to patients remotely, according to a national study led by researchers at Virginia Commonwealth University.

The study, "The COVID-19 Telepsychology Revolution: A National Study of Pandemic-Based Changes in U.S. Mental Health Care Delivery," which was published in the journal American Psychologist, involved a survey of 2,619 licensed psychologists across the country and found that the amount of clinical work performed via telepsychology had increased 12-fold since the pandemic began.

Prior to the pandemic, psychologists reported performing 7.07% of their clinical work with telepsychology. During the pandemic, that number has soared to 85.53%. And 67.32% of psychologists reported conducting all of their clinical work with telepsychology, the study found.

"I was shocked to see how quickly telepsychology was adopted," said lead author Brad Pierce, a doctoral student in the Department of Psychology in the College of Humanities and Sciences.


" The shift from 7% of clinical work to more than 85% represents a lot of heavy lifting in a very short time. There was a concerted effort among the community to identify and remove long-standing barriers. Psychologists sought out additional training, equipment was purchased, and policies were adjusted at every level to facilitate telehealth and telepsychology."

- Brad Pierce, Study Lead Author and Doctoral Student, Department of Psychology, College of Humanities and Sciences

Pierce is part of the Social Justice in Disability and Health Lab at VCU, which aims to understand and dismantle barriers to psychological services confronted by underserved groups with disabilities and chronic health conditions. As part of that work, the lab has conducted studies into the adoption of telepsychology and its potential to address disparities in health care.

"I was proud of the mental health care community's response to COVID-19 when the need for physical distancing became apparent," Pierce said. "People still need psychological services, and the community rolled up their sleeves and got to work. Our team recognized a revolution was taking place and we wanted to gain insight about these changes as they were occurring."

After the pandemic ends, the study found, many psychologists anticipate they will continue to treat patients remotely. According to the study, psychologists projected they would continue to perform 34.96% of their clinical work with telepsychology.

"I'm hopeful that these trends show that psychology as a field is able to adapt to the needs of both providers and patients," said co-author Grace McKee, Ph.D., a Mid-Atlantic Mental Illness Research Education and Clinical Center Advanced Psychology Fellow at the Central Virginia VA Health Care system, and who is affiliated with the Department of Psychology at VCU.

Of course the initial wave of telepsychology during the pandemic has been out of necessity, but our findings suggest to me that there are benefits to continue offering it in the future even when it is safe to attend in person."

Telepsychology can be more convenient for both providers and patients, McKee said, particularly for people who may have difficulty attending in person -- whether because of financial or transportation limitations, conflicts with work schedules, responsibilities like caring for children or family members, or mobility issues due to illness or disability.

At the same time, she said, many psychologists and patients may prefer in-person treatment, and many patients lack access to the technology and to a private, safe space needed to use telepsychology.

"I think the flexibility to offer both in-person and telepsychology services is critical in being able to meet patients' needs and making psychological services more accessible," McKee said.

While the researchers found a significant shift to telepsychology, the trend was not uniform across the profession.

Psychologists working in outpatient treatment facilities saw particularly high increases, with a more than 26-fold increase in telepsychology use during the pandemic, the study found. Meanwhile, psychologists working in Veterans Affairs medical centers only reported a sevenfold increase, likely due in part to the high rates of telepsychology use in VA medical centers before the pandemic.

A larger increase in the adoption of telepsychology was seen among women, among psychologists who had access to training in telepsychology and supportive organizational policies, and among psychologists who worked in settings specializing in relationship issues, anxiety and women's issues.

"Historically, women have tended to provide the bulk of child care. We think it's possible that women psychologists with children may have needed to use telepsychology at higher rates in order to continue to provide child care in the home, especially when most schools and day cares were closed," McKee said.

"In contrast, men may have had the ability to continue some degree of in-person clinical work, particularly if they had a partner who was able to provide child care."

The lowest increases in telepsychology were found among psychologists working in rural areas and in settings that specialized in treating antisocial personality disorder, performing testing and evaluation, and treating rehabilitation populations.

Paul Perrin, Ph.D., an associate professor in the Department of Psychology and director of the Social Justice in Disability and Health Lab, said the study documents a "literal revolution in mental health care delivery taking place before our eyes amidst the COVID-19 pandemic."

"No other event in modern history has altered to this extent the landscape of psychological service provision," said Perrin, who is also a co-author of the study and a jointly appointed research psychologist at the Central Virginia Veterans Affairs Health Care System.

"Many of the barriers to telepsychology use that have been touted for years have now been dramatically lessened or even fully removed, and we are seeing an unprecedented rollout of technology-based mental health treatment. The field of psychology has put forth a substantial effort to adapt to the demands of the pandemic and unmet mental health needs that are being uncovered across the U.S."

Perrin noted one important limitation of the study: It reflects the rapid and widespread adoption of telepsychology, but does not reveal the extent to which that shift is meeting the mental health care needs of patients, particularly groups of people that experience disparities in health care.

"I believe that much more needs to be done in terms of bringing evidence-based practice to populations often marginalized in traditional mental health care," Perrin said.

"The practice of telepsychology assumes a lot of things like patient access to technology, internet or telephone, and even to payment options for telepsychology. Despite the potential of telepsychology to rise to some of the mental health needs laid bare during the pandemic, there are still many limitations and barriers to its use that need to be worked out."
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Re: Depression & Mental Health Issues Re: Covid 19

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Surveys show strong, immediate impacts of pandemic on vulnerable families

9/3/20

https://www.news-medical.net/news/20200 ... ilies.aspx

In just a few months, the COVID-19 pandemic swiftly and substantially worsened mental health among U.S. hourly service workers and their children - especially those experiencing multiple hardships, according to new research from the Center for Child and Family Policy at Duke University and Barnard College.

The study leverages real-time, daily survey data collected from Feb. 20, before the pandemic hit the U.S., to April 27, when it was well underway, to examine how the crisis affected parents' and children's mental well-being.

The 645 survey respondents were parents of young children working in hourly service-industry positions in retail, food service, or hotel industries in a large U.S. city.

Nearly half (49.5%) of the participants were Black Americans, 23% were Hispanic Americans, and 83% were women.

The findings appear today in Pediatrics.

The surveys showed strong, immediate impacts of the pandemic on vulnerable families. Parents saw quick deterioration in their own mental well-being, reporting more frequent "negative moods" since March 14, the day after the first major restrictions in response to COVID-19 were announced.

The majority of respondents experienced multiple hardships, including household job loss (60%), income decline (69%), caregiving burden (45%) and illness (12%).

" The COVID pandemic has created substantial hardship for working families. What's worse is that the more hardship families experienced, the worse parents' and children's mental health."

-Anna Gassman-Pines, Study Co-Author and Associate Professor of Public Policy, Sanford School of Public Policy, Duke University

Not surprisingly, those who experienced two and three hardships reported more negative moods, worse sleep quality and more uncooperative child behavior than those who did not. For both parents and children, mental health was worst among those who suffered all four hardships.

"These results should raise concern, given the strong links between parental psychological well-being and the well-being of children," the authors write.

Gassman-Pines and co-author Elizabeth Ananat of Barnard College suggest pediatricians should screen for mental health problems among children in their practices, with particular attention to children whose families are especially vulnerable to both the economic and health aspects of the crisis.

During the stressful pandemic, pediatricians should also help parents understand and watch for potential signs of mental distress, the authors write. Those may include uncooperative behavior and acting out.

The authors also urge the government to provide more support for families, through restarting expanded unemployment insurance benefits and increasing the generosity of the Supplemental Nutrition Assistance Program.

"What we really see here is that, as hardships pile up, the combined weight causes severe distress for families. Resilience only takes you so far, and the multiple dimensions of hardship caused by this pandemic -- lost jobs, lost child care and education, sickness -- are stretching families to the breaking point," said Ananat. "Families need support, from their pediatricians and, hopefully, from the government."
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Re: Depression & Mental Health Issues Re: Covid 19

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Dealing with Depression During Coronavirus

https://www.helpguide.org/articles/depr ... avirus.htm

In the midst of the global COVID-19 pandemic, it’s easy to feel overwhelmed by hopelessness and despair. But these tips can help improve your mood and ease depression.

Understanding depression

If isolation, anxiety, economic uncertainty, and the daily onslaught of bad news generated by the coronavirus pandemic are taking a heavy toll on your mood, you’re not alone. In the U.S., nearly half the respondents to a recent Kaiser Family Foundation poll felt the pandemic was harming their mental health—and that picture is repeated around the world. The stress of social isolation, the worry about jobs, money, and health, and the profound feelings of loss that many of us are experiencing at the moment can trigger depression for the first time or exacerbate symptoms if you’ve already been diagnosed.

When you’re suffering from depression, life can seem overwhelmingly bleak and hopeless. It can interfere with your ability to think straight, drain your energy, and make it difficult to get through the day. Even as some countries and regions begin to ease stay-at-home restrictions, it seems unlikely that life will fully return to normal any time soon. But no matter what constraints you’re living under at the moment, these strategies can help you counteract loneliness, ease negative thoughts, improve your mood, and cope with symptoms of depression.

How COVID-19 affects depression


This is a distressing, uncertain time. Even as some places start to open up again after months of lockdown, the end may still seem a long way off. You may have lost your job, be struggling financially, and worried about if and when the economy will pick up. You could be grieving the loss of loved ones or the life you knew before the pandemic, or feeling frustrated and cut off by continued social distancing. Living in the age of coronavirus can have a profound effect on your mood.

Isolation and loneliness fuels depression. Human beings are social creatures. Being cut off from the love, support, and close contact of family and friends can trigger depression or make existing symptoms worse. Months of social distancing and sheltering at home can leave you feeling isolated and lonely, having to face your problems alone.

A troubled relationship may be even worse than loneliness. While strong and supportive relationships are crucial for your mental wellbeing, being forced to spend months quarantined in a troubled, unhappy, or abusive relationship can be even more damaging to your mood than being alone.

Anxiety can lead to depression
. All the fear and uncertainty surrounding COVID-19 means it’s natural to worry. When your worries spiral out of control, though, they can cause panic and anxiety. Since anxiety and depression are believed to stem from the same biological vulnerability, one can often lead to the other.

Stress levels are soaring. Experiencing a major change in your life, such the death of a loved one, the loss of a job, being diagnosed with a serious illness, or financial or relationship difficulties, can bring overwhelming levels of stress. As a result of this pandemic, you may be experiencing several of these major stressors at once, making you more vulnerable to depression.

We’re turning to unhealthy ways of coping. The boredom, loneliness and stress of being in lockdown, struggling financially, or having to juggle a job and home school your kids, can prompt unhealthy ways of coping. Maybe you’re drinking too much, abusing drugs, or overeating junk food in an attempt to self-medicate your mood and deal with stress. While these methods may provide a brief respite, in the long-run they’ll make your depression symptoms much worse. Instead, you can use the following healthy strategies to boost your mood and ease your depression.

Change your focus

There’s no easy fix for recovering from depression, and finding the energy and motivation to take the first step can be tough. But you have more control over your mood than you may realize.

It’s true that these are painful and worrying times, and few people have much to be cheerful about at the moment. But at the same time, depression can make things seem even worse than they really are. When you’re depressed, everything is filtered through a lens of negativity. By simply recognizing that, you can start to change your focus and take the first step to feeling more optimistic.

Distract yourself. When you’re depressed, out of work, and isolated from your social network, the negative thoughts running over and over in your head can seem never ending. But you can break the cycle by focusing on something that adds meaning and purpose to your life. Perhaps there’s something you’ve always wanted to learn, like a new language or a musical instrument? Or perhaps you’ve always wanted to write a novel, take up cooking, or grow your own vegetables? Focusing on a project or goal, even a small one, can give you a welcome break from negative thoughts and worries—and add a sense of meaning to your days.

Find simple sources of joy. While you can’t force yourself to have fun, you can push yourself to do things that will boost your mood throughout day. Try listening to uplifting music (even getting up and dancing around if you can) or finding a reason to laugh by watching funny videos on YouTube or episodes of your favorite sitcom. Spending time in nature—whether it’s walking in the park, paddling on the beach, or going for a hike—can ease stress and put a smile on your face, even if you’re alone. Or try playing with your kids or a pet—they’ll benefit as much as you will.

Limit your consumption of news.
Yes, you want to stay informed, but overconsuming sensationalistic news or unreliable social media coverage will only fuel your negativity and fear. Limit how often you check news or social media and confine yourself to reputable sources.

Maintain a routine. Sleeping too much or too little, skipping meals or exercise, and neglecting your personal care only feeds into your depression. Establishing and maintaining a daily routine, on the other hand, adds structure to your day, even if you’re alone and out of work. Try to include set times for exercising, spending time outside, and communicating with friends each day.

Express gratitude. When you’re depressed, especially at this awful time, it can seem that everything in life is bleak and hopeless. But even in the darkest days, it’s usually possible to find one thing you can be grateful about—the beauty of a sunset or a phone call from a friend, for example. It sounds cheesy but acknowledging your gratitude can provide a respite from negative thinking and really boost your mood.

Find new ways to engage with others

Meeting friends and family in person is still difficult for many of us at the moment, but that doesn’t mean you have to resign yourself to feeling isolated and alone. While nothing beats the mood-boosting power of face-to-face contact, chatting over a video link, on the phone, or via text can still help you feel more connected. Reach out to close friends and family, take this opportunity to look up old friends, or schedule online get-togethers with groups of people. Even if your depression symptoms make you want to retreat into your shell, it’s vital you regularly stay in contact with people.

How to really CONNECT with others

Whether you’re talking with a friend or loved one at a social distance, via video, or on the phone, it’s important to strive for more than just a surface connection. The deeper the connection you establish, the more you’ll both benefit.

Move beyond small talk.
To really establish a connection that will ease your loneliness and depression, you need to take a risk and open up. Sticking to small talk and limiting yourself to a surface connection with others can actually make you feel even lonelier.

Share about yourself.
Open up about what you’re going through, the feelings you’re experiencing. It won’t make you a burden to the other person. Rather, your friend or loved one will most likely be flattered that you trust them enough to confide in them, and it will only deepen the bond between you.

Nothing needs to get “fixed”.
Depression relief comes from making a connection and being heard by someone. The person you talk to doesn’t need to come up with solutions, they just listen to you without judging or criticizing. And the same is true when you’re listening to them.

Adopt healthy daily habits

Your daily habits can play a big role in helping you to overcome depression. During this health crisis, it’s tempting to slip into bad habits, especially if you’re stuck at home and not able to work. You may sleep irregular hours, overeat to relieve the stress and boredom, or drink too much to fill the lonely evenings. But by adopting a healthier daily routine, you can bolster your mood, feel more energized, and relieve symptoms of depression.

Get moving. Exercising is one of the last things you feel like doing when you’re depressed—but it’s also one of the most effective ways of boosting your mood. In fact, regular exercise can be just as effective as antidepressant medication in relieving depression. Even if you’re still under lockdown or a stay-at-home order, there are creative ways to fit movement into your daily routine.

Practice relaxation techniques.
Incorporating a relaxation technique such as meditation, progressive muscle relaxation, or a breathing exercise into your daily schedule can provide a welcome break from the cycle of negative thinking, as well as relieve tension and anxiety.

Eat a mood-boosting diet. In times of stress, we of often turn to “comfort foods” packed with unhealthy fats, sugar, and refined carbs. But these foods, along with too much caffeine and alcohol, can adversely impact your mood. Instead, focus on fresh, wholesome foods whenever possible and increase your intake of mood-enhancing nutrients such as omega-3 fatty acids.

Sleep well.
Just as depression can impact your quality of sleep, poor sleep can also contribute to depression. When you’re well rested, it’s easier to maintain your emotional balance and have more energy and focus to tackle your other depression symptoms. Changing your daytime habits and bedtime routines can help improve how well you sleep at night.

Use reminders to keep yourself on track.
When you’re depressed, it’s easy to forget the small steps that can help to lift your mood and improve your outlook. Keep reminders of the tips that work for you on your phone or on sticky notes around your home.
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