How to advise patients who are struggling with mental health issues due to the pandemic

From the beginning of COVID, psychiatrists warned that after the pandemic ended, there would be a new pandemic, the mental health pandemic. Sadly, that is now exactly what we are seeing. We were already experiencing a mental health crisis in our country prior to COVID-19, but over the past two years, we have seen the COVID pandemic worsen mental health conditions such as anxiety, depression and substance abuse disorders.

The pandemic has affected every aspect of our lives, from health, job security, economic stability and beyond. Mental Health America’s online screening program, taken by over 2 million patients, revealed that 75% scored positive, or with moderate to severe symptoms of a mental health issue. Of these patients, 68% had never been diagnosed with a mental health disorder prior to COVID.

It hasn’t just affected adults either. In October of 2021, the American Academy of Child and Adolescent Psychiatry and the American Academy of Pediatrics declared a national emergency in children’s mental health.

What can health care professionals do to help?

There is a nationwide shortage of psychiatrists in our country, and therefore it will take the efforts of all physicians to navigate us out of this mental health pandemic. This may make physicians who are not trained in mental health care uneasy, but there are tools that every physician can use to take care of patients until they can be seen by a psychiatrist or therapist.

It all starts with good communication. We, as physicians, are all skilled in the art of communication. The most important part of any medical evaluation is gathering a good history, which hinges on a physician’s ability to communicate effectively and to ask the right questions. Patients often want to share with their doctors but may be hesitant due to fear and/or stigma.

Physicians can ease that fear by creating a safe environment for their patients to talk. That can be a safe place in the clinic or via telehealth. Telehealth has done tremendous things for mental health care and is a very effective way to communicate with patients.

Regardless of the method used to communicate, physicians can lead the conversation with one simple question: “How are you?” This lets the patient know that they are safe and that you care. It provides the opening that they may need to share their feelings.

Patients can feel comfortable opening up when they feel heard

Once the patients are comfortable sharing, it is important for physicians to listen and let the patients be heard. If patients get stuck, it may be helpful to ask open-ended questions. Provide reassurance to patients that it is normal to feel stressed and overwhelmed during this time, but also inform them that it could be cause for concern or intervention if they feel stronger, unsettling depression.

Doctors can encourage their patients to use healthy coping skills to manage the stress, like exercise, a healthy diet, meditation, journaling and other forms of self-help.

It’s also key to advise patients to avoid negative coping skills like alcohol or other substance use. Substance use disorders have increased dramatically during the pandemic, but patients may be reluctant to admit or open up about their ongoing substance use. Just encouraging patients to avoid these negative coping skills may be the nudge they need to share with you their struggles with substances and to ask for help.

After speaking with patients, be prepared with resources to give patients should they need further help. Be equipped with community referral sources as well as places where patients can seek immediate help should they need it, such as the Suicide Prevention Lifeline or SAMHSA’s Disaster Distress Helpline.

As a psychiatrist myself, I would be remiss if I didn’t also encourage physicians to guard their own mental health and to take care of themselves as well. Self-care is not selfish. Physician burnout is at an all-time high, and many physicians are hesitant to seek help because the stigma and fear of retribution.

If you are struggling and need someone to talk to, the Physician Support Line is available at 1-888-409-0141. This is a physician helpline staffed with volunteer psychiatrists to provide emotional support. It is free and confidential.  

One of the most important things we as physicians can do for our patients and colleagues is to continue to talk about mental health. Normalizing mental health care is how we end the stigma.

Related reading:

Is burnout the correct term to use?

What needs to be done to improve physicians’ mental health and reduce burnout