COVID-19 and Mental Health

As a result of the COVID-19 pandemic, there is a high likelihood that there will be a measurable increase in Canadians experiencing mental health and neurological problems. The causes for these brain disorders may be directly resulting from COVID-19 infection, like patients having strokes caused by the virus increasing coagulation to pathogenic levels [Beyrouti et al. 2020], or indirect, like people suffering with anxiety and depressive symptoms exacerbated by uncertainty and isolation [Domènech-Abella et al. 2019]. Research on past epidemics have shown that mothers infected with some viruses at specific times in their pregnancies are much more likely to give birth to a child who will later be diagnosed with autism spectrum disorder or schizophrenia [Patterson 2009]. This means that we might be dealing with consequences of this pandemic for decades, especially if Canadians continue to be infected in increasing numbers before a successful vaccine is available.

This problem highlights the need for proactive responses from the Canadian federal and provincial governments, Canadian scientists and researchers, and public health officials. It is more important than ever for us to glean information from the epidemics and pandemics of the past, as well as current mental heaIth epidemics. There is a potential to mitigate or avoid some of the worst effects by supporting groups recent research has shown to be vulnerable, such as indigenous peoples, farmers, graduate students, and healthcare providers.

There are several Canadian institutions and policies in place that are well-poised to respond to the prospect of increased need for brain health initiatives in the upcoming months and years as we deal with this pandemic. First off, we can make sure that the policy and funding are in place for existing mental health supports, both outreach and public resources. The more and better access Canadians have now to mental health support, the less resources will be required for crises in the future.

On that note, we need to make sure vulnerable people have funding and access to financial resources necessary to ensure access to food, housing, and other essential needs. Stress is a precipitating factor for many mental health and neurological disorders, so supporting our citizens now will almost certainly cost taxpayers less than paying for healthcare later.

We can also invest now in research, science, engineering, public health, and epidemiology, among other fields. While some scientific domains are clearly important to stimulate in pandemics (including epidemiology, microbiology, immunology, and medicine), it is critical that we broaden our view now to make sure that key information from less obvious domains is used as quickly and effectively as possible. For example, recent research from New York City suggests that acute stroke is a symptom of COVID-19 infection in some patients [Avula et al. 2020]. Stroke requires rapid emergency medical support, so if people who would usually not be at high risk for stroke now are due to COVID-19 infection, public awareness of this could save lives and lessen permanent symptoms in affected people. Funding for research like this is paramount to make sure that we are as prepared for future waves of infection as possible. It is also important to make sure that research on health issues that are secondary to infection, or in uninfected people, also gets funded by the Canadian granting agencies. Mental health research is even more important during this pandemic than it was before, so we need to make sure that neuroscience is funded and that researchers are able to access their laboratories and clinics in a safe way.

Knowledge translation initiatives are also fundamental to our response to COVID-19, and deserve policy and funding support as well. Canadians need to have access to good information about practices that they can do to maintain good mental health during times of high stress, and resources in the event they are experiencing mental illness. Knowing when to seek professional help, and from whom, can minimize the burden to our strained health care system, and prevent uninfected people from needing to visit an emergency room, where they are more likely to be exposed to COVID-19. We can also engage the public to participate in research as patients or healthy controls, and encourage them to read about and support Canadian science.

Overall, the best way that Canada can prepare for and respond to this pandemic is to act quickly and with foresight, so that we can invest now in the science and research that will protect us from facing much larger repercussions for generations to come.

References
Avula, A. et al. Brain Behav Immun. 2020;S0889-1591(20)30685-1.
doi: 10.1016/j.bbi.2020.04.077.Online ahead of print.

Beyrouti, R. et al. J Neurol Neurosurg Psychiatry. 2020 Apr 30;jnnp-2020-323586.
doi: 10.1136/jnnp-2020-323586. Online ahead of print.

Domènech-Abella, J et al.J Affect Disord. 2019 Mar 1;246:82-88.
doi: 10.1016/j.jad.2018.12.043. Epub 2018 Dec 17.

Patterson P. Behav Brain Res. 2009 Dec 7;204(2):313-21.
doi: 10.1016/j.bbr.2008.12.016. Epub 2008 Dec 24.