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Mental Health in a Time of
COVID-19: Preparing Faith &
Community Partners
Stephen Grcevich, MD
President and Founder, Key Ministry
April 28, 2020
A truly
unprecedented
situation!
Public officials are
forced to consider
possible mental
health impacts of
COVID-19 with
insufficient data
2
Contributing factors to a
mental health pandemic
• Quarantine/social isolation
• Traumatization of frontline
healthcare providers
• Unemployment, financial hardship
• Educational disruptions
• Domestic violence, child abuse
• Impacts on mental health service
delivery
3
Impact of quarantine, isolation,
exposure to COVID-19 patients
• Hawryluck (2004): 129 adults, 68%
healthcare workers, quarantined for an
average of ten days, elapsed time 36 days
• PTSD observed in 28.9%
• 31.2% met criteria for depression.
PTSD symptoms were highly
correlated with the onset of
depressive symptoms.
• Sprang (2013): 30% of children, 25% of
adults quarantined met criteria for PTSD,
children’s mean PTSD score 4X higher
than peers
Hawryluck L et al. Emerg Infect Dis 2004; 10: 1206-12
Sprang G. Disaster Med Public Health Prep 2013; 7:105-10
Impact on Chinese
healthcare workers, medical
staff after SARS, COVID-19
• Liu (2012): Healthcare workers
quarantined were 4.9X more likely to
experience depression three years later
compared to peers
• Liu (2020): 1563 medical staff treating
COVID-19 patients
• Depression prevalence 50.7%
• Anxiety 44.7%
• “Stress-related symptoms” - 73.4%
Liu X et al. Compr Psychiatry 2012; 53:15-23
Liu S et al. Lancet Psychiatry 2020;7(4):e17–e18.
Relationship between
suicide rates and
unemployment
• Relative risk increased 20-
30% with unemployment in
last recession
• Larger effect in countries
with low baseline
unemployment
Nordt C. et al. Lancet Psychiatry 2015; 2:239-45 6
Overdose deaths
and
unemployment
• Overdose death rates from opioids increase by 3.6% for every
1% increase in unemployment
• Emergency department visits increase by 7% for every 1%
increase
• 46,802 overdose deaths by opioids in U.S. (2018)
7
Hollingsworth A et al. J Health Econ. 2017 Dec;56:222-233
High levels of emotional distress, substance abuse from COVID19
8
Coronavirus impact on
young people with
mental health needs
• 32% grew “much worse”
• 51% “a bit worse”
• 9% “made no difference”
• 6% “became a bit better”
• 1% “became much better”
26% reported they could no longer
access mental health support
Source: youngminds.org.uk. Conducted 3/20-3/25
9
“Most reviewed studies reported
negative psychological effects
including post-traumatic stress
symptoms, confusion, and
anger. Stressors included longer
quarantine duration, infection
fears, frustration, boredom,
inadequate supplies, inadequate
information, financial loss, and
stigma.”
Brooks S et al. Lancet:2020; 395: 912–20 10
“Scaling up treatment in the
midst of crisis will take creative
thinking. Communities and
organizations could consider
training nontraditional groups to
provide psychological first aid,
helping teach the lay public to
check in with one another and
provide support.”
Galea S, Merchant R, Lurie N. JAMA Intern Med,
PublishedOnline April 10, 2020
11
How can faith-based
communities support mental
health during COVID-19?
• Combating social isolation
• Psychological first aid training
• Meaningful service opportunities for
individuals, families
• Offer practical help
• Purvey hope
Everly GS et al. J Nerv Ment Dis. 2018 Apr;206(4):301
Pfefferbaum B et al. Eur J Psychotraumatology;2018(9):1425577
12
Preparing a longer- term
response
• Building peer support, pastoral
care infrastructure
• Mental health, recovery groups
• Celebrate Recovery
• Fresh Hope
• Grace Alliance
• NAMI
• Relationships with and current
referral lists of local mental health
professionals, facilities
• Direct provision of care
13
keyministry.org
• Training
• Conferences
• Video training
• Roundtables
• Consultation to churches
• Resources
• Networking with other ministries
• Social media, sermon videos, research
• Someone to come alongside your
ministry!
14

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Mental Health in a Time of COVID-19: Preparing Faith and Community Partners

  • 1. Mental Health in a Time of COVID-19: Preparing Faith & Community Partners Stephen Grcevich, MD President and Founder, Key Ministry April 28, 2020
  • 2. A truly unprecedented situation! Public officials are forced to consider possible mental health impacts of COVID-19 with insufficient data 2
  • 3. Contributing factors to a mental health pandemic • Quarantine/social isolation • Traumatization of frontline healthcare providers • Unemployment, financial hardship • Educational disruptions • Domestic violence, child abuse • Impacts on mental health service delivery 3
  • 4. Impact of quarantine, isolation, exposure to COVID-19 patients • Hawryluck (2004): 129 adults, 68% healthcare workers, quarantined for an average of ten days, elapsed time 36 days • PTSD observed in 28.9% • 31.2% met criteria for depression. PTSD symptoms were highly correlated with the onset of depressive symptoms. • Sprang (2013): 30% of children, 25% of adults quarantined met criteria for PTSD, children’s mean PTSD score 4X higher than peers Hawryluck L et al. Emerg Infect Dis 2004; 10: 1206-12 Sprang G. Disaster Med Public Health Prep 2013; 7:105-10
  • 5. Impact on Chinese healthcare workers, medical staff after SARS, COVID-19 • Liu (2012): Healthcare workers quarantined were 4.9X more likely to experience depression three years later compared to peers • Liu (2020): 1563 medical staff treating COVID-19 patients • Depression prevalence 50.7% • Anxiety 44.7% • “Stress-related symptoms” - 73.4% Liu X et al. Compr Psychiatry 2012; 53:15-23 Liu S et al. Lancet Psychiatry 2020;7(4):e17–e18.
  • 6. Relationship between suicide rates and unemployment • Relative risk increased 20- 30% with unemployment in last recession • Larger effect in countries with low baseline unemployment Nordt C. et al. Lancet Psychiatry 2015; 2:239-45 6
  • 7. Overdose deaths and unemployment • Overdose death rates from opioids increase by 3.6% for every 1% increase in unemployment • Emergency department visits increase by 7% for every 1% increase • 46,802 overdose deaths by opioids in U.S. (2018) 7 Hollingsworth A et al. J Health Econ. 2017 Dec;56:222-233
  • 8. High levels of emotional distress, substance abuse from COVID19 8
  • 9. Coronavirus impact on young people with mental health needs • 32% grew “much worse” • 51% “a bit worse” • 9% “made no difference” • 6% “became a bit better” • 1% “became much better” 26% reported they could no longer access mental health support Source: youngminds.org.uk. Conducted 3/20-3/25 9
  • 10. “Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma.” Brooks S et al. Lancet:2020; 395: 912–20 10
  • 11. “Scaling up treatment in the midst of crisis will take creative thinking. Communities and organizations could consider training nontraditional groups to provide psychological first aid, helping teach the lay public to check in with one another and provide support.” Galea S, Merchant R, Lurie N. JAMA Intern Med, PublishedOnline April 10, 2020 11
  • 12. How can faith-based communities support mental health during COVID-19? • Combating social isolation • Psychological first aid training • Meaningful service opportunities for individuals, families • Offer practical help • Purvey hope Everly GS et al. J Nerv Ment Dis. 2018 Apr;206(4):301 Pfefferbaum B et al. Eur J Psychotraumatology;2018(9):1425577 12
  • 13. Preparing a longer- term response • Building peer support, pastoral care infrastructure • Mental health, recovery groups • Celebrate Recovery • Fresh Hope • Grace Alliance • NAMI • Relationships with and current referral lists of local mental health professionals, facilities • Direct provision of care 13
  • 14. keyministry.org • Training • Conferences • Video training • Roundtables • Consultation to churches • Resources • Networking with other ministries • Social media, sermon videos, research • Someone to come alongside your ministry! 14