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      Addressing the mental health impact of COVID-19 through population health

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          Abstract

          The COVID-19 pandemic has and will continue to result in negative mental health outcomes such as depression, anxiety and traumatic stress in people and populations throughout the world. A population mental health perspective informed by clinical psychology, psychiatry and dissemination and implementation science is ideally suited to address the broad, multi-faceted and long-lasting mental health impact of the pandemic. Informed by a systematic review of the burgeoning empirical research on the COVID-19 pandemic and research on prior coronavirus pandemics, we link pandemic risk factors, negative mental health outcomes and appropriate intervention strategies. We describe how social risk factors and pandemic stressors will contribute to negative mental health outcomes, especially among vulnerable populations. We evaluate the scalability of primary, secondary and tertiary interventions according to mental health target, population, modality, intensity and provider type to provide a unified strategy for meeting population mental health needs. Traditional models, in which evidence-based therapies delivered are delivered in-person, by a trained expert, at a specialty care location have proved difficult to scale. The use of non-traditional models, tailoring preventive interventions to populations based on their needs, and ongoing coordinated evaluation of intervention implementation and effectiveness will be critical to refining our efforts to increase reach.

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          Most cited references152

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          The psychological impact of quarantine and how to reduce it: rapid review of the evidence

          Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. 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. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
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            Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

            Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.
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              Impact of COVID-19 Pandemic on Mental Health in the General Population: A Systematic Review

              Highlights • The Coronavirus disease 2019 (COVID-19) pandemic has resulted in unprecedented hazards to mental health globally. • Relatively high rates of anxiety, depression, post-traumatic stress disorder, psychological distress, and stress were reported in the general population during the COVID-19 pandemic in eight countries. • Common risk factors associated with mental distress during the COVID-19 pandemic include female gender, younger age group (≤40 years), presence of chronic/psychiatric illnesses, unemployment, student status, and frequent exposure to social media/news concerning COVID-19. • Mitigation of COVID-19 induced psychological distress requires government intervention and individual efforts.
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                Author and article information

                Journal
                Clin Psychol Rev
                Clin Psychol Rev
                Clinical Psychology Review
                Elsevier Science
                0272-7358
                1873-7811
                5 March 2021
                5 March 2021
                : 102006
                Affiliations
                [a ]Center for Innovation to Implementation, VA Palo Alto Healthcare System, United States of America
                [b ]National Center for PTSD, Dissemination and Training Division, VA Palo Alto Care Healthcare System, United States of America
                [c ]Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States of America
                [d ]Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, WA, United States of America
                [e ]Center for m2 Health, Palo Alto University, Palo Alto, CA, United States of America
                [f ]Department of Psychology, University of Colorado, Colorado Springs, United States of America
                [g ]Mission Rock Enterprise, LLC, United States of America
                [h ]Department of Epidemiology and Population Health, Stanford University, United States of America
                [i ]Department of Psychology, University of Kansas, United States of America
                [j ]University of California, Berkeley, United States of America
                [k ]School of Behavioral Health, Loma Linda University, United States of America
                [l ]San Francisco VA Health Care System, United States of America
                [m ]Department of Medicine, University of California, San Francisco, United States of America
                Author notes
                [* ]Corresponding author at: 795 Willow Road (152-MPD), Menlo Park, CA 94025, United States of America.
                Article
                S0272-7358(21)00049-0 102006
                10.1016/j.cpr.2021.102006
                7934657
                33714167
                abfc29bd-b1d8-46a7-b888-e38db3869683
                Published by Elsevier Ltd.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 16 July 2020
                : 26 February 2021
                : 2 March 2021
                Categories
                Review

                Clinical Psychology & Psychiatry
                covid-19,mental health,risk factor,intervention,evidence-based psychotherapy,population mental health

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