COVID-19 has taken a toll on every aspect of life as we know it. From work to income to physical health and social interaction. While our hospitals fill up with COVID-19 patients, the impact of the pandemic on mental health is weighing heavily on the minds of healthcare experts and practitioners, not to mention individuals coping with a vat of changes outside of their control. 

The widespread and growing prevalence of anxiety disorders has come under the spotlight over the last several years as more and more patients seek treatment for stress, anxiety, and depression. According to research by the University of Oxford, anxiety disorders impacted an estimated 284 million people worldwide and is the most widespread mental health disorder globally. 

The pandemic has only exasperated the prevalence of stress and anxiety among South Africans. The South African Depression and Anxiety Group (SADAG) conducted a recent survey and found that nearly half of respondents indicated that financial pressures were one of the main challenges faced during lockdown. In addition, over half of respondents were dealing with major anxiety. 

In a statement by Suntosh Pillay, a clinical psychologist working in the public sector in KZN, he alluded to the fact that there is a direct relationship between socio-economic wellbeing and mental health. This may come as no surprise given the far-reaching effects of the pandemic, but it is cause for concern on the already overburdened healthcare system in treating an additional cohort of mental health patients. 

Ahead of Mental Health Awareness month October, we looked at our data to determine the trends in mental health that private medical professionals are seeing in their practices. 

What trends are we seeing? 

There are multiple ICD-10 codes related to mental health. For the purpose of our investigation we looked at the trend for Generalised Anxiety.  

From the graph we can see that although overall claims volumes took a substantial dip during lockdown stage 4 and 5, the proportionate claim volumes for general anxiety were significantly higher. In this previous article, we discussed the reasons for a decline in doctors visits during the most stringent stages of lockdown, but the increase in claims volumes for generalised anxiety supports the notion that COVID-19 has had a direct impact on mental health. 

In addition to stress and anxiety caused by fear of individuals and family members contracting the virus, other possible contributing factors to increased anxiety could be attributed to: 

1. Fear of the unknown – spanning financial, career and health, the unknown is a significant contributor to pandemic-induced anxiety  
2. Isolation – social distancing has had an impact on human’s natural inclination to connect and socialise, often relieving everyday stress. With physical distancing in place, many are feeling the adverse effects of a lack of physical and social contact 
3. Panic over resources – bulk buying and long queues to access necessities was one indicator of the stress and panic kicking human survival instincts into overdrive  
4. Information overload – it is virtually impossible to avoid any mention or information about the spread and devastation of COVID-19 across news, social media, and internet in general. The constant flow of negative reports has left many susceptible to anxiety and depression  
5. Capsized travel and social plans –international and local travel plans had to be cancelled or postponed. For many, these trips are often a huge part of stress relief and relaxation. Not to mention the fact that those who planned group gatherings for special celebrations, weddings, birthdays, anniversaries, etc. had to either postpone, cancel, or drastically minimise their original plans. 

In addition to the rise in mental health claims, we noted a spike in the adoption of Telehealth Consults to treat anxiety and depression. 

Why are we seeing rapid uptake of Telehealth for mental health consults and treatment? 

Even before the outbreak of COVID-19, Telehealth has been regarded as an effective mechanism to treat mental health. However, Telehealth in general has been met with caution and sometimes scepticism from practitioners and patients. But the pandemic has resulted in a significant shift in the perceived value and benefits of Telehealth to provide care for individuals seeking mental health support and treatment. The shift has been attributed to: 

1. Increased access 

Telehealth enables the screening and provision of treatment to patients remotely. Eliminating the need to travel to hospitals or doctors’ rooms also limits possible exposure to COVID-19. Providing remote access has been a welcome development for many patients, not only to reduce their risk of acquiring the virus, but also as a viable means to continue ongoing treatment. 

2. Greater convenience and ease 

Telehealth is a powerful way to provide safe, routine care for people with mental illness and other chronic conditions that make them more vulnerable to complications should they acquire COVID-19. For patients already dealing with mental illness, the ability to see their doctor virtually removes a number of barriers to continuing treatment. Particularly for patients who are experiencing an increase in anxiety, depression and stress that could demotivate or prevent them from keeping an in-person appointment. 

We also cannot forget about healthcare workers themselves and the impact of the pandemic on their mental health. Nurses and doctors working on the frontlines are not only dealing with the stress of long hours and increased patient volumes, they are also living with the stress of being exposed to the virus and have lost colleagues to the pandemic. It’s not always practical for healthcare workers to take time off to seek support and treatment for mental health, telehealth offers a convenient way for them to get the help they need. 

3. Better patient engagement 

A study by the University of Zurich, published in the Journal of Affective Disorders (2013), split a cohort of 62 patients undergoing mental health treatment in half. The study concluded that depression was alleviated in 53% of those who received virtual therapy, in comparison to those who were given in-person counselling. Three months following the completion of the study, 57% of the virtual therapy patients showed no signs of depression compared to 42% with in-person therapy. 

This speaks to the efficacy of telehealth in treating mental health. Patients who are treated virtually are found to be more likely to give honest accounts of their condition and follow through with scheduled appointments. In a previous article, we discussed the perceived safety that patients found when interacting via a screen that led to them being more open in sharing information with their doctors. 

4. Safer 

As mentioned previously, it’s paramount that we protect the health of doctors and healthcare workers who are at a high risk of severe illness should they contract COVID-19. Telehealth is a practical way to protect healthcare professionals from excessive exposure.  It also gives asymptomatic doctors who’ve contracted COVID-19 the ability to continue to consult with patients using telehealth platforms while in quarantine at home. 

Our data, along with the findings of numerous studies and surveys, highlights the effectiveness of telehealth in helping patients and healthcare workers improve or maintain their psychological well-being. In a time when fear of exposure, loss of income, isolation and the absence of a cure or vaccine, it is in everyone’s interest to explore the ability of telehealth to treat a growing mental health secondary pandemic propagated by COVID-19.   

Do you have an easy-to-use telehealth solution in place to treat depression, anxiety, and post-traumatic stress disorder (PTSD) remotely or from your practice? Healthbridge has been helping private practitioners run better businesses for over 20 years. Click here to speak to us about a telehealth solution that enables better access, safety, and engagement with your patients.