Protective and Non-Protective Factors of Mental Health Distress in the United States during the COVID-19 Pandemic: A Systematic Review

Background and objectives: Health care organizations continue to respond to the COVID-19 global pandemic and an ongoing array of related mental health concerns. These pandemic-related challenges continue to be experienced by both the U.S. population and those abroad. Materials and methods: This systematic review queried three research databases to identify applicable studies related to protective and non-protective factors of mental health distress experienced during the pandemic within the United States. Results: Three primary factors were identified as protective factors, potentially helping to moderate the incidence of mental distress during the pandemic: demographics, personal support/self-care resources, and income/financial concerns. Researchers also identified these same three constructs of non-protective factors of mental health distress, as well as two additional variables: health/social status and general knowledge/government mistrust. Conclusions: This systematic review has identified protective and non-protective factors of mental health distress experienced in the United States during the COVID-19 pandemic (to date) that can further assist medical providers in the U.S. and beyond as the pandemic and related mental health concerns continue at a global level.

Come for Information, Stay for Support: Harnessing the Power of Online Health Communities for Social Connectedness during the COVID-19 Pandemic

The COVID-19 pandemic created a globally shared stressor that saw a rise in the emphasis on mental and emotional wellbeing. However, historically, these topics were not openly discussed, leaving those struggling without professional support. One powerful tool to bridge the gap and facilitate connectedness during times of isolation is online health communities (OHCs). This study surveyed Health Union OHC members during the pandemic to determine the degree of COVID-19 concern, social isolation, and mental health distress they are facing, as well as to assess where they are receiving information about COVID-19 and what sources of support they desire. The survey was completed in six independent waves between March 2020 and April 2021, and garnered 10,177 total responses. In the United States, OHCs were utilized significantly more during peak lockdown times, and the desire for emotional and/or mental health support increased over time. Open-ended responses demonstrated a strong desire for connection and validation, which are quintessential characteristics of OHCs. Through active moderation utilizing trained moderators, OHCs can provide a powerful, intermediate and safe space where conversations about mental and emotional wellbeing can be normalized and those in need are encouraged to seek additional assistance from healthcare professionals if warranted.

The impacts on the mental health of residents of 16 favelas observed during the coronavirus pandemic in Brazil

The COVID-19 pandemic in Brazil has caused a scenario of extreme social vulnerability, with high unemployment rates and severe cuts to social benefits and policies. Aims: analyze the impacts of the pandemic on the mental health and quality of life on people living in contexts of high-levels of armed and lethal violence and social fragility. Methods: A longitudinal cohort study was undertaken with a convenient sample of fifty individuals who live in 16 favelas in Rio de Janeiro (Brazil) before and during the COVID-19 pandemic. The interviews included enquired about the respondent’s capacity to cope with the pandemic and their access to services as well as questions about mental health (Brief Symptoms Inventory), and Quality of Life (Manchester Short Assessment of Quality of Life). Results: The results revealed a decrease in the somatization dimension of the BSI scale and a worsening on the objective index (SIX) of quality of life. Mental health distress increased more in the male group when compared to the female group during the COVID-19 pandemic. It seems likely; therefore, the COVID-19 pandemic presents a major challenge for people living in a context of urban violence and social deprivation. Conclusions: The worsening of mental distress and quality of life during the pandemic impacts both genders and suggests the need for policies directed to health and employment protection.

Examining Mental Health Differences Between Transgender, Gender Nonconforming, and Cisgender Young People in British Columbia

Foundry is an integrated service network delivering services to young people across British Columbia, Canada. To better understand the needs of transgender and gender nonconforming young people accessing Foundry—this study compares rates of mental health distress between transgender and gender nonconforming young people and cisgender young people accessing services and examines the extent to which race may have amplified the association between transgender and gender nonconforming identity and mental health distress. We analyzed the difference using a two-sample t-test. We used stratified simple linear regression to test the association of race with transgender and gender nonconforming identity and mental health distress. Participants were recruited from a network of community health centers in British Columbia, Canada. The quantitative sample (n = 727) had a mean age of 21 years (SD = 2), 48% were non-white, 51% were white, and 77% were from Metro Vancouver. Compared to cisgender young people, transgender and gender nonconforming young people reported significantly higher levels of mental health distress. Transgender and gender nonconforming youth were more distressed than cisgender youth across both race strata but non-white transgender and gender nonconforming young people were not more distressed than white transgender and gender nonconforming young people. The findings from this study emphasize the need for increased education and understanding of transgender and gender nonconforming concepts and health concerns as well as on promoting intersectoral collaboration of social services organizations beyond simply health care.

Essential but Ill-Prepared: How the COVID-19 Pandemic Affects the Mental Health of the Grocery Store Workforce

Objectives Frontline essential workers face elevated risks of exposure to COVID-19 because of the interactive nature of their jobs, which require high levels of interaction with the general public and coworkers. The impact of these elevated risks on the mental health of essential workers, especially outside the health care sector, is not well studied. To address this knowledge gap, we examined correlations between perceptions of workplace risks and mental health distress among grocery store workers in Arizona. Methods We collected the first statewide sample of essential workers outside the health care sector focused on mental health and well-being. A total of 3344 grocery store workers in Arizona completed an online survey in July 2020. We used multiple regression models to identify demographic and work-based correlates of mental health distress. Results Levels of mental health distress among respondents were high: 557 of 3169 (17.6%) reported severe levels and 482 of 3168 (15.2%) reported moderate levels. Perceptions of workplace safety were strongly correlated with significantly reduced levels of mental health distress (ß = –1.44; SE = 0.20) and reduced perceived stress (ß = –0.97; SE = 0.16). Financially disadvantaged workers and employees aged <55 reported high levels of mental health distress. Perceptions of safety and protection in the workplace were significantly correlated with availability of safety trainings, social distancing, and policies governing customer behaviors. Conclusions Lacking sufficient workplace protections, grocery store employees in Arizona experienced high levels of mental health distress during the COVID-19 pandemic. Providing clear federal and state policies to employers to guide implementation of workplace protections may help reduce sources of mental health distress.

Experiences of renal healthcare practitioners during the COVID-19 pandemic: a multi-methods approach

Background Globally, renal healthcare practitioners provide intensive and protracted support to a highly complex multi-morbid patient population however knowledge about the impact of COVID-19 on these practitioners is extremely limited. Objective This study aimed to explore the experiences of COVID-19 with renal healthcare practitioners during the first global lockdown between June 2020 and September 2020. Methods A multi-methods approach was carried out including a quantitative survey and qualitative interviews. This was a multinational study of renal healthcare practitioners from 29 countries. Quantitative: A self-designed survey on COVID-19 experiences and standardised questionnaires (General Health Questionnaire-12; Maslach Burnout Inventory). Descriptive statistics were generated for numerical data. Qualitative: Online semi-structured interviews were conducted. Data was subjected to thematic analysis. Renal healthcare practitioners (n = 251) completed an online survey. Thirteen renal healthcare practitioners took part in semi-structured interviews (12 nurses and 1 dietician). Results The majority of participants surveyed were female (86.9 %; n = 218), nurses (86.9 %; n = 218) with an average 21.5 (SD = 11.1) years’ experience since professional qualification, and 16.3 years (SD = 9.3) working in renal healthcare. Survey responses indicated a level of preparedness, training and satisfactory personal protective equipment during the pandemic however approximately 40.3 % experienced fear about attending work, and 49.8 % experienced mental health distress. The highest prevalence of burnout was emotional exhaustion (35.9 %). Three themes emerged from the qualitative analysis highlighting the holistic complexities in managing renal healthcare, a neglected specialist workforce, and the need for appropriate support at work during a pandemic. Conclusions Results have highlighted the psychological impact, in terms of emotional exhaustion and mental health distress in our sample of renal healthcare practitioners. As the pandemic has continued, it is important to consider the long-term impact on an already stretched workforce including the risk of developing mental health disorders. Future research and interventions are required to understand and improve the provision of psychological support for specialist medical and nursing personnel.

Suboptimal diabetic control and psychological burden after the triple disaster in Japan: the Fukushima Health Management Survey

IntroductionA triple disaster struck eastern Japan in March 2011. We investigated the psychological distress and post-traumatic stress disorder (PTSD) symptoms caused by the disaster in people without or with diabetes mellitus.Research design and methodsThis cross-sectional analysis examined the 16 097 evacuees (1820 (11.3%) with and 14 277 (88.7%) without diabetes mellitus) included in the Fukushima Health Management Survey. Non-specific mental health distress was assessed using the Kessler-6 Scale, and traumatic symptoms were evaluated using the PTSD Checklist. Logistic regression analyses were used to estimate the OR and 95% CI associated with symptoms, adjusted for diabetes-related and disaster-related factors.ResultsIn the age-adjusted and sex-adjusted logistic models, suboptimal diabetic control (hemoglobin A1c (HbA1c) ≥7%) was associated with both psychological distress and possible PTSD. In the same models, current smoking, evacuation, and sleep dissatisfaction were associated with psychological distress and possible PTSD. In the multivariate-adjusted logistic models, HbA1c ≥7% was associated with psychological distress, independent of job change, evacuation, or sleep dissatisfaction.ConclusionAfter the triple disaster, non-specific mental health distress was associated with suboptimal diabetic control. Thus, patients with diabetes, especially those with suboptimal diabetic control, may be vulnerable to postdisaster psychological burden.