Since the outbreak of COVID-19 in Europe, levels of stress and anxiety have risen substantially. Unsurprisingly, the devastating loss of life due to COVID-19 has created profound grief and fear within communities. Compounding this sense of fear and loss are the more indirect impacts of the pandemic. Necessary lockdown measures have caused an economic slump. This has induced collective anxiety as businesses struggle to survive and individuals file for state aid. Lockdown measures have restricted daily routines and increased loneliness which has contributed negatively to the population’s mental health. Consequently, substance and alcohol dependency is expected to rise, whilst self-harm and suicide rates among at risk individuals are also expected to increase.
Dr Hans Kluge, the director of the European branch of the World Health Organisation, anticipated these impacts. In March, he stated: “Unprecedented measures to slow and interrupt transmission of COVID-19 are buying us time and reducing pressure on our health systems, but at a significant social and economic cost. Physical distancing and isolation measures, the closure of schools and workplaces, are particularly challenging us. It is absolutely natural for each of us to feel stress, anxiety, fear and loneliness during this time.”
Negative impacts on mental health are being addressed across Europe. Belgian Health Minister Maggie De Block acknowledged the potential for a mental health crisis: “You can die from this virus, but also from loneliness.” This view has been echoed by experts across Europe. According to Diego Figueras, a psychiatrist at San Carlos Hospital in Madrid, “the accumulated trauma and psychological suffering will be an enemy as invisible as the virus, with the potential to leave as many, if not more consequences, especially in the case of loneliness.
The severity of lockdown measures have varied across Europe. But Spain has imposed one of the longest and strictest lockdowns. The slight easing of the Spanish lockdown last week allowed children under fourteen to go outside for the first time in six weeks. The policy adjustment came after professionals who work with children reported heightened levels of stress and anxiety amongst younger age groups. The campaign to lift restrictions was led by the psychologist Heike Freire who indicated that the plight of Spanish citizens may be particularly acute due to the nature of their housing stock – many live in apartments with limited access to fresh air and sunlight.
Following the partial easing of the lockdown, children still face significant disruption. This is not unique to Spain, as schools across Europe remain closed. In the absence of schools and nurseries, children can face a severe lack of structure, stimulation and socialisation. Elements which are normally integral to a child’s development and wellbeing have been halted. Moreover, children across the world are facing anxieties about the consequences of the COVID-19 outbreak for themselves and their families.
In the UK, experts have expressed concerns over the impact of the pandemic and subsequent lockdown on those who already rely on mental health services. A leading consultant addictions psychiatrist explained some of the ways in which people with existing mental health issues may be affected. “We are no longer able to monitor and support community detox safely so we are having to take risks we would not usually take. We are having to balance the risk of our patients catching the virus against the risks of dispensing large amounts of opioid medication to them at once. Those with complex health issues who are unsafe to detox at home are the biggest worry for us as many inpatient detox units have closed their doors to complex cases because they can’t rely on hospital support and the acute hospitals are not accepting planned detoxes.”
Studies have been commissioned across Europe to gain an understanding of the pandemic’s impact on mental health. Early results are already beginning to illustrate the severity of the situation.
According to the Office of National Statistics, more than 25 million people in the UK experienced high levels of anxiety in late March when the lockdown was announced. The survey found that increased levels of anxiety mainly stemmed from concerns for personal wellbeing (8.5 million), job security (6.2 million) and the impact of Covid-19 on their finances (5.3 million).
The Belgian public health institute, Sciensano, has also collected the experiences of 44,000 respondents and the results have grave implications for the extent of the mental health crisis. The report concludes that depressive disorders have sharply increased from 10% in 2018 to a current rate of 16%. Additionally, the survey found that people between the ages of 16 and 24 would be among those most affected. The prevalence of depression has tripled in young women (30%) and quadrupled in young men (29%).
A French study surveyed 2,000 employees to ascertain the impacts of teleworking on mental health. It found that 18% of teleworkers showed symptoms of severe anxiety, depression and other mental disorders. This figure was even higher for those confined as a couple (20%) or with a child (22%). The study also found that it was primarily women who reported that their mental health had been impacted negatively. It is believed that this may be attributable to the multiple roles women are having to take on in both a domestic and professional capacity during the pandemic.
Italian universities have also begun to conduct research into the effect of the pandemic on mental health. Italy was the first European country to have a considerable outbreak of COVID-19 and the situation in regions such as Lombardy was devastating. Dr Rodolfo Rossi, a research fellow at the University of Rome said the results confirmed his expectations: “we can see an increased prevalence of anxiety, depression and insomnia”. The results from the online questionnaire found that 37% or the respondents had post-traumatic stress symptoms, 17% depressive symptoms, 20% severe anxiety, 7% insomnia and 21% stress.
It is likely that the true extent of the mental health crisis won’t be known for some time. However, it is clear from testimony and early studies that Europe’s mental health is suffering in the wake of COVID-19 and should remain a concern and a priority during the recovery period.