As COVID-19 cases in intensive care units surge with more younger people and patients who are staying for longer, a group of Manitoba doctors fear Canadians could soon see a major spike in post-traumatic stress disorder.
Manitoba ICUs have increased capacity by 150 per cent but there are younger patients being admitted every day, and because of the virus, patients are not allowed visits from loved ones.
“They’re younger and younger. And what is tragic and what is heartbreaking for the staff, these patients suffer with their illness alone. Their families can’t come into the hospital,” intensive care unit physician Dr. Eric Jacobsohn said.
But Jacobsohn believes that even for those who are fortunate enough to recover and be sent home eventually there will be lasting mental impacts.
“The psychological trauma, to the patients who survive this to the families, is just immense. I think we will have an epidemic of post-traumatic stress disorder when this is all done,” he said.
Clinical psychologists have said it is not uncommon for some patients to face severe mental health issues after leaving the hospital and it often comes with many traumas.
“Many people who come out of surgery tend to have difficulties with mental health and a lot of that comes with a change in lifestyle,” Dr. Rehman Abdulrehman said.
“Many cardiac patients, for example, if they’re not given information on what to expect before they go in for surgery, when they come out of it, actually will tend to have a decline in mental health.”
However, Dr. Abdulrehman said with COVID-19, a patient can deteriorate quickly and it leaves little time for them to be able to fully grasp what might change after they get better.
“With COVID, people don’t always have that opportunity. Everything has come up so quickly, people don’t have the opportunity to have that sort of pre habilitation before anything,” he said.
“They go into intensive care and they come out of it and their lifestyle and their abilities are significantly diminished and that would certainly impact difficulties with mental health, including PTSD.”
Doctors fear Canada may also see a rise in suicides in the months to come as patients struggle with mental health issues.
A team of researchers with The Ottawa Hospital have found patients discharged from the intensive care unit have higher risks of suicide and self-harm after going home compared with those treated in acute care.
The research also suggests that younger patients with histories of mental illness could be especially susceptible to suicide attempts following especially traumatic stays in the ICU.
Suicide was more common in younger adults aged 18 to 34, patients with pre-existing diagnoses of depression, anxiety or post-traumatic stress disorder and people who, while in the ICU, received invasive treatments such as dialysis or being placed on a ventilator.
Other risk factors the research flagged were ICU survivors from lower-income neighborhoods, or patients sent home alone as opposed to a shared living situation such as long-term care.
“In my mind’s eye, I can picture that patient: a younger patient with pre-existing mental illness who comes to the ICU for invasive life support and is probably discharged home to an independent setting with lower economic status. That is, in so many ways, the patient of the third wave of this pandemic,” lead researcher Dr. Shannon Fernando said.
The confluence of these risk factors worries Fernando as he watches ICUs across Ontario being overwhelmed by COVID-19 patients.
Fernando said that while most of the focus of mental health impacts from the pandemic has been on the effect of restrictions and public health measures on the general population, the psychological effect on COVID-19 patients themselves has been largely quiet.
Dr. Abdulrehman said Canada is in the midst of a mental health crisis and COVID-19 has helped create a perfect storm.
“We did put ourselves in this perfect storm where we weren’t addressing mental health. We didn’t increase the number of providers for mental health care, the psychiatrist or psychologist,” he said.
“And we have a low number for those individuals and now we’re in a position where we are needing to address it and we don’t have enough of those services.”
Stress throughout the pandemic has also acted as a mental health trigger for many.
“Stress will certainly impact mental health. So we are in the middle of a very stressful situation globally and certainly here in Canada, particularly in Manitoba,” he said, which is making some people’s mental health deteriorate.
He said there needs to be a focus on mental health moving forward and it could start with a task force of experts, more funding and a new public health campaign to highlight that mental health impacts everyone.
“I think the way we looked at mental illness before was the haves and the have nots. Those of us who are healthy and those poor people who have mental illness. That is not how it works,” he said.
“Mental health is a health issue. It applies to all of us. All of us are at risk.”
If you are in need of support, you can call:
Manitoba Suicide Prevention & Support Line: 1-877-435-7170
Klinic Crisis Line: (204) 786-8686
Kids Help Phone: 1-800-668-6868
Crisis Services Canada: 1-833-456-4566
Questions about COVID-19? Here are some things you need to know:
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To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out. In situations where you can’t keep a safe distance from others, public health officials recommend the use of a non-medical face mask or covering to prevent spreading the respiratory droplets that can carry the virus. In some provinces and municipalities across the country, masks or face coverings are now mandatory in indoor public spaces.
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