People who were seriously ill with coronavirus and needed hospital treatment should be screened for post-traumatic stress disorder (PTSD) and have regular check-ups for at least a year, according to psychiatrists and psychologists examining the effect the virus has had.
The Covid Trauma Response Working Group – which includes mental health experts from University College London, King’s College London, Oxford University, the University of Haifa in Israel and the NHS – said those who had been in intensive care would have been seriously ill enough to be at risk of PTSD, and called for a national screening programme.
It is estimated that there could be tens of thousands of people at risk of PTSD because of the seriousness of their Covid-19 symptoms. More than 100,000 people have been admitted to hospital because of the virus.
Dr Michael Bloomfield from University College London said: “Given the very frightening and invasive nature of the Covid-19 critical care experience, the imminent risk of death and the potential for long-term medical complications, those most severely affected by Covid-19 are likely to be at high risk of developing post-traumatic stress disorder and other stress-related mental health difficulties.
“There may also be features unique to Covid-19 and its pandemic status that exacerbate its psychological impact, such as being isolated from family during and after hospital admission. Failure to deal with this immediately could lead to serious long-term mental health difficulties.
Based on its analysis of the effects of other infectious outbreaks, the group estimates that rates of mental health problems in survivors of severe Covid-19 symptoms to be 30% for PTSD, 15% for depression and 15% for anxiety disorders.
It has published clinical guidelines designed to inform NHS planners and clinicians of the principles for addressing the mental health needs of people who have been critically ill with the virus.
Its key recommendations include:
- Actively monitoring and providing timely treatment for patients with Covid-19 for mental health problems, including PTSD
- Setting up a national “screen and treat” service, managed through regional mental health screening programmes either within hospitals or in the community
- Establishing specialist psychological trauma services to facilitate the delivery of “screen and treat” programmes
- Giving patients who had severe Covid-19 regular check-ups for at least a year.
The guidance says that, at a minimum, patients should receive a full psychological clinical assessment prior to discharge from hospital and a structured mental health assessment within four weeks of discharge.
At the moment, patients need to self-refer to a GP or to an Improving Access to Psychological Therapies service if they are concerned about their mental health.