Public health: Mental health concerns during COVID-19 revealed

The observed increase in calls to mental health helplines during the first wave of the COVID-19 pandemic was largely driven by fears of the virus itself and loneliness resulting from stay-at-home orders, rather than domestic violence, addiction or suicidal ideation, suggests a Nature paper. The findings, based on an analysis of data from around eight million calls to helplines around the world, illustrate the insights that can be gained from these data to gauge public mental health concerns.

Monitoring public mental health is difficult because data are often infrequent, especially in times of crisis. Helpline calls offer a real-time measure of mental health concerns and are particularly relevant during a pandemic, when face-to-face contact carries infection risks and may not be possible owing to stay-at-home rules.

Marius Brülhart and colleagues examined around eight million calls to 23 helplines across 14 European countries, the United States, China, Hong Kong, Israel and Lebanon, made between 2019 and early 2021. They found that, on average across helplines, call volumes peaked six weeks after the initial outbreak of the pandemic, exceeding pre-pandemic levels by 35%. The increase was mainly driven by fear (including fear of infection), loneliness and, later in the pandemic, physical-health concerns. Relationship issues, economic problems, violence and suicidal ideation, however, were less prevalent than before the pandemic. The authors suggest that issues directly tied to the pandemic therefore seem to have replaced, rather than exacerbated, underlying anxieties. This pattern was found to appear both during the first wave and subsequent COVID-19 waves. Suicide-related calls were found to increase when containment policies became more stringent and decreased when income support was extended, suggesting that financial relief may help to alleviate distress triggered by lockdown measures.