Study: Mental health of minorities especially affected during pandemic

The results of a UK mental health survey conducted before and after the start of the pandemic found that British minorities were more impacted by the pandemic, but all citizens reported an increase in mental distress, according to a study yesterday in PLOS One.

The study was based on answers to the UK Household Longitudinal Study, and authors compared responses from participants between 2017 and 2019 to responses from the same participants in April 2020, during the first lockdown in the United Kingdom. Participants were asked to rate their mental distress on a scale from 0 to 36.

Among all participants, mental distress increased from 11.28 [95% confidence interval [CI], 11.17 to 11.40] in 2017-2019 to 12.51 (95% CI, 12.38 to 12.63) in April 2020, a 0.21 standard-deviation increase (95% CI,0.19, 0.23).

"Women and Black, Asian, and minority ethnic men experienced a higher average increase in mental distress than White British men from 2017-2019 to April 2020," the authors said in a press release.

The reasons are multifactorial, the authors wrote: Minorities were more likely to live in urban centers hit hardest by the pandemic, live in larger households, and report having pre-existing health conditions. Overall, the authors suggest lockdown measures and physical distancing affected minorities more than whites.
Jan 6 PLOS One study
Jan 6 PLOS press release

Isolation plagues seniors with cognitive impairment in COVID lockdowns

The COVID-19 pandemic has worsened feelings of loneliness and entrapment for some older adults with cognitive impairment who live alone—some of whom say they wish they would just get the virus and die, according to a University of California at San Francisco (UCSF) study published yesterday in The Gerontologist.

Shortly after the pandemic and related lockdowns began, the researchers started conducting phone interviews with 24 San Francisco Bay residents who were, on average, 82 years old.

Some participants lived in cramped or uncomfortable homes, where they said they felt "trapped," and some struggled with misinformation about COVID-19. Pandemic-related lockdowns precluded most from seeing friends at worship services, senior centers, or restaurants.

One study participant reported feeling "fed up with the life that I have been given," while another, who had Alzheimer's disease, viewed the virus as "an escape plan." For some, long lines at stores triggered memories of war or starvation, and some cited fears of death or racial attacks after the death of George Floyd in Minneapolis on May 25, 2020.

Participants who had family support were likely to have lower levels of distress, and home health aides were recognized as providing invaluable companionship and assistance. Unfortunately, though, the US government covers aides' services only for those with medical conditions and very low incomes.

Seventeen participants were women, 13 spoke only Spanish or Cantonese, 18 were divorced or widowed, 10 relied on family for care, 8 depended on home health aides, and 6 needed the care of both family and aides.

"This is a demographic at high risk for loneliness and distress, as well as negative health outcomes, even before the pandemic," lead author Elena Portacolone, PhD, MBA, MPH, said in a UCSF press release. "Some participants were particularly distressed, two of them had had suicidal ideation before the pandemic, yet they received little or no support for their mental health."

The authors called for establishment of a "therapeutic alliance" of home health aides, social workers, case managers, and mental health providers for the 4.3 million older Americans with cognitive impairment who live alone. "These services are critical for maintaining the health and wellbeing of older adults living alone with cognitive impairment," coauthor Julene Johnson, PhD, said in the release.
Jan 6 Gerontologist study
Jan 6 UCSF press release