This research delved into the various levels of interaction from micro, at the level of the individual, all the way to macro, at the level of larger systems, like society. Researchers found that social connectedness, resilience, and trust operated at all levels of effective mental health programs, while accountability was present at only the macro level of these interventions. Such research findings can be used to improve outcomes for existing interventions to better serve the mental health needs of the public.
Understanding the Research
This study highlighted that successful mental health interventions during the pandemic required the four elements of trust, social connectedness, resilience, and accountability, which support each other across all levels. Based on this study, trust and social connectedness had been prevalent prior to the pandemic and remained present during COVID-19 with respect to effective mental health promotion at all levels of operations. Before the pandemic, accountability represented mental health promotion at each system level, while it was associated with the larger level top-down policies for pandemic management and communications during COVID-19. While resilience was associated with responsiveness and adaptation of the government, providers, and individuals during COVID-19, it had referred to power-sharing and collaborative decision-making regarding mental health interventions for communities and individuals prior to the pandemic. Stakeholders noted that resilience can often be used to shift responsibility for health from factors in the larger system to the responsibility of individuals, which is why power-sharing may be needed first to ensure that the needs of clients are prioritized. When power is not shared, as was the case during the pandemic, access to trauma-informed culturally safe care may be reduced if those with lived experience of marginalization are dismissed.
Social Connectedness Helps
Leela R. Magavi, MD, a Johns Hopkins-trained psychiatrist and regional medical director for Mindpath Health, says, “This review indicates that elements inclusive of social connectedness, resilience, accountability, trust, and power-sharing may positively impact mental health interventions for individuals with chronic medical conditions.” Dr. Magavi explains that this research study only assimilates the findings of existing data so more research is needed to further comprehend the intricacies of this topic. “Social connectedness has the capacity to bolster emotional, intellectual, and motor functions,” she says. Social connectedness can help release neurotransmitters, which is why Dr. Magavi highlights it can lead to improved sleep, concentration, and mood. “This could consequently improve individuals’ self-compassion and decrease the likelihood of engaging in unhealthy behaviors,” she says. Dr. Magavi notes, “Individuals with disabilities and chronic conditions may turn to socialization when facing tumultuous times. Robust interventions founded upon critical social elements can help individuals with chronic conditions feel less alone and embrace their strengths.” Individuals with chronic conditions are more likely to experience depressive and anxiety symptoms as well as painful, self-deprecating thoughts, so Dr. Magavi explains how knowing that they have something to turn to when they are distressed can help them take control of their emotions. Dr. Magavi highlights how this study examined research on a global platform to increase the efficacy of interventions. “It would be helpful to better understand how interventions may be individualized based on an individual’s story, culture or specific medical condition,” she says. Patients and friends with chronic conditions have shared with Dr. Magavi the value of connecting via technology platforms from their own homes. “Many of them have significant difficulty with daily functionality and benefit from attending groups, meetings and therapy via Zoom,” she says. Dr. Magavi notes, “I strongly believe that limiting access to virtual platforms such as telemedicine and teletherapy would adversely affect thousands of individuals with chronic conditions; having this accessibility stripped away could lead to demoralization, depression and anxiety.” Since it could emphasize the fact that they are unable to experience things like others solely due to their disability, Dr. Magavi explains how this could make them feel ostracized and alone. “As physicians, we must continue to advocate for our patients and fight for mental health parity,” she says.
Collaborative Care Needed
Neuroscientist and clinical social worker, Renetta Weaver, LCSW-C, CEAP, says, “While health professionals did a great job to protect people from the physical effects of COVID-19, we need to put that same energy into ways for people to also prioritize and protect their emotional and mental health.” Weaver explains, “Relationships are essential between patient and provider, at the organizational level and at the societal level. We all work best when we know we are being seen, heard, valued and cared for.” According to neuroscience, Weaver notes that two thirds of physical disease has an emotional root so how patients experience their medical care determines how they feel. “It puts patients at ease when they experience healthcare as a collaborative process vs. an authoritative process,” she says. Weaver highlights that it is possible for us to be subject matter experts and also acknowledge that our clients are the experts on themselves. “They need to know that they are seen, valued, matter and have autonomy to make decisions with the information we provide to them,” she says. When collaborating with patients during the pandemic, Weaver notes that it showed them how much they were valued, as it positioned them as the experts on their life. “I believe this approach allowed them to continue to thrive in their recovery, despite the challenges of COVID-19,” she says.
Social Disconnection Takes Its Toll
Adult and geriatric psychiatrist and director of the Pacific Neuroscience Institute at Providence Saint John’s Health Center, David A. Merrill, MD, PhD, says, “The pandemic severely disrupted our social connectedness." Dr. Merrill explains, “This has led to a crisis in mental health affecting individuals of all ages, from children out of schools to older adults prevented from their typical senior center routines.” For older adults with pre-existing physical conditions, Dr. Merrill notes that they have been particularly impacted by social distancing, given its impact on activities like in-person physical therapies and group meetings. Dr. Merrill highlights, “Social connectedness matters for mental health. There is a physical toll, in addition to the psychological stress, that comes with social isolation. Isolation worsens physical health conditions.” Since prior studies have shown that social disconnection comes with a cost, Dr. Merrill explains, “The practice of doctors becoming “social prescribers”, routing patients to both virtual and safe in-person small group activities, is both cost-effective and enjoyable for patients and their loved ones.” Dr. Merrill notes, “Rather than just giving a pill, we can combine medicinal interventions with socially supportive ones to improve both physical and mental well-being in ourselves and each other.”
