Primary Care in a Pandemic: Spotting Mental Health Needs and More

Free online toolkit aims to support providers in identifying problems their patients may be experiencing, and intervening early
Michigan Medicine - University of Michigan

Newswise — Desperately ill COVID-19 patients are pouring into America’s hospitals and capturing headlines nationwide. But a wave of a more invisible kind has started to hit another part of the nation’s health care system.

The number of people dealing with mental distress caused by enduring months of pandemic, economic disruption and political turmoil is rising fast. And America’s primary care clinics – general internal medicine, family practice, pediatrics and gynecology offices – are the front line for Americans’ mental health concerns.

To help primary care clinics cope with this influx, the University of Michigan Department of Psychiatry has created an online toolkit that draws on the expertise of its mental health specialists and researchers.

The toolkit recognizes that regular checkups and appointments for non-COVID-related ills have become key opportunities to find out who needs help for new or worsening mental health issues, even if they don’t yet recognize it.

For primary care providers in the state of Michigan, Michigan Medicine offers even more support through the free MC3 program that connects them to psychiatrists for same-day consultation in managing patients who are under the age of 26, pregnant or recently gave birth.

Mental distress and beyond

The COVID-19 provider toolkit also gives primary care teams tools to identify people whose economic situation threatens their physical and mental health, by interrupting their ability to pay for housing and utilities, their food supply and their access to the medication for chronic conditions.

On top of that, the toolkit pays special attention to the secondary impacts of the isolation caused by virtual school and work, and reduced social contact.

Less interpersonal interaction in other settings means that primary care providers may be some of the first to spot signs that their patients have become victims of someone else’s psychological turmoil through child abuse and neglect, intimate partner violence including spousal abuse, and elder abuse.

The overall goal: to help primary care providers offer trauma-informed care, based on the best available evidence from the last two decades of psychiatric research.

“Pandemics and quarantines are known to cause a significant increase in mental health and substance use issues,” says Leslie Swanson, Ph.D., a psychologist and clinical associate professor of psychiatry at U-M who helped lead the effort to develop the toolkit along with psychologist and clinical assistant professor Angela Fish, Ph.D.

Swanson adds, “It is our hope that the toolkit will increase awareness of the pandemic’s impact across the lifespan and across diverse groups and serve as a comprehensive resource for providers, with screening measures and concrete tools to assist with meeting patients’ needs.”

A comprehensive kit

Swanson and her colleagues collaboratively created the toolkit in partnership with providers from adult primary care and pediatrics.

They especially sought to provide rapid access to screening tools, validated questionnaires and suggested scripts for members of primary care teams to use to identify traumatic stress reactionsabuse from intimate partners and those who live with children or older adults, substance use and sleep difficulties during the pandemic.

They included materials aimed at helping providers adjust their approach when connecting about mental health and substance use with people from different backgrounds, including recent immigrants, LGBTQ+ people, and people from Asian, Black, Hispanic and Middle Eastern backgrounds. 

And, the toolkit includes links to high quality information that providers can give their patients of all ages and the parents or caregivers who care for them – including materials found on the U-M Depression Center Toolkit that has offered free online resources for years. Many of these materials are available in several languages.

The team also hopes the tools will be useful long after COVID-19 is under control, because trauma can last and manifest itself long after a crisis has passed.

Downstream effects

Primary care providers who are caring for people who are recovering from COVID-19, especially those who have been hospitalized in intensive care, may especially need support in handling intense mental health issues.

But even people who have not contracted coronavirus are being seriously affected, says Elizabeth Duval, Ph.D., a U-M psychologist and assistant professor of psychiatry also involved in the toolkit’s development. Among people who have sought specialized mental health care, “There’s a lot of anxiety about contracting COVID-19, uncertainty about transmission risk, and fear and grief associated with losing a loved one to COVID,” she says. “It’s impacting a lot of people in profound ways in terms of our ability to function.”

Michelle Riba, M.D., clinical professor of psychiatry, associate director of the U-M Depression Center, and director of the PsychOncology Program at the U-M Rogel Cancer Center, voices similar concerns. “I’m worried about post-traumatic stress. People are tired and not sleeping well, and we’re seeing PTSD-like symptoms. We’re seeing a lot of people self-disclosing that they’re anxious, depressed, maybe not attending to their medical issues, so we’re seeing people coming to get medical attention with more serious illness, including psychiatric problems.”

More free toolkits

For people who already had been diagnosed with a mental health condition before COVID-19 arrived, the department offers a special toolkit for managing the added burden of living in the time of a pandemic.

For people who want to learn more about keeping themselves and their loved ones mentally well despite the ongoing pandemic, there’s a toolkit of general resources including tips for reducing stress, improving sleep and the key roles of exercise and good nutrition. And the Zero to Thrive program, also led by U-M Psychiatry faculty, offers a toolkit for parents of young children, pregnant women, and childcare providers.

And for people who are grieving someone lost to COVID-19, or any other cause during this time of social distancing and altered grief rituals, the department offers this page of information and links.

Filters close

Showing results

110 of 4573
Released: 15-Jan-2021 5:40 PM EST
Research Links Social Isolation to COVID-19 Protocol Resistance
Humboldt State University

As health officials continue to implore the public to wear masks and practice social distancing, recent research by Humboldt State University Psychology Professor Amber Gaffney provides key insights into connections between social isolation, conspiratorial thinking, and resistance to COVID-19 protocols.

Newswise: Rapid blood test identifies COVID-19 patients at high risk of severe disease
Released: 15-Jan-2021 5:35 PM EST
Rapid blood test identifies COVID-19 patients at high risk of severe disease
Washington University in St. Louis

Scientists at Washington University School of Medicine in St. Louis have shown that a relatively simple and rapid blood test can predict which patients with COVID-19 are at highest risk of severe complications or death. The blood test measures levels of mitochondrial DNA, which normally resides inside the energy factories of cells. Mitochondrial DNA spilling out of cells and into the bloodstream is a sign that a particular type of violent cell death is taking place in the body.

Released: 15-Jan-2021 2:55 PM EST
COVID-19 deaths really are different. But best practices for ICU care should still apply, studies suggest.
Michigan Medicine - University of Michigan

COVID-19 deaths are indeed different from other lung failure deaths, according to two recent studies, with 56% of COVID-19 patients dying primarily from the lung damage caused by the virus, compared with 22% of those whose lungs fail due to other causes. But, the researchers conclude, the kind of care needed to help sustain people through the worst cases of all forms of lung failure is highly similar, and just needs to be fine-tuned.

Released: 15-Jan-2021 2:50 PM EST
45% of adults over 65 lack online medical accounts that could help them sign up for COVID-19 vaccinations
Michigan Medicine - University of Michigan

As the vaccination of older adults against COVID-19 begins across the country, new poll data suggests that many of them don’t yet have access to the “patient portal” online systems that could make it much easier for them to schedule a vaccination appointment. In all, 45% of adults aged 65 to 80 had not set up an account with their health provider’s portal system.

Released: 15-Jan-2021 1:30 PM EST
New England Journal of Medicine publishes COVID-19 treatment trial results
University of Texas at San Antonio

A clinical trial involving COVID-19 patients hospitalized at UT Health San Antonio and University Health, among roughly 100 sites globally, found that a combination of the drugs baricitinib and remdesivir reduced time to recovery, according to results published Dec. 11 in the New England Journal of Medicine.

Released: 15-Jan-2021 12:40 PM EST
DNA test can quickly identify pneumonia in patients with severe COVID-19, aiding faster treatment
University of Cambridge

Researchers have developed a DNA test to quickly identify secondary infections in COVID-19 patients, who have double the risk of developing pneumonia while on ventilation than non-COVID-19 patients.

Released: 15-Jan-2021 12:30 PM EST
Fight CRC To Present Research Findings on The Impact of COVID-19 on the Colorectal Cancer Community at 2021 GI ASCO
Fight Colorectal Cancer

Fight Colorectal Cancer presents abstract at Gastrointestinal Cancer Symposium highlighting the need to address the barriers and opportunities for care within the colorectal cancer community during the COVID-19 pandemic

Released: 15-Jan-2021 12:25 PM EST
Technion to Award Honorary Doctorate to Pfizer CEO Dr. Albert Bourla
American Technion Society

Israel's Technion will award an honorary doctorate to Pfizer CEO and Chairman Dr. Albert Bourla, for leading the development of the novel vaccine against SARS-CoV-2, the virus that causes COVID-19. The honorary doctorate will be conferred at the Technion Board of Governors meeting in November 2021.

Released: 15-Jan-2021 11:30 AM EST
UW researchers develop tool to equitably distribute limited vaccines
University of Wisconsin-Madison

Researchers at the University of Wisconsin School of Medicine and Public Health and UW Health have developed a tool that incorporates a person’s age and socioeconomic status to prioritize vaccine distribution among people who otherwise share similar risks due to their jobs.

Showing results

110 of 4573