Mental Health Aspects of COVID-19


In December 2019, the first case of a severe respiratory illness caused by a new type of coronavirus (SARS-COV2) was identified in Wuhan, China. It was named COVID-19 (Corona Virus Disease 2019) and by January 2020 the World Health Organization (WHO) declared it to be an International Public Health Emergency. In March 2020, the COVID-19 was characterized as a pandemic because large numbers of people in several countries or continents were affected.Currently, COVID-19 has spread to 199 countries and territories of the world. As at today, there are more than 1,000,000 cases of the disease and more than 70,000 people have died from the disease.

Some of the preventive measures instituted to prevent the transmission of SARS-COV2 include frequent hand washing, avoiding touching one’s eyes, nose and mouth and practicing respiratory hygiene. Another major aspect of managing a pandemic is by separating affected people and suspected carriers of the illness from unaffected members of the community. When the separation is not total, this is called social distancing. Quarantine is when persons who are healthy but may have been exposed to the infectious agent are isolated to prevent the spread of the disease to the unexposed healthy people.

Mental Health Impacts in the General Public

On its own, the COVID-19 pandemic is likely to be stressful for a lot of people because of fears and worries about their health and that of loved ones. A further important factor is misinformation which may worsen existing stress as people react to bad news differently. Some of the manifestations of stress can include changes in sleep or eating patterns, difficulty concentrating and worsening of prior health problems. Some persons, in a bid to cope with the stressor, may increase their use of alcohol, tobacco or other psychoactive substances which can cause further physical, social and mental health problems.

The massive anxiety and fear associated with pandemics can trigger categorizing people as “the well” who stigmatize “the unwell” as being causes or carriers of the illness. In this kind of situation, people tend to disseminate messages that scapegoat or stereotype the unwell thus further disrupting the mental health of people in the community. An example of this behaviour is calling the SARS-COV2 virus the “Chinese virus”.

Another indirect impact of the COVID-19 pandemic on the mental health of people is through job loss. The International Labour Organization has warned that the economic fallout from the COVID-19 pandemic could cause the loss of up to 25 million jobs. In the United States of America, according to the Department of Labour, a record 3.3 million people filed claims for unemployment as the COVID-19 pandemic shut down large parts of America’s economy and the full scale of the impact of the crisis began to emerge. The negative effects of unemployment can be interpersonal such as the disruption of social work relationships and daily structure; and intrapersonal - loss of one's sense of purpose and self esteem. Being unemployed could also worsen anxiety about the future.

Impacts in People with Pre-existing Mental Illness

Individuals with pre-existing mental health problems may have their illnesses exacerbated in the wake of a pandemic. This may occur as a result of worrying about COVID-19 or its implications.
Transportation may also be disrupted and medications discontinued due to separation from caregivers or inability to access health services including medication prescription. With symptom relapse, it may become difficult for affected patients to comply with the public health measures instituted to control the pandemic . These measures may be disregarded during a mental health crisis and this can further worsen both their mental and physical health.

Individuals with substance use disorders represent a unique category of patients who may struggle a lot during isolation. This is because they are at risk of developing withdrawal symptoms which can be severe, depending on their prior level of use. If quarantined or isolated, the unavailability of substance may make them unlikely to remain in Isolation centers or comply with the quarantine requirements.

Psychological Effects of Social Distancing, Quarantine and Isolation

All forms of social distancing lead to social isolation which can have negative psychological effects. Those in isolation may be anxious about their health and the well-being of their loved ones while those who are healthy but in quarantine may be anxious about the possibility of developing symptoms. They may also worry about the impact of the illness on their lives and relationships. Because we live in a communitarian culture, separation from social support and interaction can lead to adverse psychological effects both in the isolated and their loved ones who are not isolated.

Patients in isolation may develop some neuropsychiatric complications as a direct consequence of the infection. These can can include delirium, anxiety, depressed mood, a sense of hopelessness and despair, psychological trauma (acute stress disorder in the short term or post-traumatic stress disorder in the long term) and cognitive impairments.

Effects on the Mental Health of Children, Adolescents and Elderly people

In addition to the impact in the general population, the “Stay-at-home Policy” which included closure of schools can have tremendous impact on adolescents and younger children as there is a loss of the social support provided by school friends and colleagues. They may no longer have the sense of structure and stimulation that is provided by the school environment which are all essential for good mental well-being. Adolescents may also struggle with complying with the quarantine or isolation rules and may be more likely to break quarantine.

For some children, social distancing by staying at home can expose them to forms of child abuse or parental discord or violence if the home is not a safe space. Where isolation or quarantine is needed, young children will need to have closely acquainted caregivers to foster good transition from the familiar home environment to the isolation or quarantine center. 

Older people and those with underlying medical conditions are more vulnerable to COVID-19. Knowing this can increase their level of distress and they may experience more feelings of fear, anxiety and sadness. Social distancing may also worsen feelings of loneliness which can worsen mental well-being, especially for those who are far from their loved ones. For those with cognitive decline or dementia, special care and attention are required during quarantine or isolation as they have limited ability to provide for themselves and may not be able to follow instituted public health measures.

Mental Health of Healthcare Workers

Healthcare workers may be at higher risk of adverse mental health effects during this pandemic. This is because they are expected to care for others while being exposed to the disease itself. They may also have concerns about their own health, that of family members and other colleagues; and worry about contracting or transmitting the illness.

They may further be unable to use social support due to intense work schedules and stigma. The high expectations and unavailability of needed materials may result in feelings of helplessness and hopelessness, which may worsen their stress. Those who have to go to work or who work for long periods of time because of shortage of staff may even be more affected. Symptoms of stress may include feeling sad or anxious, hostility, and numerous bodily symptoms such as general body aches. In line with this, a study done in China showed that frontline healthcare workers were 1.5 times more likely to experience distress and symptoms of depression and anxiety, compared to those who were not on the frontline. 

Long-term Psychological Effects

It may be difficult to predict the long-term impacts of the COVID-19 pandemic on mental health, however we can extrapolate from information about other infectious disease outbreaks in the past. 
In the wake of an infectious disease pandemic, people may begin to mourn the loss of functioning, structure, source of livelihood and loved ones. They may consequently feel depressed, demoralized, helpless and confused. For those who lost loved ones, grief for their loss may be overwhelming. Another important consideration is the risk for developing trauma-related disorders, including acute stress disorder and post-traumatic stress disorder. This may depend on how closely the individual was affected and how vulnerable they were.

The impact of stigma in the lives of survivors may be significant as they may become the targets of stigma and aggression and may even be rejected in their local communities. This may make it difficult for some to return to their previous employments or their homes. Entire communities or groups of people (for example Asians in this particular pandemic) may find themselves victims of stigmatization in the aftermath of the COVID-19 pandemic. Healthcare workers who worked at great peril to their own health may also suffer burnout, fatigue, psychological distress and even symptoms of post-traumatic stress disorder.


We need to find opportunities to amplify positive and hopeful stories and images of local people who have experienced COVID-19. For example, stories of people who have recovered or who have supported loved ones and are willing to share their experiences. We should also honour caretakers and healthcare workers supporting people affected with COVID-19 in our communities.

Activities that facilitate both physical and mental well-being like maintaining regular schedules, exercise, maintaining social contact e.g. through social media, looking out for others, volunteering, reading books and magazines and listening to good music should be encouraged. We should reach out to elderly people (e.g. by telephone calls) to minimise their feelings of loneliness.

Rumors and unsubstantiated news should be avoided and time should be spent researching accurate, and understandable information from reliable sources about the COVID-19 outbreak and effective strategies to prevent an infection.

For children, parents should take time to talk with their children or adolescents about the COVID-19 outbreak. Information should be provided in a way that they can understand. Parents should encourage active listening and an understanding attitude with the children such that they are able to express and communicate their disturbing feelings in a safe and supportive environment. Children would also benefit from maintaining regular routines to minimise the sense of disruption they may feel.

Mental health and psychosocial considerations must be incorporated into all response activities. These may include training people and putting systems in place to identify and provide care for people with common and severe mental health conditions. This may include training health and non-health workers in quarantine and isolation sites about essential psychosocial care principles, psychological first aid and how to make referrals when needed. 

During quarantine and isolation, where possible, safe communication channels should be provided to reduce loneliness and psychological isolation. Social media and telephones should be used to maintain communication with loved ones and with the outside world. 

All workers responding to the COVID-19 outbreak should be provided with access to sources of psychosocial support, this must be of equal priority with ensuring their physical safety through adequate knowledge and equipment. Psychosocial programs that are mindful of providing services for the families of healthcare workers can go a long way in supporting staff and protecting morale.


In conclusion, although the COVID-19 pandemic will affect our lives in ways we may not have anticipated, it also affords us opportunities to develop our emotional resilience, reach out to other people and care for our neighbors. When we recognize and seize these opportunities, in many ways we will protect and improve not just our own physical and mental well-being, but also that of people around us.

Written by Ayomipo Jeremiah Amiola; MBChB(Ife) and reviewed by Olakunle Oginni; MBBS(Ibadan), MSc(KCL), MRCPsych, FWACP(Psych)

Have you learnt a thing or two? Please leave your comments in the comments section below.

For questions, clarifications or help, please send an email to


D. Huremović  (ed.),  Psychiatry of Pandemics.Springer Nature Switzerland  AG 2019

Interim Briefing Note Addressing Mental Health and Psychosocial Aspects of COVID-19 Outbreak (developed by the IASC’s Reference Group on Mental Health and Psychosocial Support) Published 17 March 2020.

Unemployment and Mental Health.
Olivera Batic-Mujanovic et al. Influence of Unemployment on Mental Health of the Working Age Population. Mater Sociomed. 2017 Jun; 29(2): 92–96.doi: 10.5455/msm.2017.29.92-96. Available at

Lai J et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020 Mar 23; 3:e203976. (

Mental Health and Psychosocial Considerations During COVID-19 Outbreak. Prepared by the World Health Organization.

This Drawing by Bolu Ezra Ikuemonisan (Lord Kubols) was Titled: Help Me; the work addresses the issue of mental health in relation to suicide and the possible causes with a covert aim of bring these issues to bare, so they can be dealt with.


  1. This is surgical sir. This work out to be published and advocacy in this regard be employed in all interventions and social responses during this pandemic.

    Dr ADEYEYE Ayodele, Ogbomoso, Oyo State Nigeria.

    1. Thank you very much sir. We will work on your suggestions sir

  2. OLADAPO OLUWASEUN6 April 2020 at 07:48

    What a well researched and aptly written article. It shows the impact of the pandemic not just as respiratory virus but also as a disease of significant mental import. Thanks for the exposé sirs.

    1. Exactly Oluwaseun and that underscores the importance of incorporating mental health considerations into all forms of treatment.

  3. Absolutely brilliant! Thanks for giving such an explicit account of the heavy mental health impacts of the ongoing COVID pandemic with well-thought-out, practicable recommendations. I'm currently working on a project assessing the psychological effects of this pandemic on various families in my state and I can so relate to all that I have read here.

    Great job, Doc!

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  5. I am always inspired by your write up, my friend. One cannot quantify how badly many have been affected by the current pandemic that caught everyone by surprise. I believe your suggestions would go a long way in bringing about the alleviation of the mental health burden caused by this pandemic.


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