Mitigating the psychological effects of social isolation during the covid-19 pandemicBMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1904 (Published 21 May 2020) Cite this as: BMJ 2020;369:m1904
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I thank Razai et al, for their article on the psychological effects of COVID-19 related public health restrictions. (1)
The effect of self-isolation on the young must not be underestimated. Amongst those aged 12-25, loneliness, psychological distress and mental health conditions were already an epidemic without the effects of COVID-19. The Young Australian Loneliness Survey conducted by Swinburne University and VicHealth found that 1 in 2 young people in Victoria, Australia were lonely some or all of the time with 1 in 4 of those reporting a level of loneliness deemed to be problematic. (2) Similar, albeit less severe, statistics can be found for the United Kingdom. (3) Worldwide, the incidence of any mental health condition amongst young people in their twenties is 19.8% for men and 32.4% for women highlighting the prevalence of these conditions in normal circumstances. (4)
However, the outbreak of COVID-19 is not a normal circumstance. Many young people have found themselves physically split from their social groups. There is evidence to suggest that close in-person relationships with friends and the community are a major protective factor against mental health conditions in young people. (5) The pandemic has taken this away from many worldwide. Non face to face relationships are no substitute for physical connectedness with Hu finding that virtual interactions are less effective at lowering mood loneliness than their real life equivalents. (6)
Not only has the pandemic led to a loss of connectedness but it has also made access to daily activities such as education, employment, healthcare and recreation difficult in many areas. This has wide reaching implications for mental health. Many will face a loss of identity from losing access to a crucial part of their daily routine and may experience a disconnect from reality as a result. (7) Some young people already at risk will have lost access to support that was assisting with alcohol and drug abuse, homelessness and poverty which will lead to more unfavourable mental health outcomes.
The implications of COVID-19 on young people are serious and it is incumbent on all medical practitioners to be cognizant of the multifaceted impacts that public health restrictions can have on young people. In a cohort that is already reticent to seek care, doctors must approach issues of young people’s mental health in a sympathetic and comprehensive manner during this time. Otherwise, the potential exists to compound the harm that COVID-19 has already done to young people.
1. Razai MS, Oakeshott P, Kankam H, Galea S, Stokes-lampard H. Mitigating the psychological effects of social isolation during the covid-19 pandemic. BMJ. 2020;369(m1904):1–5.
2. Lim MH, Eres R, Peck C. The Young Australian Loneliness Survey: understanding loneliness in adolescence and young adulthood. Victorian Health Promotion Foundation (VicHealth). Melbourne; 2019.
3. Snape D, Manclossi S. Children’s and young people’s experiences of loneliness: 2018. Office for National Statistics. London; 2018.
4. Gustavson K, Knudsen AK, Nesvåg R, Knudsen GP, Vollset SE, Reichborn-Kjennerud T. Prevalence and stability of mental disorders among young adults: Findings from a longitudinal study. BMC Psychiatry. 2018;18(1):1–15.
5. Saeri AK, Cruwys T, Barlow FK, Stronge S, Sibley CG. Social connectedness improves public mental health: Investigating bidirectional relationships in the New Zealand attitudes and values survey. Aust N Z J Psychiatry. 2018;52(4):365–74.
6. Hu M. Will online chat help alleviate mood loneliness? Cyberpsychology Behav. 2009;12(2):219–23.
7. Conroy SA, O’Leary-Kelly AM. Letting go and moving on: Work-related identity loss and recovery. Acad Manag Rev. 2014;39(1):67–87.
Competing interests: No competing interests