Impact of Covid-19 on old age patient mental health and service provision

College of Psychiatrists of Ireland, Online Winter Conference, 6 November 2020

Dr Rachel Wallace, who is based in St James’s Hospital, Dublin, presented two research studies on older individuals, which she carried out in the hospital during the early stages of the Covid-19 pandemic. She began by reminding attendees that there was a “huge amount of anxiety and mounting fear” about the pandemic in March as there was limited data on the SARS-CoV-2 virus. Early on it was clear that older adults were more vulnerable to the ill-effects of this virus and there were many fears of an overwhelmed hospital system due to reports from Italy, where a “slight ageism” towards hospital beds was witnessed in relation to Covid-19. The first study Dr Wallace presented was planned pre-Covid-19 to investigate rates of depression and anxiety in older individuals, but with the emergence of the pandemic, an additional question relating to the infection was included. Of the 69 participants, 23 per cent reported being lonely, 13 per cent tested positive for depression, 42 per cent tested positive for anxiety, and 32 per cent reported being worried about Covid-19.

Those who tested positive for depression were almost twice as likely to be worried about Covid-19 compared to those who scored negatively. Only five of the concerns relating to Covid-19, however, were about their health. The majority of worries were centred around hospital services, ability to see family members, the ability to get laundry done, and general worries for the nation and the world. “Overall, there wasn’t a huge amount of personalisation” Dr Wallace said. This study also highlighted positive coping mechanisms within these individuals, which Dr Wallace believes could potentially be of benefit to younger generations who should perhaps view these older individuals as “pillars of strength” instead of vulnerable individuals. The second study presented by Dr Wallace was an audit of pre-and mid-pandemic service provision in the Old Age Liaison Psychiatry service in St James’s Hospital. The first 18 weeks of the pandemic were compared to an 18-week period in 2018.

Dr Wallace investigated changes in referral patterns and service responsiveness, or the ability to provide the service. She found that almost the same amount of referrals were made in each 18-week period. However, in 2018 all services were carried out face-to-face, whereas in 2020 most were done via the phone.