Nov 18, 2021 - Science

Fear and loneliness caused surge of early pandemic calls for help

Percentage change of calls to helplines, by reason
Source: Brülhart, M., Klotzbücher, V., Lalive, R. et al. in Nature; Chart: Thomas Oide/Axios

Fear and loneliness replaced relationship and livelihood concerns during the pandemic, a team of scientists said after looking at millions of helpline calls in multiple countries before and after the COVID-19 pandemic started.

The big picture: Doctors and policymakers are trying to assess the impact of quarantines, school closures and other public health measures on our emotional and mental well-being. Using helpline data could become an important assessment tool, the researchers said.

  • "When it comes to tracking mental health, we are so far behind," says Cindy Liu, director of the Developmental Risk and Cultural Resilience Laboratory at Brigham and Women’s Hospital, who published a perspective piece in Nature.
  • Liu says she's "impressed" by the potential usage of helpline data.

The impact of pandemic measures on mental health was unclear because "we have no historical data to compare these situations to," says Marius Brülhart, professor of economics at the University of Lausanne and co-author of the study, published Wednesday in Nature.

  • "At the beginning of the pandemic, there were wild claims, with some people saying having lockdowns and social distancing is going to lead people to despair. They're going to take to the bottle, they're going to start hitting their spouses, and they're going to start being suicidal. On the other end of the spectrum, you have people saying, 'actually, no, you need to have lockdowns to calm the population — people are very anxious,'" Brülhart tells Axios.

What they found: The team examined 8 million calls or texts to 23 helplines in 14 EU countries, the U.S., China, Hong Kong, Israel and Lebanon from 2019 to early 2021.

  • They found a 35% rise on average in helpline calls, which peaked about six weeks after the initial outbreak.
  • "We were really interested to see what was behind the increase in the calls, and we were kind of relieved to see there were two main motives for people to call: They were anxious about the virus and anxious about getting infected. The other one was loneliness, [as] people with stay-at-home orders were cut off from their social circle," Brülhart says.
  • The risk of suicide did not appear to increase, he says, matching U.S. reports showing a national decline in 2020.

The team then looked at data from 10 of the countries that described why roughly 2.2 million people reached out during the initial pandemic wave.

  • They found the timing of strict lockdown and social distancing measures was linked to increased calls due to fear, loneliness and suicidal thinking.
  • However, the timing of governments' financial support for workers appeared to help alleviate that distress, Brülhart says.

Between the lines: There are few real-time trackers to gauge mental health during a global public health emergency such as a pandemic. For instance, suicide statistics can be released years later, Brülhart says, whereas infection rates, hospitalizations and economic indicators are updated quickly.

  • Helplines tend to track their completely anonymized data in real-time and tend to be relatively consistent globally. Brülhart says that "there's this sort of dormant treasure of information that strangely mental health researchers have not tapped yet."

Yes, but: The data is anonymized so certain characteristics, factors or entire groups may not be included, Liu and Brülhart say.

  • Another limitation, Liu points out, is that the categories looked at — for example, loneliness, relationship concerns and interpersonal violence — are related and intersecting, as "life in general is kind of messy."
  • "Loneliness itself is probably an ongoing concern. It may have been present before the pandemic and got worse during the pandemic — and actually still may be an issue, but not necessarily presented as loneliness. It can still be very much a relationship issue. So, I think there's more room for growth in how to actually categorize the content of these calls," Liu says.

Go deeper: The risk of loneliness and trauma from COVID-19

If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: dial 711 then 1-800-273-8255) or the Crisis Text Line by texting HOME to 741741.

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