In addition to the ongoing strains of COVID-19, health care faces another epidemic – undiagnosed and untreated mental illness. The extent of the problem stems from many factors. The lack of obvious physical symptoms, social stigma, and a profound lack of mental health care providers all contribute to the burden of untreated mental illness. When people are hospitalized for other conditions, such as cancer, underlying mental illness may quickly spiral out of control. This leads to patient distress, unnecessary complications, and extended hospital stays.
Five things hospital-based clinicians can do to mitigate the effects of untreated mental illness:
- Take a mental health history – take time to ask about depression, anxiety, substance abuse and history of trauma. Ask “is there anything else we need to know to take care of you in the hospital?”
- Identify and avoid triggers – For individuals with a history of trauma, understand avoid triggering stimuli, including light, sounds, or specific physical contact.
- Manage Medications- Be meticulous in the continuation and appropriate adjustment of all psychoactive medications.
- Assist with family dynamics – Be aware that family interactions may be a source of ongoing trauma. Be alert, engage social workers for family assessment in the event of concern.
- Beware of Bedside procedures – Understand that “minor” procedures, such as IV starts or dressing changes may be highly traumatic to vulnerable patients. Take time to involve nursing colleagues for support and premedicate appropriately.
