Vol 1, No 1 (2020)

The current COVID-19 pandemic is associated with fear, insecurity, and perceived social isolation worldwide. In this editorial, we discuss the influence of the COVID-19 pandemic on mental health among the general population and among particularly vulnerable groups (e.g., people with pre-existing mental illness). Additionally, we explore the role of e-mental health options in times of social distancing. Preliminary empirical evidence indicates that a wide range of people have experienced mental health difficulties due to the COVID-19 pandemic and corresponding infection-control measures. E-mental health options are a feasible means of addressing psychological distress and mental illness during the pandemic. Thus, these options should be made available in a timely fashion. Future multidisciplinary research is needed to develop e-mental health strategies that specifically focus on the consequences of social isolation, economic hardship and fear of infection.

Background. In 2020, the COVID-19 pandemic evoked a variety of research into the virus and its effects on mental health. A variety of mental health and psychological problems have been reported: stress, anxiety, depressive symptoms, insomnia, denial, stigma, anger and fear.

Objectives. To assess the level of anxiety, depression and distress in the general population during the lockdown in Russia and to reveal factors associated with distress.

Methods. An online survey was carried out from 22–27 April 2020 (the fourth week of lockdown) among the general population (mostly Moscow residents). The survey questions covered general information about people’s social and demographic characteristics, experience of COVID-19, health condition (physical and mental), attitudes and views on the pandemic, and the need for psychological support. The survey included the Hospital Anxiety and Depression Scale (HADS) and evaluation of the preceding week’s subjective distress level using a visual numeric scale (from 0 to 10). We also asked respondents to specify the causes of distress, adopted from the WHO information sheet relating to the major psychological challenges of the COVID-19 pandemic.

Results. In total, 352 responses were collected (men = 74, women = 278; age (M ± SD) = 36.81 ± 11.36 y.o.). Most respondents (n = 225, 63.92%) did not have any personal experience of the coronavirus infection. Normal levels of anxiety and depression scores were prevalent in the sample. Higher than normal levels of HADS anxiety/depression (> 7 scores) were observed in 105 (29.83%) and 59 (16.76%) respondents, respectively; mean (95% CI) scores for HADS anxiety/depression were 6.23 [5.77, 6.68] /4.65 [4.22, 5.08] (women) and 4.20 [3.32, 5.09] /3.46 [2.63, 4.29] (men), respectively.
The leading causes of distress were: 1) the risk of financial problems in the future (n = 267, 76.3%); 2) violation of plans and the disruption to normal life (n = 235, 67.1%; and n = 240, 68.6%, respectively); 3) the health of elderly or chronically diseased relatives (n = 205, 58.6%) and 4) being in self-isolation (n = 186, 53.1%).

Conclusion. The level of anxiety and depression during the COVID-19 pandemic in the study sample did not exceed the norm for the population in non-pandemic conditions. Our assessment of distress levels captured existing emotional problems, and distress levels were found to be connected with the reported need for psychological support.

Background. Virtual reality (VR) has been effectively used in the treatment of many mental health disorders. However, significant gaps exist in the literature. There is no treatment framework for researchers to use when developing new VR treatments. One recommended treatment across a range of diagnoses, which may be suitable for use in VR treatments, is Cognitive Behavioural Therapy (CBT). The aim of this systematic review is to investigate CBT treatment methods that utilize VR to treat mental health disorders.

Objectives. To investigate how CBT has been used in VR to treat mental health disorders and to report on the treatment characteristics (number of sessions, duration, and frequency) that are linked to effective and ineffective trials.

Methods. Studies were included if patients had a mental health diagnosis and their treatment included immersive VR technology and CBT principles. Data were extracted in relation to treatment characteristics and outcomes, and analysed using narrative synthesis.

Results. Ninety-three studies were analysed. Exposure-based VR treatments were mainly used to treat  anxietyrelated disorders. Treatments generally consisted of eight sessions, once a week for approximately one hour. VR treatments were commonly equal to or more effective than ‘traditional’ face-to-face methods. No specific treatment characteristics were linked to this effectiveness.

Conclusion. The number, frequency and duration of the VR treatment sessions identified in this review, could be used as a treatment framework by researchers and clinicians. This could potentially save researchers time and money when developing new interventions.

The mental health system in Portugal evolved from an institutional-centred system to a community-based system, a process which began in 1998 and has gathered pace since 2006.
The approval and implementation of the Portuguese Mental Health Law and the Portuguese National Mental Health Care Plan has contributed to the implementation of institutions and regulations aimed at decentralized, local and less restrictive models of care. The implementation and evolution process has been steady and gradual, introducing many of the envisioned changes whilst adapting existing mental health institutions and services.
The current article describes this transition process, attempting to identify the strengths and weaknesses of the Portuguese Mental Health System from a community-centred perspective.

Lebanon is a medium-income country in the Eastern Mediterranean which has seen a surge in interest in mental health over the past two decades following years of stagnation. The mental health needs of the country at primary care level and for severe psychiatric disorders are underserved. Political instability, chronic underfunding and widespread stigma have all contributed to maintaining a traditional model of private clinics affiliated with inpatient and long-stay psychiatric units. A number of initiatives have recently been launched to cater for patients with psychotic disorders and also to offer partial hospitalization for others with mood-related conditions. In parallel, the Ministry of Public Health, with international funding, has been instrumental in its efforts to standardize care at a national level, particularly for early detection and treatment in primary care settings. The priorities of the national mental health programme are consistent with the global trend in shifting services to the community. Hurdles remain, in line with those facing countries with similar socio-demographics and resources. These include limited third-party coverage of mental health, absence of training opportunities in multidisciplinary community settings and some clinicians’ reluctance to update their ways of working. Development of a local workforce, familiar with evidence-based models of care and dedicated to providing a patient-centred approach in the least restrictive settings, is essential for consolidating community care in Lebanon. This would be reinforced by (overdue) legislation and implementation of a mental health law.

Asia is the largest and the most populous continent on earth. South Asia has a population of around 1.8 billion, thus constituting about one fourth of humanity. India, Pakistan, Bangladesh, Sri Lanka, Nepal, Bhutan, the Maldives and Afghanistan are the countries in South Asia and many of them are Muslim-majority nations. Although India is predominantly a Hindu nation with a total population of 1.4 billion, there are more Muslims in India than in Pakistan and other South Asian nations. Hindus, Muslims, Christians, Sikhs and followers of other religions have lived peacefully in South Asia for centuries. However, certain incidents of communal violence and other untoward occurrences in South Asia suggest that Islamophobia is present here too. The authors discuss demography, cultures and the possible effect of Islamophobia on the mental health of the people of South Asia.