Letter to the Editor

Mental health care in rural and remote areas necessitate greater attention during the COVID-19 pandemic

AUTHORS

Jooyoung Moon1 MD, Public Health Doctor

Hanna Moon2 MD, Physician *

CORRESPONDENCE

*Dr Hanna Moon

AFFILIATIONS

1 Department of Emergency Medicine, Sungju Moogang Hospital, North Gyeongsang Province, South Korea

2 Department of Obstetrics and Gynecology, Yonsei University Medical Center, Seoul, South Korea

PUBLISHED

12 September 2020 Volume 20 Issue 3

HISTORY

RECEIVED: 4 September 2020

ACCEPTED: 8 September 2020

CITATION

Moon J, Moon H.  Mental health care in rural and remote areas necessitate greater attention during the COVID-19 pandemic. Rural and Remote Health 2020; 20: 6404. https://doi.org/10.22605/RRH6404

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ETHICS APPROVAL

Not required.

This work is licensed under a Creative Commons Attribution 4.0 International Licence


full article:

Dear Editor

In the media, there are many reports of the somatic symptoms of COVID-19 and the types of medical treatment available. However, there is a relative lack of emphasis on the psychological and psychiatric effects of COVID-19 on individuals and communities. COVID-19 has resulted in social isolation, financial insecurity and weakening of social support systems1. The effects of such changes on mental health have been studied in a survey of the UK population, which has shown that adult mental health deteriorated during the COVID-19 lockdown, as compared to before lockdown2. The data reflected the persistence of existing socioeconomic health inequalities, showing the need to differentiate priorities and solutions depending on each individual’s circumstances.

Pre-COVID-19 literature had already shown that suicide rates are higher in rural communities3. Many factors have been attributed to this maldistribution, including limited access to care, reluctance to seek care, older age and higher rates of disability. At a time such as this, when the pandemic itself acts as a significant stressor to people’s lives, there is a much greater need for people in rural communities to seek mental health care.

In South Korea, mental health assistance programs, such as suicide prevention programs, are available in many rural community health centres4. However, there is not enough public awareness of these programs, and the resources are left untapped in many cases. Even when people are educated about these resources, sometimes patients go against their physician’s advice to seek assistance. In Sungju Moogang Hospital, located in a rural farming district in South Korea, a patient was admitted to the emergency room with complaints of dyspnoea and chest discomfort. No abnormalities were present on lab findings or after electrocardiogram. He showed symptoms consistent with anxiety disorder, which he attributed to the fears of contracting the coronavirus. He was educated on mental health support centres, but was too reluctant to seek help due to fears of being stigmatised as mentally ill. A few weeks later, he was admitted again to the emergency room due to a suicide attempt; this time, he agreed to seek psychiatric assistance, and has remained stable on medication since.

Many ideas and improvements are filling the gaps in mental health care during this difficult time5, but it is evident that more emphasis on rural and remote communities is needed. The unique characteristics and needs of rural communities will necessitate different solutions to this intangible issue, and the media can and should certainly help by bringing it to greater public attention.

Jooyoung Moon, Department of Emergency Medicine, Sungju Moogang Hospital, North Gyeongsang Province, South Korea

Hanna Moon, Department of Obstetrics and Gynecology, Yonsei University Medical Center, Seoul, South Korea

references:

1 Kaiser Family Foundation. The implications of COVID-19 for mental health and substance use. 2020. Available: https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use (Accessed 2 September 2020).
2 Pierce M, Hope H, Ford T, Hatch S, Hotopf M, John A, et al. Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. Lancet Psychiatry 2020; S2215-0366(20)30308-4. https://doi.org/10.1016/S2215-0366(20)30308-4
3 Thorne K, Price E, Fiske A, Scotti J. Traumatic stress and suicide risk: the role of rural origin. Journal of Rural Mental Health 2017; 41(1): 42-53. https://doi.org/10.1037/rmh0000062
4 Roh S, Lee SU, Soh M, Ryu V, Kim H, Jang JW, et al. Mental health services and R&D in South Korea. International Journal of Mental Health Systems 2016; 10: 45. https://doi.org/10.1186/s13033-016-0077-3 PMid:27257434
5 Moreno C, Wykes T, Galderisi S, Nordentoft M, Crossley N, Jones N, et al. How mental health care should change as a consequence of the COVID-19 pandemic. Lancet Psychiatry 2020; 7(9): 813-824. https://doi.org/10.1016/S2215-0366(20)30307-2