Integrated Behavioral Health Model for COVID-19 Patients
The COVID-19 pandemic has impacted health outcomes for noncommunicable diseases (NCD's), lifestyle behaviors, psychiatric and substance use disorders in two ways. First, individuals infected with COVID-19 who have comorbid NCD's, lifestyle risk factors and psychiatric conditions are at greater risk for morbidity and mortality than individuals without these comorbidities, and many suffer ongoing physical symptoms and/or psychiatric problems [1]. Second, the population at large is responding to the COVID-19 pandemic with increased depression, anxiety, and unhealthy lifestyle behaviors that are attributed to fear of COVID-19 infection, stress associated with job losses and reduced income, social distancing and lockdown measures [2]. The adverse impact of COVID-19 on medical, lifestyle and psychiatric conditions points to a need for an integrated behavioral approach that systematically addresses lifestyle habits underlying NCD onset and progression and the psychiatric problems for patients infected and for those at risk of infection [2].
For the population at risk of contracting COVID-19, reducing NCD risk factors, improving lifestyle habits, and treating depression, anxiety and other problems will reduce the risk of adverse outcomes if infected with COVID-19 [3]. The population at large needs an approach to address the psychological consequences of COVID-19 [4]. An integrated behavioral health approach to NCD's, lifestyle and psychiatric problems delivered via telehealth and enhanced with other health technologies such as mHealth (smartphone apps), wearables and remote monitoring is needed in response to the COVID-19 pandemic.
COVID-19 patients with NCD's such as diabetes, hypertension, and cardiovascular disease are at greater risk of complication and death [5]. Lifestyle health behaviors and obesity contribute to NCD's and poor outcomes for COVID-19 patients [3]. Optimal nutrition status to strengthen the immune system has been used as a measure of resilience towards stabilization during the COVID-19 pandemic [6]. Healthy eating may be adversely impacted by the stress of COVID-19 lockdown, social isolation and greater difficulty accessing healthy foods [7]. Physical exercise is recommended as a therapy to prevent adverse physical and psychological consequences of the COVID-19 quarantine, especially among the elderly [8].
In addition, a public health survey in China found that 53.8% of respondents rated the psychological impact of the pandemic as moderate to severe [1]. COVID-19 patients with mental health disorders face more barriers to access to care due to stigma and discrimination in health care settings [9] and comorbid mental health disorders may result in less effective medical treatment [10].
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