How to Build a Plane While Flying It: Conducting Research on the Mental Health Impact of COVID-19 During the Pandemic

COVID-19 has been the focus of a tremendous amount of research since it emerged as a novel illness in late 2019. By spring 2020, public health restrictions to slow the spread of infection, such as stay at home orders, affected nearly all Americans. Stressors related to the pandemic included limited information about the disease, barriers to clinical care, and fear of rampant spread. Such dramatic changes to daily life have led to negative impacts on mental health.

Studying the mental health impact of COVID-19 while the pandemic is ongoing presents challenges to clinicians and researchers. Constraints on direct in-person assessment has required the adoption of new methods to collect relevant data. Furthermore, the ability to quickly pivot, conduct and adapt studies on COVID-19 can be constrained by funding and timelines.

Our workshop is relevant for CL psychiatrists who are engaged at the mental-medical interface and are asked to respond to the challenges of caring for COVID-19 patients. We will present findings from studies on COVID-19 launched by investigators at the National Institute of Mental Health (NIMH) Intramural Research Program (IRP), where the infrastructure and stable funding allowed for a quick response. In addition, we will discuss adaptations employed to effectively conduct research on mental health during a pandemic.

Haniya Raza will present a study on the emotional impact of COVID-19 conducted as part of a collaboration with a National Institute of Allergy and Infectious Disease longitudinal project that enrolls patients who have survived SARS-CoV-2 infection (NCT04411147). The qualitative data on COVID illness experiences were collected during virtual visits for 100 COVID-19 survivors between June-December 2020 using a semi-structured interview (SSI) that accompanied a mental health evaluation. The SSIs were audio-recorded and then analyzed for unique themes by the research team.

Joyce Chung will speak about the relationship between pre-existing medical and/or mental illness and mental health outcomes during the early phase of the pandemic. This analysis came from a large online study she led on the mental health impact of the COVID-19 pandemic (NCT04339790). The participants included a subgroup of 2,000 participants enrolled from all 50 U.S. states during April-May 2020 when little was known about COVID-19 or risk factors for poor clinical outcomes.

Onyi Okeke will examine the attitudes of research participants regarding the benefit and burden of a set of mental health evaluations embedded within a natural history study of COVID-19. Her research focused on the fact that several different methods were used when adapting and conducting the study. These included utilizing an online survey system to complete measures, undergoing in-person neurocognitive assessments via iPad while adhering to safety procedures (masks and face shields), using videoconferencing to conduct mental health diagnostic interviews.