Covid-19 and mental health: a transformational opportunity to apply an evidence-based approach to clinical practice and research

Covid-19 was first recognised in December 2019 and is now posing critical challenges for public health, clinical research and medical care worldwide.1 The covid-19 outbreak has rapidly evolved into a fast-moving global pandemic, with world updates produced on a daily basis.2 For busy clinicians, this presents a problem of information overload: while there is a sea of information, finding easily accessible, reliable and up-to-date answers to immediate clinical questions can be difficult and time-consuming. The data available are a broad sweep of official guidance from different organisations (including specialty-based, country-based and worldwide), original research papers, personal/professional experiences and commentaries. Mental health patients are particularly vulnerable in the context of covid-19, both directly because of their mental health difficulties, but also because of some of the long-term effects of psychotropic medication (such as metabolic syndrome with long-term antipsychotics), comorbid physical health problems and the effects of smoking.3 These factors together mean they are more vulnerable both to covid-19 itself and its complications, as well as to the adverse psychological effects of measures such as self-isolation and disruption to their normal healthcare and lifestyle.4 Moreover, the field of mental health is a particularly challenging area in which to source evidence related to covid-19. Covid-19 is primarily a respiratory disease and so much of the guidance and papers focus on the physical manifestations and their management. Mental health reports to date have generally examined the psychological effects of isolation/quarantine in the general public and psychological impacts on healthcare workers, rather than mental health patients/mental health services themselves. In addition, information specific to mental health is …