CHEST Guidelines-Mental-Health-Care-During-and-After-the-ICU_2020

Mental-Health-Care-During-and-After-the-ICU_2020_c

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The article underscores the urgent necessity of addressing mental health care during and after ICU admissions, particularly as the COVID-19 pandemic exacerbates these challenges. Critical illnesses frequently lead to post-intensive care syndrome (PICS), which includes cognitive, physical, and psychological impairments. Common mental health issues among ICU survivors are depression, anxiety, and PTSD, with delirium also being prevalent during critical illness.<br /><br />Despite these well-documented concerns, mental health care frequently remains insufficiently addressed in ICU settings in the U.S., contrasting with Europe, which has made notable strides in psychologic/psychiatric outcome reporting and treatment for ICU patients. The article calls for public health experts, hospital administrators, and clinicians to prioritize mental health interventions for ICU patients, especially in the COVID-19 context, as trauma and stressors like isolation and financial strain may increase risks of mood disorders and suicides.<br /><br />Proposed measures to bridge the mental health care gap include integrating part-time or embedded psychologists and psychiatrists in ICUs, systematic screening for delirium, and introducing nonpharmacologic interventions. Initiatives like the ABCDEF bundle and post-ICU care clinics aim to address PICS by improving management of patients' sleep cycles, orientation, and early mobilization. The article emphasizes the importance of training mental health professionals in ICU-related psychological outcomes to better support patients and families impacted by critical care.<br /><br />As a global health issue, effective action must prioritize mental health care alongside medical treatment during and following ICU admissions. The growing evidence of significant mental health needs linked to critical care highlights the necessity of expanding mental health resources and integrating psychosocial care as a standard practice in ICUs to enhance the overall quality of life for survivors.

Keywords

mental health care

ICU admissions

COVID-19 pandemic

post-intensive care syndrome

depression

anxiety

PTSD

delirium

psychologists in ICUs

psychosocial care