Accumulating evidence exploring the impact of the pandemic on mental health has been published as the Covid-19 pandemic has evolved and reflect how shock, anxiety, and fear of the early periods of the pandemic are giving way to depression and PTSD symptoms as the pandemic and its restrictions persist (Thombs et al., 2020; Vindegaard & Benros, 2020). The general findings have been those of increased psychiatric morbidity in general populations, psychiatric populations, and special groups like quarantined and isolated populations (Reagu et al., 2021; Salari, Hosseinian-Far, Jalali, et al., 2020). Social distancing among general populations and isolation/quarantine for infected cases has been the mainstay of containment in the absence of treatment (World Health Organization 2020, Center for Disease Control and prevention 2020). However, this has been challenging and variable across the globe and has been affected by economic needs, political ideologies, and sometimes the nature of the populations like patients in mental health units (International Monetary Fund 2020, McMichael, 2020). Individuals in mental health units have been specifically identified as a special population for whom the infection control measures, social distancing, and isolation can be challenging (Liu, Bao, Huang, Shi, & Lu, 2020). This population suffers from higher rates of underlying physical health illnesses, including respiratory illnesses and obesity which have been associated with higher risk of morbidity and mortality with Covid (Cormac, Ferriter, Benning, & Saul, 2005; De Hert et al., 2011; Jordan, Adab, & Cheng, 2020; Lawrence, Hancock, & Kisely, 2013). They can lack insight or cognitive capacity to appreciate the need for infection control measures and may fail to adhere to these measures on account of mental disorders or active mental illness symptoms (Zhu et al., 2020). They are longer-term residents within inpatients settings and are
ambulatory making infection control more challenging. Sometimes they may need physical restraints for aggression and violence, which may place staff and other residents at risk of infection (Callaghan et al., 2020). In response some countries have passed emergency laws or made amendments to existing mental health legislation, where they exist, to allow for infection containment in these challenging circumstances (Brown, Ruck Keene, Hooper, & O’Brien, 2020; Sani et al., 2020; Stawicki et al., 2020). However, concerns have been raised over the inadequacy of the existing mental health legislations, including the emergency changes to deal with these unprecedented situations. Concerns have also been raised over the inadequacy of these legislations in protecting patient rights and safeguarding (Brown et al., 2020; Goldman et al., 2020; Kelly, Drogin, McSherry, & Donnelly, 2020; Stavert & McKay, 2020). It is pertinent to note that these concerns come from mental health legislation systems that are well established. Here we present a view from Qatar as it grapples with the pandemic even as it is in the process of implementing the first standalone mental health legislation in the country.
Majid Alabdulla a,b,*,1, Shuja Reagu c,d,1, Bushra Elhusein e
a Chairman of the Mental Health Service, Hamad Medical Corporation, Qatar b College of Medicine, Qatar University, Qatar c Head of Mental Health Services, Hamad Medical Corporation-Qatar, Qatar d Weill Cornell Medicine, Qatar e Consultation-Liaison Psychiatry-Mental Health Service, Hamad Medical Corporation, Qatar