Patient and Clinician Satisfaction with the Early Implementation of Telemental Health Services in an Urban Behavioral Health Clinic During the COVID-19 Pandemic.

Objective: The COVID-19 pandemic served as an impetus for the rapid expansion of telehealth. In this study, we examined the experience of rapid transition to telemental health (TMH) within The Family Health Centers at NYU Langone, a large, urban, Federally Qualified Health Center, in the 3 months after the onset of the COVID-19 pandemic. Methods: We administered surveys to clinicians and patients who utilized TMH between March 16, 2020 and July 16, 2020. Patients were sent a web-based survey via email or received a phone survey (for those without email) with four languages choices: English, Spanish, Traditional Chinese, or Simplified Chinese. Results: The majority (79%) of clinicians (n = 83) rated the experience of TMH as "excellent" or "good," and felt that they could establish and maintain the patient relationship through TMH. Four thousand seven hundred seventy-two survey invitations were sent out to patients, and 654 (13.7%) responded. Ninety percent reported that they were satisfied with the service they received and rated TMH as better or the same as in-person care (81.6%) with a high mean satisfaction score (4.5 out of 5). Patients were more likely to rate TMH as better or the same as in-person care relative to the clinicians. Conclusions: These results are consistent with several recent studies that have explored patient satisfaction with TMH during the COVID-19 pandemic and demonstrate that both clinicians and patients experienced a high degree of satisfaction with mental health care delivered virtually compared with face-to-face encounters.

The positive energy of netizens: development and application of fine-grained sentiment lexicon and emotional intensity model.

The outbreak of COVID-19 has led to a global health crisis and caused huge emotional swings. However, the positive emotional expressions, like self-confidence, optimism, and praise, that appear in Chinese social networks are rarely explored by researchers. This study aims to analyze the characteristics of netizens' positive energy expressions and the impact of node events on public emotional expression during the COVID-19 pandemic. First, a total of 6,525,249 Chinese texts posted by Sina Weibo users were randomly selected through textual data cleaning and word segmentation for corpus construction. A fine-grained sentiment lexicon that contained POSITIVE ENERGY was built using Word2Vec technology; this lexicon was later used to conduct sentiment category analysis on original posts. Next, through manual labeling and multi-classification machine learning model construction, four mainstream machine learning algorithms were selected to train the emotional intensity model. Finally, the lexicon and optimized emotional intensity model were used to analyze the emotional expressions of Chinese netizens. The results show that POSITIVE ENERGY expression accounted for 40.97% during the COVID-19 pandemic. Over the course of time, POSITIVE ENERGY emotions were displayed at the highest levels and SURPRISES the lowest. The analysis results of the node events showed after the outbreak was confirmed officially, the expressions of POSITIVE ENERGY and FEAR increased simultaneously. After the initial victory in pandemic prevention and control, the expression of POSITIVE ENERGY and SAD reached a peak, while the increase of SAD was the most prominent. The fine-grained sentiment lexicon, which includes a POSITIVE ENERGY category, demonstrated reliable algorithm performance and can be used for sentiment classification of Chinese Internet context. We also found many POSITIVE ENERGY expressions in Chinese online social platforms which are proven to be significantly affected by nod events of different nature.

Learning about discrimination during childhood: Implications for racial trauma among Asians and Asian Americans during the pandemic.

OBJECTIVE: Although the COVID-19 pandemic has led to a sharp rise in anti-Asian hate crimes, limited data exist on racial trauma and its effects on Asian Americans. The current study investigated how racial discrimination and parental ethnic-racial socialization (cultural socialization, preparation for bias, and promotion of mistrust) were associated with racial trauma among Asian Americans in young adulthood. Increased cultural socialization and preparation for bias in childhood were hypothesized to be associated with lower levels of racial trauma, whereas increased racial discrimination and promotion of mistrust were hypothesized to predict higher levels of racial trauma. METHODS: Based on a retrospective report of young adults during the COVID-19 pandemic, this longitudinal nationwide study within the United States examined 133 Asian and Asian American young adults ages 18-30 who participated in an online survey regarding ethnic identity, childhood ethnic-racial socialization practices, racial discrimination-related experiences, and racial trauma. RESULTS: Lifetime discrimination, but not COVID-19-related discrimination, was associated with higher levels of racial trauma. Greater levels of preparation for bias during childhood predicted lower levels of racial trauma in young adulthood. Contrary to the hypothesis, greater levels of cultural socialization predicted higher levels of racial trauma. Promotion of mistrust was not associated with later racial trauma outcomes. CONCLUSION: The current study underscores the long-term impacts of parent-child discussions about racism (i.e., preparation for bias) to address racial trauma in young adulthood. Future research should further examine cultural socialization to determine its effects on racial trauma among Asian Americans.

Health-related quality of life among US young adults during the COVID-19 pandemic: Psychiatric symptoms and emotional experiences to target within clinical practice.

BACKGROUND: The current study aimed to determine the role of psychological experiences during the COVID-19 pandemic (depression, anxiety, loneliness, and COVID-19-related grief and worry) on young adult physical and mental health functioning as measured by health-related quality of life (HRQoL). METHODS: Using hierarchical multiple regression analyses, this cross-sectional study examined psychological predictors of physical and mental health functioning among young adults (age 18 to 30 years) from April 13 to September 5, 2020. RESULTS: Pre-existing depression diagnoses (beta = -0.124, P < .001), current depression symptoms (beta = -0.298, P < .001), and COVID-19-related worry (beta = -0.142, P < .001) significantly predicted poorer physical health functioning. Current depression and anxiety symptoms (beta = -0.342 and beta = -0.268), loneliness (beta = -0.135), and COVID-19-related grief (beta = -0.180) predicted lower self-reported mental health functioning (P < .001). Black (beta = -0.072) and Hispanic/Latinx participants (beta = -0.082) were more likely to indicate poorer physical health functioning (P < .01) relative to White participants, whereas women reported poorer mental health relative to men (beta = -0.047, P < .05). CONCLUSIONS: This study identifies potential negative impacts of pandemic-related psychological experiences for young adults' health during the COVID-19 pandemic. There is a need to consider mental health symptomatology, COVID-19-related experiences, race, and gender when designing efforts to address long-term implications on health.

Suspected Recurrence of Symptomatic COVID-19: Management During Inpatient Psychiatric Treatment.

The widespread prevalence of coronavirus disease 2019 (COVID-19) means that inpatient psychiatric units will necessarily manage patients who have COVID-19 that is comorbid with acute psychiatric symptoms. We report a case of recurrence of respiratory symptoms and positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) testing in a patient on an inpatient psychiatric unit occurring 42 days after the initial positive SARS-CoV-2 RT-PCR test, 38 days after initial symptom resolution, and 30 days after the first of 3 negative SARS-CoV-2 RT-PCR tests. Over the course of the admission, the patient was safely initiated on clozapine. Recent literature on COVID-19's potential recurrence and neuropsychiatric effects is reviewed and implications for the management of COVID-19 on inpatient psychiatric units are discussed. In the era of COVID-19 and our still-developing understanding of this illness, psychiatrists' role as advocates and collaborators in our patients' physical health care has become even more critical.

Potential Impact of COVID-19-Related Racial Discrimination on the Health of Asian Americans.

Anti-Asian discrimination and assaults have increased significantly during the Coronavirus disease 2019 (COVID-19) pandemic, contributing to a "secondary contagion" of racism. The United States has a long and well-documented history of both interpersonal and structural anti-Asian discrimination, and the current pandemic reinforces longstanding negative stereotypes of this rapidly growing minority group as the "Yellow Peril."We provide a general overview of the history of anti-Asian discrimination in the United States, review theoretical and empirical associations between discrimination and health, and describe the associated public health implications of the COVID-19 pandemic, citing relevant evidence from previous disasters in US history that became racialized.Although the literature suggests that COVID-19 will likely have significant negative effects on the health of Asian Americans and other vulnerable groups, there are reasons for optimism as well. These include the emergence of mechanisms for reporting and tracking incidents of racial bias, increased awareness of racism's insidious harms and subsequent civic and political engagement by the Asian American community, and further research into resilience-promoting factors that can reduce the negative health effects of racism.

Psychological correlates of poor sleep quality among U.S. young adults during the COVID-19 pandemic.

OBJECTIVE: Uncertainty due to the COVID-19 pandemic may result in problematic sleep that can lead to negative effects on overall health. This unprecedented and stressful time can be even more detrimental for young adults with pre-existing mental health conditions. The purpose of this study is to investigate potential risk factors (i.e., current mental health symptoms, and COVID-19-related grief and worry) on sleep quality of U.S. young adults during the initial months of the global pandemic. METHOD: This cross-sectional study examined 908 young adults in the weeks following the declaration of the coronavirus pandemic as a national emergency by the United States. A series of hierarchical multiple regression analyses examined depression, anxiety, and PTSD, as well as COVID-19-related grief and worry as predictors of young adults' sleep quality. RESULTS: Young adults experienced high rates of sleep problems during the first two months (April to May 2020) of the pandemic. Depressive and anxiety symptoms appear to be predictors of sleep quality regardless of any pre-existing diagnosis. Furthermore, high levels of PTSD symptoms and COVID-19-related worry were associated with young adults' poor sleep. CONCLUSIONS: Our findings point to possible psychological factors that uniquely explain young adults' poor sleep quality during the COVID-19 pandemic in the U.S. This study shed new light on how the COVID-19 pandemic might affect the sleep behaviors of young adults without a pre-existing mental health diagnosis. Implications for supporting young adults sleep and well-being during the pandemic are addressed.

In-patient psychiatry management of COVID-19: rates of asymptomatic infection and on-unit transmission.

BACKGROUND: New York City's first case of SARS-associated coronavirus (SARS-CoV-2) disease 2019 (COVID-19) was identified on 1 March 2020, prompting rapid restructuring of hospital-based services to accommodate the increasing numbers of medical admissions. Non-essential services were eliminated but in-patient treatment of psychiatric illnesses was necessarily maintained. AIMS: To detail the response of the NYU Langone Health in-patient psychiatric services to the COVID-19 outbreak from 1 March to 1 May 2020. METHOD: Process improvement/quality improvement study. RESULTS: Over this time period, our two in-patient psychiatric units (57 total beds) treated 238 patients, including COVID-19-positive and -negative individuals. Testing for COVID-19 was initially limited to symptomatic patients but expanded over the 62-day time frame. In total, 122 SARS-CoV-2 polymerase chain reaction (PCR) tests were performed in 98 patients. We observed an overall rate of COVID-19 infection of 15.6% in the patients who were tested, with an asymptomatic positive rate of 13.7%. Although phased roll-out of testing impaired the ability to fully track on-unit transmission of COVID-19, 3% of cases were clearly identified as results of on-unit transmission. CONCLUSIONS: Our experience indicates that, with appropriate precautions, patients in need of in-patient psychiatric admission who have COVID-19 can be safely managed. We provide suggested guidelines for COVID-19 management on in-patient psychiatric units which incorporate our own experiences as well as published recommendations.

Factors associated with depression, anxiety, and PTSD symptomatology during the COVID-19 pandemic: Clinical implications for U.S. young adult mental health.

This study sought to identify factors associated with depression, anxiety, and PTSD symptomatology in U.S. young adults (18-30 years) during the COVID-19 pandemic. This cross-sectional online study assessed 898 participants from April 13, 2020 to May 19, 2020, approximately one month after the U.S. declared a state of emergency due to COVID-19 and prior to the initial lifting of restrictions across 50 U.S. states. Respondents reported high levels of depression (43.3%, PHQ-8 scores ≥ 10), high anxiety scores (45.4%, GAD-7 scores ≥ 10), and high levels of PTSD symptoms (31.8%, PCL-C scores ≥ 45). High levels of loneliness, high levels of COVID-19-specific worry, and low distress tolerance were significantly associated with clinical levels of depression, anxiety, and PTSD symptoms. Resilience was associated with low levels of depression and anxiety symptoms but not PTSD. Most respondents had high levels of social support; social support from family, but not from partner or peers, was associated with low levels of depression and PTSD. Compared to Whites, Asian Americans were less likely to report high levels across mental health symptoms, and Hispanic/Latinos were less likely to report high levels of anxiety. These factors provide initial guidance regarding the clinical management for COVID-19-related mental health problems.