LAUSR

Past experiences on viral epidemics have underscored the importance of considering mental health an integral part of any health response to biological disasters, including the COVID-19 outbreak [1]. In this context, telephone helplines are deemed crucial for timely and effective treatment of emerging mental health issues as well as emergency cases [2]. Despite its significance, there is dearth of research on the mental health effects of the COVID-19 pandemic, while there are no data at all emanating from telephone helplines. According to data from the European Centre for Disease Prevention and Control, until 21st of April, 1.073.947 COVID-19 cases have been identified in Europe and 103.989 deaths [3]. In Greece, figures have remained as low as 2.401 cases with 121 deaths, largely due to the timely public health measures to prevent the spreading of the virus [4]. In this context, the establishment of a nationwide Telephone Helpline for the Psychosocial Support amid COVID-19, operated by the First Department of Psychiatry, University of Athens, has been an immediate response to the pandemic in Greece. Here, we present data from a random sample of 576 out of 1.728 calls we received during a 3-week period since the outset of the restrictive measures. The Helpline operates on a daily basis, including weekends, from 10:00 to 22:00, and it consists of psychologists and psychiatrists. Concomitantly, upon completion of the call, the following information was garnered for service evaluation and research purposes: callers’ socio-demographic characteristics (gender, age, place of residence, family status, living arrangement, education, and employment status), reason for calling, beliefs about the coronavirus, mental health status, media exposure, frequency of experienced emotions, and mode of intervention provided. The research protocol had been approved by the Ethics Committee of the Frist Department of Psychiatry, University of Athens-Eginition Hospital. This letter presents preliminary data regarding the content of calls and mental health status. Among the 576 calls, only 7 (1.2%) callers were confirmed cases of COVID-19. Concerning their content, most calls pertained to the quarantine (482 calls, 83.7%), and more specifically to feelings of restraint (56%) and loneliness (52.9%). Moreover, 463 calls (80.4%) were centred on COVID-19 per se. Among them, the most frequent complaint was fear of illness, with 37.4% of calls being made by people not vulnerable to COVID-19 and 26.6% by people who were. It merits noting that for 19.4% of COVID-19 pertinent calls, primary concern was directed at the health of beloved ones. Finally, 175 calls (30.4%) were germane to anxiety over the economy. In one out of three calls (36.5%), the belief that the virus is unpredictable was ubiquitous. As regards emerging mental health issues, Goldberg screening tools for anxiety and depression were employed [5] consonant with research on helpline counseling services both in Greece [6] and worldwide [7]. Additionally, previous use of the scales in the Depression Helpline in Greece amid the recession was the main reason for opting for these screening tools, as comparisons between these two time periods are enabled. It merits noting that at the time which the helpline started its operation, there was no COVID-19 related instrument available in the country. Evidence on symptom prevalence during the previous 2 weeks (Table 1) corroborates the superiority of anxiety symptoms over depressive ones; however, a greater percentage of callers is above the threshold for clinically important depression than * Marina Economou [email protected]