Many clinicians I work with have experienced at least some confusion with why they are supposed to conduct a medical history assessment. They are not physicians, and while we are all aware of medical situations that can manifest as psychological maladies, at the end of the day we are still not physicians.  So, it can feel that we are encroaching on issues that are outside our clinical expertise. While it is true, we are not physicians (unless of course you are, and then this may not be speaking to you), our awareness of our client’s medical condition and history, and ensuring that our client has gone through a recent physical to ensure these symptoms are not originating from a medical condition, is important.
    Now, enter the frame of “Long COVID”. A recent report published by SAMHSA, somewhere between 7.7 to 23 million people in the United States are living with Long COVID. There is some evidence that Post-COVID-19 illness has left a significant number of individuals with cognitive impairments along with symptoms of depression, anxiety, and insomnia. And while the vast majority of those with symptoms of Long COVID had significant symptoms which required hospitalization, those individuals with mild to moderate symptoms which did not require hospitalization still are at some risk.
    While studies are still ongoing to better understand the mechanisms underlying Long COVID, several hypotheses have been formulated to explain how COVID-19 may have impacted the central nervous system, and they may be of interest to study to better understand. But the area which impacts behavioral health clinicians more directly is related to what the longer-term impacts might be.
    In studying COVID-19 against other human coronaviruses, the data supports an expected increase in cognitive and psychiatric symptoms, including cognitive decline, dementia, and affective disorders. There is some concern among the community that Long COVID may be dismissed as a psychosomatic condition, which is contrary to the scientific evidence. But this dismissal may have additional mental health impacts.
    There is still a lot to be learned about the impacts and effective treatment options for Long COVID. But with the significant spread which occurred in 2020 -2021, there is a likelihood that you will treat individuals with Long COVID and being aware of your client’s prior diagnosis of COVID-19 with a significant course of treatment may modify how you approach developing your treatment plan with them. Identification of this begins with ensuring that you are assessing for it.