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The recent guidance from the American Academy of Physical Medicine and Rehabilitation (AAPM&R) on long COVID, particularly regarding mental health, underscores a significant challenge faced by patients: the often overlooked mental health symptoms post-COVID-19 infection.

Dr. Abby Cheng, a notable physiatrist and contributor to the AAPM&R's "Long COVID Mental Health Consensus Guidance Statement," emphasized in a recent interview with Patient Care the tendency of both healthcare professionals and personal acquaintances to dismiss the mental health struggles of long COVID sufferers. She is advocating for a treatment approach that begins with listening and validating the patient's experiences, a crucial step in forming a therapeutic relationship, especially critical in long COVID cases.

"I'd say the first step to treatment is really to establish a therapeutic alliance by listening to the patient, believing them and validating their experience. This is true anytime. But it's particularly important in patients with long COVID," Cheng said.

In March 2021, the AAPM&R initiated the Post Acute Sequelae of SARS-CoV-2 (PASC) Collaborative, a multidisciplinary effort to provide clinical guidance for treating long COVID. This collaboration has resulted in eight consensus guidance statements addressing various post-COVID complications, including mental health.

The guidance on mental health acknowledged the complexities involved in treating symptoms in long COVID patients. Challenges include combating stigma, differentiating between mental and physical health issues, and the general scarcity of mental health professionals. The AAPM&R's statement also addressed the dismissive attitudes patients often encounter, which can hinder proper diagnosis and treatment.

The AAPM&R guidance clarified that new or worsening mental health symptoms can be a consequence of PASC. It stressed the importance of not simplistically attributing all PASC symptoms to pre-existing mental health conditions.

Overall, the guidance underscored the essential role of thorough assessment and management of mental health symptoms in long COVID patients, regardless of whether the symptoms or PASC appeared first.