Enhancing GP care of mental health disorders post-COVID-19: a scoping review of interventions and outcomes

Abstract

Objectives: Considerable literature has examined the COVID-19 pandemic’s negative mental health sequelae. It is recognised that most people experiencing mental health problems present to primary care and the development of interventions to support GPs in the care of patients with mental health problems is a priority. This review examines interventions to enhance GP care of mental health disorders, with a view to reviewing how mental health needs might be addressed in the post-COVID-19 era. Methods: Five electronic databases (PubMed, PsycINFO, Cochrane Library, Google Scholar and WHO ‘Global Research on COVID-19’) were searched from May – July 2021 for papers published in English following Arksey and O’Malley’s six-stage scoping review process. Results: The initial search identified 148 articles and a total of 29 were included in the review. These studies adopted a range of methodologies, most commonly randomised control trials, qualitative interviews and surveys. Results from included studies were divided into themes: Interventions to improve identification of mental health disorders, Interventions to support GPs, Therapeutic interventions, Telemedicine Interventions and Barriers and Facilitators to Intervention Implementation. Outcome measures reported included the Seven-item Generalised Anxiety Disorder Scale (GAD-7), the Nine-item Patient Health Questionnaire (PHQ-9) and the ‘The Patient Global Impression of Change Scale’. Conclusion: With increasing recognition of the mental health sequelae of COVID-19, there is a lack of large scale trials researching the acceptability or effectiveness of general practice interventions. Furthermore there is a lack of research regarding possible biological interventions (psychiatric medications) for mental health problems arising from the pandemic.

Remote mental health care interventions during the COVID-19 pandemic: An umbrella review

“…( Keyes et al, 2022;Soklaridis et al, 2020) TMH: improves scheduling of consultations and counseling; time efficient; reduces consultation time. (Ardekani et al, 2021;Bertuzzi et al, 2021;Keyes et al, 2022;Li et al, 2021;Selick et al, 2021) TMH: difficulties to reach all populations (e.g.…”

“…( Keyes et al, 2022;Soklaridis et al, 2020) TMH: improves scheduling of consultations and counseling; time efficient; reduces consultation time. (Ardekani et al, 2021;Bertuzzi et al, 2021;Keyes et al, 2022;Li et al, 2021;Selick et al, 2021) TMH: difficulties to reach all populations (e.g. new patients; people in LMICs; economically disadvantaged) (Appleton et al, 2021;Li et al, 2021;Tuczyńska et al, 2021) VMH: quality and usability of e-packages/social media platform for healthcare workers (Drissi et al, 2021) VMH: lack of cultural or contextual adaptations (e.g.…”

“…apps); not effective when used as a standalone therapy. (Hatami et al, 2022;Murphy et al, 2021) TMH evaluated as (cost-) effective and feasible/ acceptable (Ali et al, 2021;Ardekani et al, 2021;Bertuzzi et al, 2021;Hatami et al, 2022;Keyes et al, 2022;Lemieux et al, 2020;Linardon et al, 2022 ;Murphy et al, 2021;Selick et al, 2021) TMH/VMH: lack of (long-term) effectiveness studies during COVID-19 (Abd-Alrazaq et al, 2021;Appleton et al, 2021;Lignou et al, 2022;Thenral & Annamalai, 2020) TMH: effective evaluation for (early stage of) common mental health disorders (Abraham, Jithesh, et al, 2021;Chiesa et al, 2021;Mohammadzadeh et al, 2022) TMH care evaluated as not effective for prevention and rehabilitation care. (Abraham, Jithesh, et al, 2021) TMH versus VMH: therapistguided online therapies more efficacious in reducing depression and anxiety than self-help internet-based treatment or apps.…”

“…(Hatami et al, 2022) VMH: evaluated as being effective for marginalized populations (Abraham, Jithesh, et al, 2021) TMH/VMH effective during COVID (e.g. people already receiving care/with established therapeutic relationship) (Appleton et al, 2021;Keyes et al, 2022;Linardon et al, 2022 ;Selick et al, 2021) VMH (e.g. iCBT) more effective in selected highly motivated patients (Keyes et al, 2022)…”

Primary Mental Health Care in a New Era

“…Meanwhile, ministerial recommendations insisted on enhanced cooperation and teamwork between primary and community mental health services with secondary specialized mental health care, emphasizing the need for community services’ contribution in quality health interventions, and underscoring mental health care in primary and community-based settings. Few recent articles have investigated how best to overcome these barriers in the post-COVID-19 era [ 21 ]. Addressing emerging barriers and challenges to treating common mental health conditions and interventions to enhance the primary care of mental health disorders, aiming to review how mental health needs might be managed in the post-COVID-19 era, is a priority.…”