Experiences of living with mental health problems during the COVID-19 pandemic in the UK: a coproduced, participatory qualitative interview study

Gillard, Steve; Dare, Ceri; Hardy, Jackie; Nyikavaranda, Patrick; Olive, Rachel Rowan; Shah, Prisha; Birken, Mary; Foye, Una; Ocloo, Josephine; Pearce, Ellie; Stefanidou, Theodora; Pitman, Alexandra; Simpson, Alan; Lloyd‐Evans, Brynmor

doi:10.1101/2020.11.03.20225169

Cited by 30 publications

(46 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, as in other settings where COVID-19 measures led to outdoor NSP provision ( Seaman et al, 2021 ), there were some concerns about privacy. The move to provide drug and health service consultations remotely was not universally well-received, which reflects findings from other groups with mental health issues during COVID-19 ( Gillard et al, 2020 ). Services may wish to consider recent innovations from providers in the US ( Tringale & Subica, 2021 ) to overcome these issues.…”

Section: Discussionmentioning

confidence: 80%

Living Under Coronavirus and Injecting Drugs in Bristol (LUCID-B): A qualitative study of experiences of COVID-19 among people who inject drugs

Kesten¹,

Holland²,

Linton³

et al. 2021

International Journal of Drug Policy

View full text Add to dashboard Cite

Background : People who inject drugs (PWID) are a high-risk group for COVID-19 transmission and serious health consequences. Restrictions imposed in the UK in response to the pandemic led to rapid health and housing service alterations. We aimed to examine PWID experiences of: 1) challenges relating to the COVID-19 public health measures; 2) changes to opioid substitution therapy (OST) and harm reduction services; and 3) perceived effects of COVID-19 on drug use patterns and risk behaviour. Methods : Telephone semi-structured interviews were conducted with 28 PWID in Bristol, Southwest of England. Analysis followed a reflexive thematic analysis. Results : Concern about COVID-19 and adherence to public health guidance varied. Efforts made by services to continue providing support during the pandemic were appreciated and some changes were preferred, such as less frequent OST collection, relaxation of supervised consumption and needle and syringe programmes (NSP) home delivery. However, remote forms of contact were highlighted as less beneficial and more difficult to engage with than in-person contact. Public health guidance advising people to ‘stay home’ led to increased isolation, boredom, and time to ruminate which impacted negatively on mental health. Lockdown restrictions directly impacted on sources of income and routine. Changes in drug use were explained as a consequence of isolation and fewer interactions with peers, problems accessing drugs, reduced drug purity and reduced financial resources. Conclusion : This study captures the significant impacts and challenges of the COVID-19 pandemic on the lives of PWID. While rapid adaptations to service delivery to help mitigate the risks of COVID-19 were appreciated and some changes such as relaxation of supervised daily OST consumption were viewed positively, barriers to access need further attention. Going forwards there may be opportunities to harness the positive aspects of some changes to services.

show abstract

Section: Discussionmentioning

confidence: 80%

Living Under Coronavirus and Injecting Drugs in Bristol (LUCID-B): A qualitative study of experiences of COVID-19 among people who inject drugs

Kesten¹,

Holland²,

Linton³

et al. 2021

International Journal of Drug Policy

View full text Add to dashboard Cite

show abstract

“…The rapid, highly variable and often piecemeal adoption of telemental health modalities during the pandemic [ 7 ] has highlighted a range of very significant challenges, risks and implementation barriers. These include deterioration in the quality of care received by service users with certain mental health conditions; digital exclusion of those with limited technological access or expertise, or those facing significant social disadvantage, potentially exacerbating inequalities that already exist; lack of technological infrastructure and clear protocols within services; difficulty in establishing and maintaining therapeutic relationships; problems with conducting high quality assessments; and service users who lack private space or find participating in sometimes intimate and distressing discussions at home intrusive [ 2 , 24 – 26 ]. A range of other ethical, regulatory, technological, cultural and organisational barriers to wider implementation of telemental health and its integration with routine face-to-face care have also been identified, both before and during the pandemic [ 17 , 27 – 30 ].…”

Section: Introductionmentioning

confidence: 99%

Service user experiences and views regarding telemental health during the COVID-19 pandemic: A co-produced framework analysis

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background The prominence of telemental health, including providing care by video call and telephone, has greatly increased during the COVID-19 pandemic. However, there are clear variations in uptake and acceptability, and concerns that digital exclusion may exacerbate previous inequalities in access to good quality care. Greater understanding is needed of how service users experience telemental health, and what determines whether they engage and find it acceptable. Methods We conducted a collaborative framework analysis of data from semi-structured interviews with a sample of people already experiencing mental health problems prior to the pandemic. Data relevant to participants’ experiences and views regarding telemental health during the pandemic were identified and extracted. Data collection and analysis used a participatory, coproduction approach where researchers with relevant lived experience, contributed to all stages of data collection, analysis and interpretation of findings alongside clinical and academic researchers. Findings The experiences and preferences regarding telemental health care of the forty-four participants were dynamic and varied across time and settings, as well as between individuals. Participants’ preferences were shaped by reasons for contacting services, their relationship with care providers, and both parties’ access to technology and their individual preferences. While face-to-face care tended to be the preferred option, participants identified benefits of remote care including making care more accessible for some populations and improved efficiency for functional appointments such as prescription reviews. Participants highlighted important challenges related to safety and privacy in online settings, and gave examples of good remote care strategies they had experienced, including services scheduling regular phone calls and developing guidelines about how to access remote care tools. Discussion Participants in our study have highlighted advantages of telemental health care, as well as significant limitations that risk hindering mental health support and exacerbate inequalities in access to services. Some of these limitations are seen as potentially removable, for example through staff training or better digital access for staff or service users. Others indicate a need to maintain traditional face-to-face contact at least for some appointments. There is a clear need for care to be flexible and individualised to service user circumstances and preferences. Further research is needed on ways of minimising digital exclusion and of supporting staff in making effective and collaborative use of relevant technologies.

show abstract

“…Furthermore, whilst increased use of remote mental health care might be acceptable for a limited period, during a public health crisis, in the long term it could lead to problems with accessibility, equity of care and service quality [9,10,13]. The limited availability of online support reported by participants in our study, suggests that Greenhalgh et al [14] are correct in suggesting that the evidence relating to video-based remote care needs to be strengthened.…”

Section: Discussionmentioning

confidence: 71%

Business as Un-usual: Access to mental health and primary care services for people with severe mental illness during the COVID-19 restrictions

Newbronner

Spanakis

Wadman

et al. 2021

Preprint

View full text Add to dashboard Cite

Aims: To explore: how satisfied people with severe mental illness (SMI) are with the support received during the pandemic; understand any difficulties encountered when accessing both mental health and primary care services; consider ways to mitigate these difficulties; and assess the perceived need for future support from mental health services. Materials and Methods: A representative sample was drawn from a large transdiagnostic clinical cohort of people with SMI, which was recruited between April 2016 and March 2020. The sample was re-surveyed a few months after the beginning of the restrictions. Descriptive frequency statistics were used to analyse the quantitative data. The free text responses were analysed thematically. Results: 367 participants responded to the survey. Two thirds were receiving support from mental health services with the rest supported in primary care or self-managing. A quarter thought they would need more mental health support in the coming year. Half had needed to used community mental health services during the pandemic and the majority had been able to get support. A minority reported that their mental health had deteriorated but they had either not got the supported they wanted or had not sought help. The biggest service change was the reduction in face-to-face appointments and increasing use of phone and video call support. Nearly half of those using mental health services found this change acceptable or even preferred it; acceptability was influenced by several factors. Participants were more likely to be satisfied with support received when seen in person. Discussion: Although most participants were satisfied with the mental health support they had received, a minority were not. This, couple with findings on future need for mental health support has implications for post pandemic demand on services. Remote care has brought benefits but also risks that it could increase inequalities in access to services.

show abstract

Experiences of living with mental health problems during the COVID-19 pandemic in the UK: a coproduced, participatory qualitative interview study

Cited by 30 publications

References 22 publications

Living Under Coronavirus and Injecting Drugs in Bristol (LUCID-B): A qualitative study of experiences of COVID-19 among people who inject drugs

Living Under Coronavirus and Injecting Drugs in Bristol (LUCID-B): A qualitative study of experiences of COVID-19 among people who inject drugs

Service user experiences and views regarding telemental health during the COVID-19 pandemic: A co-produced framework analysis

Business as Un-usual: Access to mental health and primary care services for people with severe mental illness during the COVID-19 restrictions

Contact Info

Product

Resources

About