Global impact of the COVID-19 pandemic on mental health services: A systematic review

Duden, Gesa Solveig; Gersdorf, Stefanie; Stengler, Katarina

doi:10.1016/j.jpsychires.2022.08.013

Cited by 60 publications

(43 citation statements)

References 69 publications

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“…In a systematic review of the global impact of the pandemic on mental health services (MHS), Duden et al (2022) [ 180 ] identified several inadvertent consequences of changes in service provision, both adverse and beneficial. In particular, reduced provision of services resulted in impaired access to services early on, but a transition to remote services provided by telephone or internet communication systems, termed ‘telepsychiatry’, resulted in improved access later [ 180 ].…”

Section: Review Resultsmentioning

confidence: 99%

“…Infection control measures resulted in reduced hospital inpatient capacity in many countries, e.g., reduced by 40% in Germany. In addition, many countries reduced or ceased the provision of social, community and rehabilitation services, with the result that many patients were less likely to receive timely outpatient care after discharge from hospital [ 180 ]. The WHO’s Mental Health Atlas 2020 found that 93% of countries investigated reported some disruption to MHS, with only 7% reporting that all services remained fully operational [ 181 ].…”

Section: Review Resultsmentioning

confidence: 99%

“…While NPIs hindered access for most patients, Duden et al [ 180 ] argued that the widespread transition to telepsychiatry provided better access for some. In fact, some patients benefited in that they felt less threatened by remote consultation.…”

Section: Review Resultsmentioning

confidence: 99%

“…Noting that many services were keeping some of their digital transition, the authors suggest that this may bring about a ‘historical transformation’ by stimulating ‘a large-scale extension of telepsychiatry’. Thus, the long-term consequences of the NPIs may offer some benefits for MHS [ 180 ].…”

Section: Review Resultsmentioning

confidence: 99%

“…This potential for secondary prevention has been severely curtailed by NPIs, even in high-income countries such as the UK [ 54 , 83 ]. Similarly, mental health services might under ordinary circumstances have capacity to deal with the adverse impacts of an emergency, e.g., by providing counselling to those at risk of PTSD, but this capacity was severely curtailed by restrictions imposed early in the pandemic [ 180 , 182 ]. In addition, while childhood immunisation programmes have the potential to offset the influence of NPIs on immunity and susceptibility to infectious diseases, these have been adversely impacted by the pandemic and by reconfiguration of services, giving rise to a risk of re-emergence of diseases such as measles [ 124 ].…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities

ÓhAiseadha

Quinn

Connolly³

et al. 2023

IJERPH

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Since the start of the COVID-19 pandemic in early 2020, governments around the world have adopted an array of measures intended to control the transmission of the SARS-CoV-2 virus, using both pharmaceutical and non-pharmaceutical interventions (NPIs). NPIs are public health interventions that do not rely on vaccines or medicines and include policies such as lockdowns, stay-at-home orders, school closures, and travel restrictions. Although the intention was to slow viral transmission, emerging research indicates that these NPIs have also had unintended consequences for other aspects of public health. Hence, we conducted a narrative review of studies investigating these unintended consequences of NPIs, with a particular emphasis on mental health and on lifestyle risk factors for non-communicable diseases (NCD): physical activity (PA), overweight and obesity, alcohol consumption, and tobacco smoking. We reviewed the scientific literature using combinations of search terms such as ‘COVID-19′, ‘pandemic’, ‘lockdowns’, ‘mental health’, ‘physical activity’, and ‘obesity’. NPIs were found to have considerable adverse consequences for mental health, physical activity, and overweight and obesity. The impacts on alcohol and tobacco consumption varied greatly within and between studies. The variability in consequences for different groups implies increased health inequalities by age, sex/gender, socioeconomic status, pre-existing lifestyle, and place of residence. In conclusion, a proper assessment of the use of NPIs in attempts to control the spread of the pandemic should be weighed against the potential adverse impacts on other aspects of public health. Our findings should also be of relevance for future pandemic preparedness and pandemic response teams.

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Section: Review Resultsmentioning

confidence: 99%

Section: Review Resultsmentioning

confidence: 99%

Section: Review Resultsmentioning

confidence: 99%

Section: Review Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities

ÓhAiseadha

Quinn

Connolly³

et al. 2023

IJERPH

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Utilization of Psychiatric Hospital Services Following Intensive Home Treatment

Bechdolf,

Nikolaidis,

von Peter

et al. 2024

JAMA Netw Open

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ImportanceHome treatment (HT) has been associated with fewer inpatient treatment (IT) readmission days but lacks evidence on reducing combined psychiatric hospital service use (IT, HT, day clinic).ObjectiveTo assess the association of intensive home treatment (IHT) compared with IT regarding readmission rate, social outcomes, and clinical outcomes.Design, Setting, and ParticipantsThis quasi-experimental, nonrandomized trial was conducted from 2020 to 2022 in 10 psychiatric hospitals in Germany. Propensity score (PS) matching was used to compare both treatment models at the 12-month follow-up using standardized instruments and routine hospital data. All patients were screened until the target sample size was reached, based on these criteria: stable residence with privacy for sessions, no child welfare risk, primary diagnosis within International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes F0X to F6X, residence in the catchment area, no commitment order, no acute suicidality or severe aggression requiring hospitalization, capacity to consent, not participating in other interventional studies, sufficient German language skills, no substantial cognitive deficits or intellectual impairment, and no more than 7 days in IHT or IT before recruitment. Statistical analysis was performed from February to November 2023.InterventionIHT provided daily acute psychiatric treatment at home, while IT was psychiatric inpatient treatment as usual. The mean treatment duration of the index treatment was 37.2 days for IHT and 28.2 days for IT.Main Outcomes and MeasuresThe inpatient readmission rate was the primary outcome. Secondary outcomes were combined readmission rate, total inpatient days, job integration, quality of life, psychosocial functioning, symptom severity, and recovery.ResultsOf 1396 individuals, 200 patients receiving IHT and 200 patients receiving IT were included (264 female [65%]; mean [SD] age, 45.45 [15.83] years [range, 18-88 years]). Baseline sociodemographic and psychometric characteristics did not differ significantly between the groups. At 12-month follow-up, patients in the IHT group had lower inpatient readmission rate (IHT vs IT: 31.12% vs 49.74% IT; mean difference, 18% [95% CI, 9%-28%; P &lt; .001), combined readmission rate (mean difference, 13% [95% CI, 4%-24%; P &lt; .001), and fewer inpatient days (mean difference, 6.82 days; P &lt; .001) than the IT group.Conclusions and RelevanceThis nonrandomized clinical trial found that patients receiving IHT had a lower likelihood of utilizing hospital-based psychiatric services and spent fewer inpatient days, suggesting that IHT is a viable alternative to IT.Trial RegistrationClinicalTrials.gov Identifier: NCT04745507

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The Responsiveness of Mental Health Service Professionals to Two Years of Pandemic Emergency in Italy

Magliano,

Di Maio,

Papa

et al. 2023

Adm Policy Ment Health

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This multicenter cross-sectional study explored the responsiveness of Mental Health Services (MHS) to two years of COVID-19 emergency in Italy. Specifically, the study explored the ability of staff to: acknowledge users’ capabilities and value teamwork; reinvent the service and maintain/introduce good practices; and, acknowledge the positive aspects of the pandemic experience. These aspects were investigated in relation to socio-demographic and professional variables. Professionals from 17 MHS of 15 Italian Regions completed an online questionnaire on the MHS transformation during COVID-19. Data were collected at the end of the national health emergency (March 1-April 30, 2022). Most of the 1077 participants said they: paid more attention to users’ physical health; revised treatment plans; mediated between user needs and safe work procedures; revalued the importance of gestures and habits; discovered unexpected personal resources in users; and, found positive aspects in the COVID-19 experience. The multivariate analyses showed significant differences in staff opinions related to gender, workplace, professional role, and geographic area of the MHS, covarying with staff work experience. Compared to male staff, female staff perceived MHS as more flexible and capable to maintain best practices, and female staff acknowledged more capabilities to the users. Compared to central and northern Italy staff, southern Italy staff gave more values to teamwork, perceived MHS as more capable to maintain best practices and acknowledged higher positive transformations. These findings may be useful for planning community-oriented MHS in the post-pandemic period, taking into account both the experience gained by staff and the MHS process of adaptation.

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Global impact of the COVID-19 pandemic on mental health services: A systematic review

Cited by 60 publications

References 69 publications

Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities

Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities

Utilization of Psychiatric Hospital Services Following Intensive Home Treatment

The Responsiveness of Mental Health Service Professionals to Two Years of Pandemic Emergency in Italy

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