International experiences of the active period of COVID-19 - Mental health care

Abstract

Highlights Overall, COVID-19 has had massive impacts on mental health care internationally. Most mental health systems were under-resourced and under-prepared, both to manage existing clients and to manage new clients. There were significant differences between sites, depending on the explosivity of COVID-19 and the readiness of the mental health system. Integrated, community mental health systems exhibited greater adaptability in contrast to services which depended on face-to-face and hospital-based care. There is an urgent requirement to use the lessons of COVID to drive the next wave of mental health reform, which should prioritise local, community and digital solutions.

The impact of Covid-19 pandemic on community-oriented mental health services: The experience of Friuli Venezia Giulia region, Italy

“…From this first piece of data, community services demonstrated a greater ability to maintain an adequate level of activity and provide a continuity of care during the pandemic emergency, showing a greater adaptability compared to hospitals. This was in line with a recent summary of different international experiences regarding mental care provision during the emergency [5] . In contrast with this evidence, however, community mental services worldwide tended to have closed, strongly reduced or even converted their services in favour of physical care [ 3 , 12 , 13 ].…”

“…CMHCs in FVG remained open during the pandemic crisis and were able to offer an appropriate level of healthcare, especially through the enhancement of home services. Moreover, a proportion of patients that in normal conditions would have been hospitalised for mental care were instead followed at home due to the Covid-19 emergency [5] .…”

“…In FVG, however, psychiatric patients, even with severe conditions, had the possibility of being discharged discharged from hospital and being hosted in outpatient services. This could have led to choose CMHCs for managing patients with psychopathological difficulties, and decrease pressure on hospitals, more engaged in crisis response [ 2 , 5 ].…”

“…The pervasive contagion, along with the consequent widespread fear and the necessary containment measures to limit the outbreak (e.g. quarantine and lockdown), is likely to lead psychological consequences in the general population, but the distress in people with pre-existing psychiatric conditions is likely to have been greater [ 1 , [3] , [4] , [5] ]. Although general literature provides evidence of a greater susceptibility of psychiatric patients to environmental stress related to trauma [ 1 , 6 , 7 ], a recent review focusing on the psychological impact of quarantine included only one study considering mental illness as a risk factor [4] .…”

“…Despite these recommendations, mental care has been reported to be generally under-resourced and under-prepared in assisting new psychiatric patients and those already in charge. However, community mental health systems, well integrated with general healthcare, have demonstrated better adaptability compared to systems based on inpatient care [5] .…”