Mental Health Planning During the COVID-19 Crisis: A Systematic Review of Online International Strategies and Recommendations

Abstract

Background Mental Health care systems have been dramatically affected by COVID-19. Containment measures have been imposed with negative consequences on population mental health. Therefore, an increase in both symptomatology and mental disorders incidence is expected. This research aims to identify, describe and assess the empirical background on online strategies and recommendations developed by international organizations and governments to cope with the psychological impact of COVID-19. Methods A new questionnaire has been developed to identify the existence of common patterns in the selected documents. Questions were classified in three domains: COVID-19 information, mental health strategies and mental health recommendations. The PRISMA statements were adapted to review online documents. A two-steps cluster analysis was carried out to highlight underlying behaviors in data (patterns). Results were shown by using spider graphs (pattern profiles). Multidimensional links between questions were identified and assessed by conceptual maps. Results 26 documents were included in the review. The questionnaire assessed document complexity and identified key mental health issues (i.e. tools for dealing with stress, depression and anxiety), which show a high agreement level among them. Cluster analysis highlighted the existence of common patterns in the selected question domains. Strong relationships between individual questions were also identified such as, for example, include psychological tips for maintaining good mental health and coping with COVID-19 (question nº 4), describe some psychological skills to help people cope with anxiety and worry about COVID-19 (question nº 6) and, finally, promote social connection at home (question nº 8). Conclusions When fast results are needed to develop health strategies and policies, rapid reviews associated to statistical and graphical methods are essential. Results obtained from the proposed analytical procedures are relevant to a) classify the documents about the psychological impact of COVID-19, b) develop new documents according to the selected objectives for matching population needs, c) improve psychological interventions in a pandemic, and d) adapt new documents to local situations. The relevance of adapting e-mental health to community mental health care model principles was highlighted. For developing e-mental health potential, some problems related to the digital gap, stigma and ethical issues must be considered.