Needs, gaps and opportunities for standard and e-mental health care among at-risk populations in the Asia Pacific in the context of COVID-19: A rapid scoping review.

Abstract

Background: The COVID-19 pandemic is expected to have profound mental health impact, including in the Asia Pacific Economic Cooperation (APEC) region. Some populations might be at higher risk of experiencing negative mental health impacts and may encounter increased barriers to accessing mental health care. The pandemic and related restrictions have led to changes in care delivery, including a rapid shift to the use of e-mental health and digital technologies. It is therefore essential to consider needs and opportunities for equitable mental health care delivery to the most at-risk populations. This rapid scoping review: 1) identifies populations in the APEC region that are at higher risk of the negative mental health impacts of COVID-19, 2) identifies needs and gaps in access to standard and e-mental health care among these populations, and 3) explores the potential of e-mental health to address these needs.Methods: We conducted a rapid scoping review following the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched Medline, Embase and PsychInfo databases and Google Scholar using a search strategy developed in consultation with a biomedical librarian. We included records related to mental health or psychosocial risk factors and COVID-19 among at-risk groups; that referred to one or more APEC member economies or had a global, thus generalizable, scope; English language papers, and papers with full text available.Results: A total of 132 records published between December 2019 and August 2020 were included in the final analysis. Several priority as-risk populations, risk factors, challenges and recommendations for standard and e-mental health care were identified. Results demonstrate that e-mental health care can be a viable option for care delivery but that specific accessibility and acceptability considerations must be considered. Options for in-person, hybrid or “low-tech” care must also remain available.Conclusions: The COVID-19 pandemic has highlighted the urgent need for equitable standard and e-mental health care. It has also highlighted the persistent social and structural inequities that contribute to poor mental health. The APEC region is vast and diverse; findings from the region can guide policy and practice in the delivery of equitable mental health care in the region and beyond.

Understanding Virtual Primary Healthcare with Indigenous Populations: A Rapid Evidence Review

“…One reason this is di cult is related to relationships and trust with a provider which has been argued to be eroded in the virtual care environment [26, 27,38]. One study shed light on patients who may be living in precarious or unsafe environments and the resulting barriers associated with accessing virtual care in a safe and private way [37].…”

“…Barriers associated with technology were noted often in the included articles. Many Indigenous communities experience lower socioeconomic status, may not have access to technology platforms and are commonly located in geographically rural areas with varying levels of bandwidth and internet connection [25,26,[37][38][39]. As highlighted in the literature, the technology requires expensive equipment and training that is needed upfront [31].…”

“…Technology also requires sustainable long-term funding to be maintained, which is a common challenge within Indigenous communities and with virtual care programs that are being delivered from short-term research grant funding[26, 27,31,35]. In addition to technology, internet access, and infrastructure barriers, 'digital literacy' or the 'digital divide' which is a gap in access to digital technologies and infrastructure were cited as a major barrier which may be greater in at-risk groups [35,37].…”