Outpatient Mental Health Care During the First Three High Incidence Phases of the COVID-19 Pandemic in Germany - Results from the COVID Ψ Outpatient Survey

Abstract

Background Internationally, the COVID-19 pandemic went along with significant shifts in utilization of mental healthcare inpatient and outpatient offerings. As only a few studies have examined the situation of the mental health outpatient systems in Europe so far, the COVID Ψ Outpatient Survey surveyed outpatient providers in Germany regarding changes in utilization; associated problems, challenges and contributing factors; telemedicine services; interactions with inpatient mental health and nursing home services; and experiences with post-COVID syndromes. Methods N = 105 outpatient mental health specialists of all regions of Germany took part in the online survey. It consisted of a combination of pre-formulated and free text responses. Results For the first high incidence phase (HIP) of the COVID-19 pandemic in spring 2020, 31% of the survey participants reported a decrease > 20% and 5% an increase > 20% of contacts. For the third HIP in spring 2021, 4% reported a decrease > 20% in the number of contacts, while 30% indicated an increase > 20%. Often suggested reasons for initial decreases were patients fears of infection and providers protection measures, and for later increases pandemic and lockdown-related anxieties and economic stressors, and capacity reductions of the inpatient system. The participants related the initial capacity reductions of both inpatient and outpatient system to multiple complications. Telemedicine offerings were introduced by many providers and already in summer 2021 a majority reported consultations for post-COVID syndromes. Conclusions The survey hints at changes in utilization, multiple problems but as well good-practice-solutions in the mental health outpatient system during the COVID-19 pandemic. For future crises a better surveillance is recommended.