Supporting people with severe mental health conditions during the COVID-19 pandemic: considerations for low- and middle-income countries using telehealth case management

Salum, Giovanni Abrahão; Rehmenklau, Jaqueline F.; Csordas, Michele Casser; Pereira, Flávia Pimentel; Castan, Juliana Unis; Ferreira, Anderson Borges; Delgado, Vera; Bolzan, Liana de M.; Lima, Miguel A. de; Blauth, Juarez H.; Reis, José R. dos; Rocha, Paula B.; Guerra, Tadeu Assis; Saraiva, Izabela M.; Gramz, Bruna de C.; Ronchi, Bruna R.; Ribeiro, Bruna Luísa Ferlin; Konig, Dienifer Farias; Grevet, Eugênio H.; Pinho, Leandro Barbosa de; Schneider, Jacó Fernando; Eustáquio, Paula R.; Ramos, Marcia Ziebell; Marques, Myriam Fonte; Axelrud, Luiza Kvitko; Baeza, Fernanda Lucia Capitanio; Lacko, Sara Evans

doi:10.1590/1516-4446-2020-1078

Cited by 17 publications

(25 citation statements)

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“…97 In Brazil, a hybrid model of in-person and remote services was instituted for individuals with psychotic disorders, including depot antipsychotic injections delivered during in-home visits, in which food insecurity was monitored. 98 A similar model of home visits for patients with severe mental illness is ongoing in Uganda amid the pandemic. 99 Furthermore, governments, health-care providers, and other institutions in many LMICs have adapted to the challenges imposed by physical distancing, disrupted public transportation, and lockdowns by shifting to remote services, ranging from suicide and mental health helplines, to voice-only phone-based services, to video services over smartphones or other digital devices.…”

Section: Reviewmentioning

confidence: 99%

COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health

Kola

Kohrt

Hanlon

et al. 2021

The Lancet Psychiatry

578

419

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Section: Reviewmentioning

confidence: 99%

COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health

Kola

Kohrt

Hanlon

et al. 2021

The Lancet Psychiatry

578

419

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“…Consequently, avoided if possible. Telemedicine and other approaches can help with mental health concerns as well as concerns with other NCDs in LMICs ( 199 ), and this is likely to continue. However, mindful that any approach needs to take into account individual patient's needs and their specific situation ( 237 ).…”

Section: Discussionmentioning

confidence: 99%

“…This is likely to be the case among Asian countries with cultures highly dependent on socialization in terms of support and connectedness, with such activities appreciably affected by lockdown and other measures ( 198 ). However, we are aware that issues of mental health are being addressed through increased telemedicine approaches in lower- and middle-income countries (LMICs) ( 199 ), and this is likely to continue. Restrictions on movement with lockdown measures, as well as concerns surrounding COVID-19 transmission, have also reduced immunization rates in India and Pakistan in recent months, which also needs addressing ( 200 , 201 ).…”

Section: Introductionmentioning

confidence: 99%

Rapid Assessment of Price Instability and Paucity of Medicines and Protection for COVID-19 Across Asia: Findings and Public Health Implications for the Future

Godman

Haque

Islam

et al. 2020

Front. Public Health

103

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Background: Countries have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE), with some countries adopting preventative strategies earlier than others. However, there has been considerable controversy surrounding some treatments. This includes hydroxychloroquine where the initial hype and misinformation lead to shortages, price rises and suicides. Price rises and shortages have also been seen for PPE. Such activities can have catastrophic effects on patients where there are high co-payment levels and issues of affordability. Consequently, there is a need to investigate this further.Objective: Assess changes in the availability, utilization and prices of relevant medicines and PPE during the pandemic among a range of Asian countries.Our approach: Narrative literature review combined with interviews among community pharmacists to assess changes in consumption, prices and shortages of medicines and PPE from the beginning of March 2020 until end of May 2020. In addition, suggestions on ways to reduce misinformation.Results: 308 pharmacists took part from five Asian countries. There was an appreciable increase in the utilization of antimicrobials in Pakistan (in over 88% of pharmacies), with lower increases or no change in Bangladesh, India, Malaysia and Vietnam. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries, as well as limited price rises for antimicrobials in India, Malaysia and Vietnam, although greater price rises seen for analgesics and vitamin C/immune boosters. Appreciable price increases were also seen for PPE across some countries.Conclusion: Encouraging to see increases in utilization of vitamins/immune boosters and PPE. However, increases in the utilization and prices of antimicrobials is a concern that needs addressing alongside misinformation and any unintended consequences from the pandemic. Community pharmacists can play a key role in providing evidence-based advice, helping to moderate prices, as well as helping address some of the unintended consequences of the pandemic.

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“…Worsening of mental health may be greater in patients with conditions such as schizophrenia with challenges in continuing active case management in the community during the pandemic as well as concerns with administering long-acting injections where pertinent, and performing regular blood tests in patients prescribed clozapine (Kozloff et al, 2020). Pro-active and timely support is needed for all patients with mental health conditions to avoid deteriorating conditions (Endomba et al, 2020;Salum et al, 2020;WHO, 2020g;Xiang et al, 2020). There are also reports of an increase in gender-based violence across countries, including African countries, as a result of lockdown measures, which also needs addressing going forward (Campbell, 2020;Chandan et al, 2020;Mahase, 2020b;SADC, 2020;United Nations., 2020b).…”

Section: Consequences Of Lockdown and Other Measures To Prevent And Tmentioning

confidence: 99%

Response to the Novel Corona Virus (COVID-19) Pandemic Across Africa: Successes, Challenges, and Implications for the Future

Ogunleye

Basu

Mueller³

et al. 2020

Front. Pharmacol.

176

215

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Background: The COVID-19 pandemic has already claimed considerable lives. There are major concerns in Africa due to existing high prevalence rates for both infectious and non-infectious diseases and limited resources in terms of personnel, beds and equipment. Alongside this, concerns that lockdown and other measures will have on prevention and management of other infectious diseases and non-communicable diseases (NCDs). NCDs are an increasing issue with rising morbidity and mortality rates. The World Health Organization (WHO) warns that a lack of nets and treatment could result in up to 18 million additional cases of malaria and up to 30,000 additional deaths in sub-Saharan Africa. Objective: Document current prevalence and mortality rates from COVID-19 alongside economic and other measures to reduce its spread and impact across Africa. In addition, suggested ways forward among all key stakeholder groups. Our Approach: Contextualise the findings from a wide range of publications including internet-based publications coupled with input from senior-level personnel. Ongoing Activities: Prevalence and mortality rates are currently lower in Africa than among several Western countries and the USA. This could be due to a number of factors including early instigation of lockdown and border closures, the younger age of the population, lack of robust reporting systems and as yet unidentified genetic and other factors. Innovation is accelerating to address concerns with available equipment. There are ongoing steps to address the level of misinformation and its consequences including fines. There are also ongoing initiatives across Africa to start addressing the unintended consequences of COVID-19 activities including lockdown measures and their impact on Ogunleye et al. COVID-19 in Africa NCDs including the likely rise in mental health disorders, exacerbated by increasing stigma associated with COVID-19. Strategies include extending prescription lengths, telemedicine and encouraging vaccination. However, these need to be accelerated to prevent increased morbidity and mortality. Conclusion: There are multiple activities across Africa to reduce the spread of COVID-19 and address misinformation, which can have catastrophic consequences, assisted by the WHO and others, which appear to be working in a number of countries. Research is ongoing to clarify the unintended consequences given ongoing concerns to guide future activities. Countries are learning from each other.

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Supporting people with severe mental health conditions during the COVID-19 pandemic: considerations for low- and middle-income countries using telehealth case management

Cited by 17 publications

References 1 publication

COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health

COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health

Rapid Assessment of Price Instability and Paucity of Medicines and Protection for COVID-19 Across Asia: Findings and Public Health Implications for the Future

Response to the Novel Corona Virus (COVID-19) Pandemic Across Africa: Successes, Challenges, and Implications for the Future

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