The Use of Helplines and Telehealth Support in Aotearoa/New Zealand During COVID-19 Pandemic Control Measures: A Mixed-Methods Study

Abstract

BackgroundEarly evidence suggests that the COVID-19 pandemic and associated interventions have affected mental well-being and associated health service use.Aimsthe aim of this study was to examine the effect of the COVID-19 pandemic and associated public health measures on helpline and telehealth service demand.Methodsthe study utilized a mixed methods research design. Segmented regression analyses were used first to identify changes in patterns of demand for Aotearoa/New Zealand national helplines (n = 11) from January 2020 until the end of March 2021. Thematic analysis of 23 in-depth interviews was used next to explore the reasons behind the quantitative findings from the perspective of various organizational stakeholders.Resultsthe data from 1,244,293 Aotearoa/New Zealand national helplines' contacts between January 2020 and March 2021 showed a non-significant (1.4%) upward trend for the full range of observations. Throughout this period, a peak and trough pattern was observed. Significant demand increases were observed in anticipation of containment measures (12.4% increase from January to March 2020) and significant demand decreases coincided with relaxation of restrictions (6.9% decrease from April to June 2020). There were spikes in demand during public health interventions (i.e., mental health promotion, introduction of new helpline services) and regional lockdowns, but these did not result in significant changes in trends. In general, the demand for helplines stabilized at a new higher level. Most of the contacts occurred by telephone calls. Contacts by other methods (webchat, text, email) have shown higher uptake during the periods of lockdowns. Quantitative-qualitative data triangulation showed that youth and populations who were disproportionally negatively affected by unstable economic conditions and underemployment made more frequent contacts. Providers emphasized that increased demand could be viewed positively as a successful outcome of public health messaging; however, greater capacity is needed to better serve higher demand.ConclusionsCOVID-19, related interventions, and measures of control were associated with an increase in contacts to helplines. However, the extent of the demand increases was lower than observed internationally. Moreover, in Aotearoa/New Zealand the reasons for increases in demand were often beyond the COVID-19 pandemic and measures of control.

COVID-19 related innovation in Aotearoa/New Zealand mental health helplines and telehealth providers – mapping solutions and discussing sustainability from the perspective of service providers

“…were rolled out to promote mental wellbeing and reduce distress associated with COVID-19, also promoting telehealth services (4,5). Similar to what was observed overseas (6,7), in Aotearoa there was a decrease in the use of regular face-to-face primary and secondary healthcare, including mental healthcare and, at the same time, helplines and telehealth providers saw an increase in service demand (8).…”

“…This study is a part of a broader study that investigated the use of helplines and telehealth support in Aotearoa during COVID-19 pandemic control measures that used a mixed-methods research design ( 8 ). It was approved by the University of Auckland Health Research Ethics Committee (AH3109).…”

“…Providers noted more crisis calls and higher complexity of calls from people who had already been engaged in secondary mental health care. Additionally, COVID-19, the associated pandemic control measures, and changes in demand for health services in general also resulted in disruptions in the supply of helpline and telehealth services in mental health care (8). International evidence suggests that the provision of healthcare was affected by workforce shortages, interruptions associated with workfrom-home mandates, and greater stress from operating during such unprecedented times (9)(10)(11)(12).…”

A Chatbot to Support Young People During the COVID-19 Pandemic in New Zealand: Evaluation of the Real-World Rollout of an Open Trial

“…This period represented an opportunity for the uptake and trial of digital mental health technologies, and we used the Aroha chatbot. There was an apparent requirement for support other than face-to-face support, as community access was largely suspended and demand for support increased during this time [ 15 ].…”

Mind The Gap: Data availability, accessibility, transparency, and credibility during the COVID-19 pandemic, an international comparative appraisal

“…As the COVID-19 pandemic is raging across the globe, scientific evidence on transmissibility (1) and the effectiveness of mitigation strategies (2) is accumulating. When translated into health policy, however, this evidence has produced divergent scenarios (3,4). The efficacy of each public health policy could be indirectly evaluated though COVID-19 related data, which have been made publicly available by the majority of the national health authorities, coordinated by the World Health Organisation (WHO) (5), since the very early days of the pandemic (6).…”