ABSTRACT
This letter discusses mental health care after the COVID-19 outbreak by presenting preliminary findings from a public general hospital in Madrid. The pandemic caused by the SARS-CoV-2 poses a major challenge for national health systems around the globe. In these situations, healthcare centers are urged to adjust their structures to the demands of the outbreak in order to protect both the users and the workers. However, this emergency has no precedent in the recent history, and entire hospitals and clinics need further adaptations for which there is no previous evidence. This affects mental healthcare teams, which deal with the unknown psychological consequences of an overwhelming, global crisis. La Paz University Hospital is a public general hospital that provides healthcare to a catchment area of more than half a million people in Madrid. So far, more than 2,700 confirmed cases of SARS-CoV-2 have been attended in this hospital, which required a complete restructuring process. A few days after the outbreak, its mental health team managed to develop a COVID-19 intervention protocol that was based on its previous experience during the 2014 Ebola crisis in Madrid and on the reports that were coming from China. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
Introduction: Spain went into lockdown in March of 2020 due to the COVID-19 outbreak. We had to stop the third randomization of our ongoing clinical trial (Mediavilla et al., 2019), pausing weekly group psychotherapy for 12 people with a first episode of psychosis. Only 5 weekly sessions had been delivered, thus many were just starting to form a therapeutic link with the group. In a public health emergency context, psychotherapeutic groups are considered avoidable gatherings. However, stopping psychological therapy abruptly can make participants more vulnerable. The intervention groups were launched in an online format because we could not let anyone go without psychological support in such a difficult time. Objective(s): Communicate how we adapted an ongoing clinical trial to an online format during the lockdown in Spain. Method(s): In light of our participants' needs and their acute deterioration the first two weeks of lockdown, we adapted our intervention. First, both arms (mindfulness-based v. psychoeducational multicomponent intervention) began online adaptations of the interventions. Second, a research assistant made weekly phone calls to provide basic psychosocial support, assure participants groups would continue, and later remind them of each online session. Third and last, the phoneline was accessible 24/7 (WhatsApp). Result(s): The third randomization concluded in December. Six participants were lost in the transition to online groups. However, adherence was comparable to the previous two randomizations (4/12 completed the intervention). Conclusion(s): Online psychotherapy may be used in emergencies such as a lockdown. However, the psychological mid- and longterm effects of a lockdown and online group therapy remain unknown.
ABSTRACT
Introduction: Long-term COVID-19 effects has been recently described as persistent and prolonged symptoms after an acute and severe SARS-COV-2 (1). An important concern is that the sequelae of severe COVID-19 may suppose a substantial outpatient's burden for the specialized services in reopening pandemic phase (2). Objective(s): To describe the frequency of mental health service use in COVID-19 hospitalized patients after discharge and to estimate the costs associated to the post- discharge consultations. Method(s): We used a 1-year follow-up cohort of 1455 COVID-19 inpatients hospitalized in La Paz University Hospital of Madrid, Spain between March 16th and April 15th, 2020. Data were retrieved from Psychiatry Service (PS) electronic health records and we described the frequency of mental health reason for consultation. We used information published by the Madrid health Office to estimate the cost of initial and following appointments. Result(s): Our sample consisted of 1,455 patients admitted with a COVID-19 diagnosis between March 16th and April 15th, 2020, and then discharged. Roughly half of them were men (776, 53%), 238 (16%) had a prior history of mental health problems, and 44 (3%) died. 193 participants (13%) visited the mental health department after being discharged. The total cost was estimated in 103,581 USD, of which two-thirds corresponded to patients with prior history of mental health problems. Conclusion(s): Our results indicate that the mental health burden of severe COVID-19 inpatient s after discharge was substantial during the first year of follow-up. This generate important economic impact to mental health providers and society at large.