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1.
BMJ Open ; 11(12): e052717, 2021 Dec 08.
Article in English | MEDLINE | ID: covidwho-1560653

ABSTRACT

INTRODUCTION: Improving our understanding of the broad range of social, emotional and behavioural factors that contribute to mental health outcomes in adolescents will be greatly enhanced with diverse, representative population samples. We present a protocol for a repeated self-report survey assessing risk and protective factors for mental health and well-being in school pupils aged 8-18 years with different socioeconomic backgrounds in England. The survey will provide a comprehensive picture of mental health and associated risks at the community level to inform the development of primary and secondary prevention and treatment strategies in schools. METHODS AND ANALYSIS: This protocol is for a large-scale online repeated self-report survey, representative of children and adolescents aged 8-18 years attending schools or further education colleges in participating counties in England. The survey consists of around 300 questions, including validated measures of mental health and well-being, risk and protective factors, and care-seeking behaviour and preferences. Additional questions each year vary to address current events and novel hypotheses, developed by the research team, collaborators and stakeholders. Primary analyses will investigate current and changing risk and protective factors, care-seeking behaviour and attitudes to allowing linkage of their sensitive data to other databases for research, and will compare measures of mental health to measures of well-being. ETHICS AND DISSEMINATION: The study was approved by the University of Oxford Research Ethics Committee (Reference: R62366). Tailored data summaries will be provided to participating schools and stakeholders within 3 months of data collection. The main findings will be presented at scientific meetings, published in peer-reviewed journals and shared via digital and social media channels. At the end of the study, other researchers will be able to apply for access to anonymous data extracts.

3.
BJPsych Bull ; : 1-10, 2021 Nov 12.
Article in English | MEDLINE | ID: covidwho-1515466

ABSTRACT

AIMS AND METHOD: To gain a deeper understanding of the use of online culture and its potential benefits to mental health and well-being, sociodemographic characteristics and self-reported data on usage, perceived mental health benefits and health status were collected in an online cross-sectional survey during COVID-19 restrictions in the UK in June-July 2020. RESULTS: In total, 1056 people completed the survey. A high proportion of participants reported finding online culture helpful for mental health; all but one of the benefits were associated with regular use and some with age. Reported benefits were wide-ranging and interconnected. Those aged under 25 years were less likely to be regular users of online culture or to have increased their use during lockdown. CLINICAL IMPLICATIONS: There may be benefits in targeting cultural resources for mental health to vulnerable groups such as young adults.

4.
Evid Based Ment Health ; 24(4): 161-166, 2021 11.
Article in English | MEDLINE | ID: covidwho-1443614

ABSTRACT

BACKGROUND: The effects of COVID-19 on the shift to remote consultations remain to be properly investigated. OBJECTIVE: To quantify the extent, nature and clinical impact of the use of telepsychiatry during the COVID-19 pandemic and compare it with the data in the same period of the 2 years before the outbreak. METHODS: We used deidentified electronic health records routinely collected from two UK mental health Foundation Trusts (Oxford Health (OHFT) and Southern Health (SHFT)) between January and September in 2018, 2019 and 2020. We considered three outcomes: (1) service activity, (2) in-person versus remote modalities of consultation and (3) clinical outcomes using Health of the Nation Outcome Scales (HoNOS) data. HoNOS data were collected from two cohorts of patients (cohort 1: patients with ≥1 HoNOS assessment each year in 2018, 2019 and 2020; cohort 2: patients with ≥1 HoNOS assessment each year in 2019 and 2020), and analysed in clusters using superclasses (namely, psychotic, non-psychotic and organic), which are used to assess overall healthcare complexity in the National Health Service. All statistical analyses were done in Python. FINDINGS: Mental health service activity in 2020 increased in all scheduled community appointments (by 15.4% and 5.6% in OHFT and SHFT, respectively). Remote consultations registered a 3.5-fold to 6-fold increase from February to June 2020 (from 4685 to a peak of 26 245 appointments in OHFT and from 7117 to 24 987 appointments in SHFT), with post-lockdown monthly averages of 23 030 and 22 977 remote appointments/month in OHFT and SHFT, respectively. Video consultations comprised up to one-third of total telepsychiatric services per month from April to September 2020. For patients with dementia, non-attendance rates at in-person appointments were higher than remote appointments (17.2% vs 3.9%). The overall HoNOS cluster value increased only in the organic superclass (clusters 18-21, n=174; p<0.001) from 2019 to 2020, suggesting a specific impact of the COVID-19 pandemic on this population of patients. CONCLUSIONS AND CLINICAL IMPLICATIONS: The rapid shift to remote service delivery has not reached some groups of patients who may require more tailored management with telepsychiatry.


Subject(s)
COVID-19 , Psychiatry , Telemedicine , Communicable Disease Control , Humans , Mental Health , Pandemics , SARS-CoV-2 , State Medicine , United Kingdom
5.
The Lancet Psychiatry ; 8(5):e14-e15, 2021.
Article in English | APA PsycInfo | ID: covidwho-1340924

ABSTRACT

The current article discusses an efficient way to assess the effect of COVID-19 on mental health in the general population. It is maintained tat a meta-ecological study is needed to explore te effect of geograpically and temporally different pandemic characteristics o npopulations;mental health. Despite their potential shortcomings due to confounding and aggregation bias, meta-ecological study designs have successfully answered similar global questions, such as the role of air pollution on morbidity. In a meta-ecological study, a systematic review of prevalence before and during the pandemic in various locations with different responses to the pandemic should shed light on changes in mental health problems. It is concluded that because a meta-ecological study uses published and regularly updated information, it does not require expensive or time-consuming data collection. The crowdsourcing approach will speed up the process and could be the way forward to do large-scale research in times of social isolation. Investment in methods for harnessing information in a reliable and rapid way will enable decision makers worldwide to integrate a mental health science perspective into their response to the pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

6.
Evid Based Ment Health ; 2021 Jul 20.
Article in English | MEDLINE | ID: covidwho-1322834
7.
Evidence - Based Mental Health ; 24(2):47-48, 2021.
Article in English | ProQuest Central | ID: covidwho-1208797

ABSTRACT

Factors involved include confidence (trusting or not the vaccine or provider), complacency (seeing the need or value of a vaccine) and convenience (easy, convenient access to the vaccine).3 4 Importantly, attitudes to vaccination can change and people who are initially hesitant can still come to see a vaccine’s safety, efficacy and necessity.5 Developing strategies to address hesitancy is key.6 The expedited development and relative novelty of the COVID-19 vaccines have led to public uncertainty.4 In addition, efforts to explain the mode of action of these vaccines involve a degree of complexity (eg, immune response and genetic mechanisms), which is difficult to communicate quickly and simply. Suggestions for change include offering specific discussions from mental health professionals and peer workers, vaccine education and awareness focused for those with SMI, vaccination programmes within mental health services (with coexistent organisational change to facilitate this), alignment with other preventative health strategies (such as influenza vaccination, smoking cessation, metabolic monitoring), focused outreach and monitoring uptake.13 Monitoring of vulnerable groups vaccine uptake itself presents problems. In the case of mental illness, multiple long-term conditions across mental and physical health domains as well as socio-economic factors means that both vulnerability and inequality are likely to be additive.11 However, vaccine impact may be greater among the most vulnerable despite lower vaccine uptake because the baseline absolute risk is so high.15 Therefore, in the context of a COVID-19 vaccine programme, even if vaccine uptake falls short in some high-risk groups, even small increases in vaccine uptake will still have significant health benefits.14 Uptake of vaccination is crucial both for the individual and protection of others.

10.
JMIR Ment Health ; 7(8): e21108, 2020 Aug 28.
Article in English | MEDLINE | ID: covidwho-993040

ABSTRACT

BACKGROUND: The coronavirus disease (COVID-19) presents unique challenges in health care, including mental health care provision. Telepsychiatry can provide an alternative to face-to-face assessment and can also be used creatively with other technologies to enhance care, but clinicians and patients may feel underconfident about embracing this new way of working. OBJECTIVE: The aim of this paper is to produce an open-access, easy-to-consult, and reliable source of information and guidance about telepsychiatry and COVID-19 using an evidence-based approach. METHODS: We systematically searched existing English language guidelines and websites for information on telepsychiatry in the context of COVID-19 up to and including May 2020. We used broad search criteria and included pre-COVID-19 guidelines and other digital mental health topics where relevant. We summarized the data we extracted as answers to specific clinical questions. RESULTS: Findings from this study are presented as both a short practical checklist for clinicians and detailed textboxes with a full summary of all the guidelines. The summary textboxes are also available on an open-access webpage, which is regularly updated. These findings reflected the strong evidence base for the use of telepsychiatry and included guidelines for many of the common concerns expressed by clinicians about practical implementation, technology, information governance, and safety. Guidelines across countries differ significantly, with UK guidelines more conservative and focused on practical implementation and US guidelines more expansive and detailed. Guidelines on possible combinations with other digital technologies such as apps (eg, from the US Food and Drug Administration, the National Health Service Apps Library, and the National Institute for Health and Care Excellence) are less detailed. Several key areas were not represented. Although some special populations such as child and adolescent, and older adult, and cultural issues are specifically included, important populations such as learning disabilities, psychosis, personality disorder, and eating disorders, which may present particular challenges for telepsychiatry, are not. In addition, the initial consultation and follow-up sessions are not clearly distinguished. Finally, a hybrid model of care (combining telepsychiatry with other technologies and in-person care) is not explicitly covered by the existing guidelines. CONCLUSIONS: We produced a comprehensive synthesis of guidance answering a wide range of clinical questions in telepsychiatry. This meets the urgent need for practical information for both clinicians and health care organizations who are rapidly adapting to the pandemic and implementing remote consultation. It reflects variations across countries and can be used as a basis for organizational change in the short- and long-term. Providing easily accessible guidance is a first step but will need cultural change to implement as clinicians start to view telepsychiatry not just as a replacement but as a parallel and complementary form of delivering therapy with its own advantages and benefits as well as restrictions. A combination or hybrid approach can be the most successful approach in the new world of mental health post-COVID-19, and guidance will need to expand to encompass the use of telepsychiatry in conjunction with other in-person and digital technologies, and its use across all psychiatric disorders, not just those who are the first to access and engage with remote treatment.

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