Effect of COVID-19 pandemic on utilisation of community-based mental health care in North-East of Italy: A psychiatric case register study.

AIMS: WHO declared that mental health care should be considered one essential health service to be maintained during the coronavirus disease 2019 (COVID-19) pandemic. This study aims to describe the effect of lockdown and restrictions due to the COVID-19 pandemic in Italy on mental health services' utilisation, by considering psychiatric diagnoses and type of mental health contacts. METHODS: The study was conducted in the Verona catchment area, located in the Veneto region (northeastern Italy). For each patient, mental health contacts were grouped into: (1) outpatient care, (2) social and supportive interventions, (3) rehabilitation interventions, (4) multi-professional assessments, (5) day care. A 'difference in differences' approach was used: difference in the number of contacts between 2019 and 2020 on the weeks of lockdown and intermediate restrictions was compared with the same difference in weeks of no or reduced restrictions, and such difference was interpreted as the effect of restrictions. Both a global regression on all contacts and separate regressions for each type of service were performed and Incidence Rate Ratios (IRRs) were calculated. RESULTS: In 2020, a significant reduction in the number of patients who had mental health contacts was found, both overall and for most of the patients' characteristics considered (except for people aged 18-24 years for foreign-born population and for those with a diagnosis of schizophrenia. Moreover, in 2020 mental health contacts had a reduction of 57 096 (-33.9%) with respect to 2019; such difference remained significant across the various type of contacts considered, with rehabilitation interventions and day care showing the greatest reduction. Negative Binomial regressions displayed a statistically significant effect of lockdown, but not of intermediate restrictions, in terms of reduction in the number of contacts. The lockdown period was responsible of a 32.7% reduction (IRR 0.673; p-value <0.001) in the overall number of contacts. All type of mental health contacts showed a reduction ascribable to the lockdown, except social and supportive interventions. CONCLUSIONS: Despite the access to community mental health care during the pandemic was overall reduced, the mental health system in the Verona catchment area was able to maintain support for more vulnerable and severely ill patients, by providing continuity of care and day-by-day support through social and supportive interventions.

[Vocational Perspectives for People with Mental Illness Under Corona Conditions: An Exploratory Brief Survey]. / Arbeitsperspektiven für Menschen mit psychischen Erkrankungen unter Corona-Bedingungen: Eine explorative Kurzumfrage.

OBJECTIVE: Exploratory study of corona-related impacts on vocational perspectives of people with mental illness. METHODS: Short survey with quantitative and qualitative questions among employees from vocational rehabilitation. RESULTS: More than 90 % of the n = 76 participants stated that the situation regarding vocational reintegration or job search had worsened due to corona. Moreover, 75 % considered that there would still be a negative impact on vocational rehabilitation in the longer term. In addition to the main problem of a lack of job offers, open responses on obstacles also referred to increased psychological stress among clients as well as problems in reaching cooperation partners or in dealing with online processes. CONCLUSIONS: Under Corona conditions, the work-related perspectives and participation opportunities of people with mental illness have been additionally worsened.

Clubhouses Response to COVID-19: Member Challenges and Clubhouse Adaptations.

Clubhouses have been found to improve a variety of psychosocial outcomes for individuals with mental health concerns. Due to the barriers encountered during COVID-19, Clubhouses adapted their programming to meet member's needs. The purpose of the present study was to document and synthesize Clubhouse member's needs and Clubhouse adaptations during COVID-19. Clubhouse members, staff, and directors (n = 29) from five accredited Clubhouses across Canada participated in interviews about their experiences within Clubhouses during the pandemic. Interview notes were analyzed using thematic analysis through an iterative process until consensus occurred. The results indicated a number of challenges that Clubhouse members experienced including increased mental health symptoms, isolation and loneliness, and difficulty accessing services. Clubhouse adaptations included increased communication, expansion of the meal program, and sustained program delivery through technology. The results suggest that COVID-19 has provided an opportunity for Clubhouses and other community-based organizations to innovate to meet their member's needs.

Employment and economic outcomes of persons with mental illness and disability: The impact of the Great Recession in the United States.

Objective: To examine variation in employment and economic outcomes before, during, and after the great recession by disability and mental health status. Methods: Using a sample of adults in the 1999 to 2016 National Health Interview Survey (N = 419,336), we examined changes in labor force and economic outcomes by mental health and physical disability status. We employed difference-in-differences analyses to determine whether the changes in these outcomes during and after the recession for each comparison group (those with moderate mental illness, serious psychiatric disability, or physical disability) were significantly different from the changes for persons with neither a mental illness nor a disability. Findings: While the recession impacted all groups, those with mental illnesses or physical disabilities were hardest hit. Persons with disabilities were disadvantaged on all outcomes at each period, but persons with mental illnesses were the most disadvantaged. Unemployment, poverty, and use of food stamps increased for all groups, but the increase was greatest for persons with mental health problems who also saw a more substantial decline in wage income. Conclusions and Implications for Practice: The effects of the recession persist well after the recovery period. Practitioners should be aware that although most persons with mental illnesses want to work, they face significant barriers to employment. Following economic shocks such as those brought on by the current coronavirus pandemic, interventions should focus on people who are the most vulnerable, especially those with mental health problems. Renewed focus on employment for people with mental disorders is important. (PsycInfo Database Record (c) 2021 APA, all rights reserved).