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1.
Curr Opin Psychiatry ; 34(4): 434-443, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1637741

ABSTRACT

PURPOSE OF REVIEW: To reduce the spread of infection from the coronavirus disease 2019 (COVID-19), mental healthcare facilities were forced to make the rapid transition from face-to-face services to virtual care. This systematic review aims to synthesize the extant literature reporting on barriers of telemental health (TMH) during the COVID-19 pandemic and how facilities have worked to overcome these barriers, to inform best practices for TMH delivery. RECENT FINDINGS: Most recent findings came from case studies from mental health professionals which reported on barriers related to institutional, provider and patient factors, and how these barriers were overcome. Common barriers identified in the literature include: technological difficulties; issues regarding safety, privacy and confidentiality; therapeutic delivery and the patient-provider relationship; and a loss of sense of community. Studies also reported on the benefits to TMH interventions/tools, as well as suggestions for improvements in the delivery of TMH services. SUMMARY: As the COVID-19 pandemic evolves, mental healthcare providers continue to find creative and feasible solutions to overcome barriers to the delivery of TMH. Dissemination of these solutions is imperative to ensure the best quality of mental healthcare for patients across the globe.


Subject(s)
COVID-19/prevention & control , Health Services Accessibility/statistics & numerical data , Mental Disorders/therapy , Mental Health Services , Quality Improvement , Telemedicine/methods , COVID-19/psychology , Humans , Mental Disorders/psychology , Pandemics , SARS-CoV-2
2.
PLoS One ; 16(12): e0261818, 2021.
Article in English | MEDLINE | ID: covidwho-1623662

ABSTRACT

OBJECTIVE: Our project aims to provide: an overview of the impact of the COVID-19 pandemic on the field of mental health professionals in 23 countries;a model of recommendations for good practice and proposals for methods and digital tools to improve the well-being at work of mental health professionals and the quality of services offered during crisis and post-crisis periods;an in-depth ethics review of the assessment of the use of numerical tools for psychiatry professionals and patient support, including teleconsulting. METHODS: This is a large international survey conducted among 2,000 mental health professionals in 23 countries over a 12-month period. This survey will be based on 30 individual interviews and 20 focus group sessions, and a digital questionnaire will be sent online to 2,000 professionals based on the criteria of gender, age, professional experience, psychiatric specialty, context of work in psychiatry, and geographical location. Regarding the development of telepsychiatry during the COVID-19 pandemic, a pilot study on the use of digital tools will be carried out on 100 clients of psychiatry professionals in France and Belgium. DISCUSSION-CONCLUSION: This study will contribute to the co-construction of an international organization and monitoring system that takes into account psychiatric health professionals as major resources to fight against the COVID-19 pandemic and to develop efficient processes for preparing and anticipating crises by reducing psychosocial risks as much as possible. This project also aims to design tools for remote medicine and to develop the use of numerical tools for monitoring and supporting professionals and helping professionals to build the conditions for satisfactory operational work during crises and post-crisis situations, using adapted organizational methods. Our ongoing research should support professionals in the search for existing concrete solutions to cope with emergency work situations while maintaining an optimal quality of life.


Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Mental Health Services/organization & administration , Mental Health , Pandemics , Professional Practice , Psychotherapists/psychology , SARS-CoV-2 , Belgium/epidemiology , COVID-19/virology , Female , France/epidemiology , Humans , Male , Pilot Projects , Quality of Life/psychology , Surveys and Questionnaires , Telemedicine/methods
3.
Lancet Psychiatry ; 9(1): 8-9, 2022 01.
Article in English | MEDLINE | ID: covidwho-1569159
5.
J Psychiatr Ment Health Nurs ; 28(6): 941-942, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1528402
6.
CMAJ Open ; 9(4): E988-E997, 2021.
Article in English | MEDLINE | ID: covidwho-1524571

ABSTRACT

BACKGROUND: The extent to which heightened distress during the COVID-19 pandemic translated to increases in severe mental health outcomes is unknown. We examined trends in psychiatric presentations to acute care settings in the first 12 months after onset of the pandemic. METHODS: This was a trends analysis of administrative population data in Ontario, Canada. We examined rates of hospitalizations and emergency department visits for mental health diagnoses overall and stratified by sex, age and diagnostic grouping (e.g., mood disorders, anxiety disorders, psychotic disorders), as well as visits for intentional self-injury for people aged 10 to 105 years, from January 2019 to March 2021. We used Joinpoint regression to identify significant inflection points after the onset of the pandemic in March 2020. RESULTS: Among the 12 968 100 people included in our analysis, rates of mental health-related hospitalizations and emergency department visits declined immediately after the onset of the pandemic (peak overall decline of 30% [hospitalizations] and 37% [emergency department visits] compared to April 2019) and returned to near prepandemic levels by March 2021. Compared to April 2019, visits for intentional self-injury declined by 33% and remained below prepandemic levels until March 2021. We observed the largest declines in service use among adolescents aged 14 to 17 years (55% decline in hospitalizations, 58% decline in emergency department visits) and 10 to 13 years (56% decline in self-injury), and for those with substance-related disorders (33% decline in emergency department visits) and anxiety disorders (61% decline in hospitalizations). INTERPRETATION: Contrary to expectations, the abrupt decline in acute mental health service use immediately after the onset of the pandemic and the return to near prepandemic levels that we observed suggest that changes and stressors in the first 12 months of the pandemic did not translate to increased service use. Continued surveillance of acute mental health service use is warranted.


Subject(s)
COVID-19/epidemiology , Mental Health Services/statistics & numerical data , Mental Health Services/trends , Pandemics/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Anxiety Disorders/epidemiology , Child , Emergency Service, Hospital/statistics & numerical data , Female , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Mood Disorders/epidemiology , Ontario/epidemiology , Psychotic Disorders/epidemiology , SARS-CoV-2 , Self-Injurious Behavior/epidemiology , Substance-Related Disorders/epidemiology , Young Adult
9.
BMJ ; 375: n2608, 2021 11 15.
Article in English | MEDLINE | ID: covidwho-1518139

ABSTRACT

The studyLester S, Khatwa M, Sutcliffe K. Service needs of young people affected by adverse childhood experiences (ACEs): A systematic review of UK qualitative evidence. Child Youth Serv Rev 2020;118:105429.To read the full NIHR Alert, go to https://evidence.nihr.ac.uk/alert/support-needs-of-young-people-affected-by-adverse-childhood-experiences/.


Subject(s)
Adverse Childhood Experiences/psychology , Mental Health Services , Social Support , Adolescent , Adult , Child , Female , Healthcare Disparities , Humans , Male , Qualitative Research , United Kingdom , Young Adult
10.
J Dev Behav Pediatr ; 42(7): 602-604, 2021 Sep 01.
Article in English | MEDLINE | ID: covidwho-1517918

ABSTRACT

CASE: Billy is a 2.6-year-old boy who presented for evaluation in the developmental-behavioral pediatrics (DBP) clinic 2 weeks before the onset of pandemic-related clinic restrictions. Billy had received early intervention for the past year because of speech and fine motor delays. Billy's parents requested the evaluation in the DBP clinic because his delayed speech and disruptive behaviors had raised concern that he may have autism spectrum disorder. Owing to the onset of the pandemic, subsequent visits were completed through telehealth with a developmental-behavioral pediatrician, psychologist, behavioral clinician, and social workers who developed a collaborative plan of care. Billy was diagnosed with global developmental delay, significant tantrums, and impulsivity but did not meet the criteria for autism spectrum disorder.Billy lives with his parents and 2 sisters in a rural area, 3 hours from the DBP clinic. Both of his parents have been treated for depression in the past and reported that school was difficult for them. His sisters, ages 5 and 6 years, receive speech/language therapy but have not required additional special education services. His family has endured recent stressors including a flooding event that caused significant damage to their home, financial difficulties, and the recent unexpected death of a close family member. Billy's disruptive behaviors have resulted in difficulty finding and maintaining child care, further contributing to parental stress and dysfunction in the home.Despite assistance from the social worker, additional developmental and behavioral support services near the family's home were not identified. Therefore, services were offered to Billy and his parents through telehealth. Billy's parents began behavioral parent training with a clinician embedded within the DBP clinic and, with direct support from his parents, Billy began receiving supplemental speech/language and occupational therapies through telehealth. Through recurrent engagement with Billy's parents and frequent communication among the behavioral clinician, developmental-behavioral pediatrician, psychologist, and social worker, Billy was able to make significant developmental progress, and his parents reported improved ability to manage his difficult behaviors.How can telehealth be used to help families navigate complex systems and obtain optimal care and support?


Subject(s)
COVID-19 , Child Behavior Disorders/therapy , Child Health Services , Mental Health Services , Telemedicine , Child, Preschool , Humans , Male
11.
Acta Biomed ; 92(S6): e2021448, 2021 11 03.
Article in English | MEDLINE | ID: covidwho-1504899

ABSTRACT

BACKGROUND: The new 2019 coronavirus disease (COVID-19) outbreak forced mental health providers to overcome their general reluctance about telematic assistance, shifting from a face-to-face approach to online therapy to promote continuity of care for psychiatric patients. METHODS: An ad-hoc web-based survey questionnaire assessing the impact of the COVID-19 pandemic on therapeutic setting in Mental Health Services was sent via email from March 15, 2021 to June 15, 2021 to mental health providers in Genova, Italy. The survey was anonymous and a free Google Forms® software was used. RESULTS: Two hundred nineteen mental health providers completed the survey, and the overall response rate (ORR) was 65%. During the COVID-19 pandemic period, the continuity of care was mainly guaranteed using electronic devices. Psychologists reported a higher availability of video call assistance service to guarantee continuity of care for psychiatric patients compared to psychiatrists and psychotherapists (p<0,001). Psychiatrists reported the lowest degree of satisfaction about this new telematic approach (p<0,01), while psychologists and to a lesser extent psychotherapists speculated to use it even in non-pandemic times (p=0,02). CONCLUSIONS: COVID-19 pandemic creates an opportunity to overcome normative, technological and cultural barriers to the use of online psychotherapy, showing the importance of adapting the therapeutic setting to both collective and individual needs. Despite initial concerns about its effectiveness and efficacy, a general degree of satisfaction was expressed by the majority of the mental health providers. Further efforts will be needed to enhance this new way of working and to train therapists with particular regard to those employed in the public health system.


Subject(s)
COVID-19 , Mental Health Services , Humans , Mental Health , Pandemics , SARS-CoV-2
13.
Psychiatry Res ; 302: 113999, 2021 08.
Article in English | MEDLINE | ID: covidwho-1492523

ABSTRACT

This study assesses for the impact of Covid-19 public health quarantine measures on acute care psychiatric admissions, by comparing admission data from the quarantine period to a comparator period. A chart review was conducted for all admissions to an urban acute care psychiatric centre from Mar 22 - June 5 2020 (quarantine) and January 5 - Mar 21 2020 (comparator). Data was collected on the number of admissions, demographics, patients' psychiatric history, characteristics of admissions, discharge information, patients' substance use and social factors. Data was analyzed using a student's t-test for continuous variables and Chi squared analyses for categorical variables. Results demonstrated 185 admissions during quarantine and 190 during the comparator, with no significant differences in the distribution of admissions across time periods. There was a significantly greater frequency of admissions in the 35-44 age bracket and admissions involving substance use during quarantine. Additionally, admissions during quarantine were significantly shorter, with increased frequency of involuntary status and use of seclusion. The data suggests a vulnerability specific to individuals in their 30-40s during quarantine and demonstrates a need to better understand factors impacting this group. It also suggests that quarantine is associated with changes to substance use, potentiating high acuity illness requiring admission.


Subject(s)
COVID-19/prevention & control , Hospitalization/statistics & numerical data , Mental Disorders/therapy , Mental Health Services/statistics & numerical data , Quarantine/psychology , Adult , Aged , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , Nova Scotia/epidemiology , Public Health/legislation & jurisprudence , Retrospective Studies , Young Adult
14.
Nature ; 598(7880): 235-236, 2021 10.
Article in English | MEDLINE | ID: covidwho-1472226
15.
BMJ Open ; 11(10): e047385, 2021 10 14.
Article in English | MEDLINE | ID: covidwho-1470513

ABSTRACT

INTRODUCTION: Despite high levels of mental distress, accessing psychological treatment is difficult for asylum seekers in Western host countries due to a lack of knowledge about mental disorders, and the health system, as well as due to cultural and language barriers. This study aims to investigate whether brief culturally sensitive and transdiagnostic psychoeducation is effective in increasing mental health literacy. METHODS AND ANALYSIS: The study is a parallel two-group randomised controlled trial with 1:1 individual allocation to either culturally sensitive, low-threshold psychoeducation ('Tea Garden' (TG)) or a waitlist (WL) control group. It takes place at four study sites in Germany. A total of 166 adult asylum seekers who report at least mild mental distress will be randomly assigned. The TG consists of two 90 min group sessions and provides information about mental distress, resources and mental health services in a culturally sensitive manner. The primary outcome is the percentage of participants in the TG, as compared with the WL, achieving an increase in knowledge concerning symptoms of mental disorders, individual resources and mental healthcare from preintervention to postintervention. The further trajectory will be assessed 2 and 6 months after the end of the intervention. Secondary outcomes include changes in mental distress, openness towards psychotherapy and resilience. Furthermore, healthcare utilisation and economics will be assessed at all assessment points. ETHICS AND DISSEMINATION: The study has been approved by the Ethics Commission of the German Psychological Society (ref: WeiseCornelia2019-10-18VA). Results will be disseminated via presentations, publication in international journals and national outlets for clinicians. Furthermore, intervention materials will be available, and the existing network will be used to disseminate and implement the interventions into routine healthcare. TRIAL REGISTRATION NUMBER: DRKS00020564; Pre-results. PROTOCOL VERSION: 2020-10-06, version number: VO2F.


Subject(s)
Mental Disorders , Mental Health Services , Refugees , Adult , Humans , Mental Health , Multicenter Studies as Topic , Psychotherapy , Randomized Controlled Trials as Topic
16.
Int J Environ Res Public Health ; 18(19)2021 10 07.
Article in English | MEDLINE | ID: covidwho-1463660

ABSTRACT

The Australian Institute of Health and Welfare (AIHW) has been providing support to the Australian Government Department of Health to report on mental health-related data to Australian governments on a frequent basis since April 2020 in the form of COVID-19 mental health services data dashboards. These dashboards feature extensive use of data visualizations which illustrate the change in mental health service use over time as well as comparisons with pre-pandemic levels of service use. Data are included from the Medicare Benefits Schedule (MBS), Pharmaceutical Benefits Scheme (PBS/RPBS), Australian Government-funded crisis and support organizations, and key findings from emerging research. Demand for telehealth, crisis and support organizations and online mental health information services, in particular, have increased during the pandemic. The dashboards incorporate both new and existing data sources and represent an innovative way of reporting mental health services data to Australian governments. The reporting has enabled timely, targeted adjustments to mental health service delivery during the pandemic with improved cooperative data sharing arrangements having the potential to yield ongoing benefits.


Subject(s)
COVID-19 , Mental Health Services , Aged , Australia , Government , Humans , Medicare , SARS-CoV-2 , United States
17.
J Public Health (Oxf) ; 43(Supplement_2): ii51-ii56, 2021 Oct 08.
Article in English | MEDLINE | ID: covidwho-1462462

ABSTRACT

BACKGROUND: The impact of coronavirus disease 2019 on mental health of populations is in focus recently but few studies focus on service adaptations to ensure care provision for the mentally ill. In India, where community-based mental healthcare is led by non-government organizations (NGOs), this is a crucial time to gather evidence on how these organizations adapted to the challenges. METHODS: We explored provider perspectives in an NGO providing mental health services to communities using in-depth interviews and a focus group discussion to understand the impact on services and adaptations during the COVID 19 pandemic. RESULTS: Three elements of service provision were highlighted: established relationships with communities, responsiveness to the patient needs, and resilience in ensuring continuity. Responding to the end-to-end care needs of the clients and continual adaptations were vital for ensuring continued services. Telemedicine enabled expansion of service and clientele as well as efficiency, but there were issues of casualization of therapy and poor privacy. CONCLUSIONS: The study provides an understanding of adaptations to ensure continuity of care to mentally ill during disruptions. Insights from strategies are crucial to help plan for resilient community-based mental health care services.


Subject(s)
COVID-19 , Community Mental Health Services , Mental Health Services , Humans , Pandemics , SARS-CoV-2
18.
Front Health Serv Manage ; 38(1): 32-38, 2021 Oct 01.
Article in English | MEDLINE | ID: covidwho-1455390

ABSTRACT

SUMMARY: Fighting the global COVID-19 pandemic has shifted from immediate response efforts to recognition of the long-term effects on the mental health and well-being of the general population and healthcare workforce. Leaders need to understand the vital role of behavioral health services in a population-based, integrated healthcare framework and address the needs of the behavioral health workforce to successfully deploy services in their organizations and communities.During the ongoing national response to COVID-19, three major trends have emerged: (1) a shift to telehealth and digital care, (2) greater awareness of the impact on the workforce of the shift to digital care, and (3) an open dialogue to counteract the stigma and discrimination related to mental illness and to emphasize mental well-being instead. When they address stigma and discrimination, healthcare leaders embrace a more holistic approach that welcomes behavioral health professionals as equal, vital members of the care team. They help their organizations advance the mental well-being of all.


Subject(s)
COVID-19/psychology , COVID-19/therapy , Health Personnel/psychology , Health Promotion/organization & administration , Mental Disorders/therapy , Mental Health Services/organization & administration , Social Stigma , Telemedicine/organization & administration , Adult , Attitude of Health Personnel , Female , Humans , Male , Middle Aged , Organizational Objectives , Pandemics , SARS-CoV-2 , United States
19.
BMJ Open ; 11(9): e053014, 2021 09 30.
Article in English | MEDLINE | ID: covidwho-1445631

ABSTRACT

Social distancing laws during the first year of the pandemic, and its unprecedented changes to the National Health Service (NHS) forced a large majority of services, especially mental health teams to deliver patient care remotely. For many, this approach was adopted out of necessity, rather than choice, thus presenting a true 'testing ground' for remote healthcare and a robust evaluation on a national and representative level. OBJECTIVE: To extract and analyse mental health specific data from a national dataset for 1 year (March 2020-March 2021). DESIGN: A mixed-methods study using surveys and interviews. SETTING: In NHS mental health services in Wales, UK. PARTICIPANTS: With NHS patients and clinicians across child and adolescent, adult and older adult mental health services. OUTCOME MEASURES: Mixed methods data captured measures on use, value, benefits and challenges of video consulting (VC). RESULTS: A total of 3561 participants provided mental health specific data. These data and its findings demonstrate that remote mental health service delivery, via the method of VC is highly satisfactory, well-accepted and clinically suitable for many patients, and provides a range of benefits to NHS patients and clinicians. Interestingly, clinicians working from 'home' rated VC more positively compared with those at their 'clinical base'. CONCLUSIONS: Post 1-year adoption, remote mental health services in Wales UK have demonstrated that VC is possible from both a technical and behavioural standpoint. Moving forward, we suggest clinical leaders and government support to sustain this approach 'by default' as an option for NHS appointments.


Subject(s)
Mental Health Services , State Medicine , Adolescent , Aged , Child , Humans , Referral and Consultation , United Kingdom , Wales
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