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3.
BMC Fam Pract ; 22(1): 143, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1295441

ABSTRACT

BACKGROUND: Integrated primary care teams are ideally positioned to support the mental health care needs arising during the COVID-19 pandemic. Understanding how COVID-19 has affected mental health care delivery within primary care settings will be critical to inform future policy and practice decisions during the later phases of the pandemic and beyond. The objective of our study was to describe the impact of the COVID-19 pandemic on primary care teams' delivery of mental health care. METHODS: A qualitative study using focus groups conducted with primary care teams in Ontario, Canada. Focus group data was analysed using thematic analysis. RESULTS: We conducted 11 focus groups with 10 primary care teams and a total of 48 participants. With respect to the impact of the COVID-19 pandemic on mental health care in primary care teams, we identified three key themes: i) the high demand for mental health care, ii) the rapid transformation to virtual care, and iii) the impact on providers. CONCLUSIONS: From the outset of the COVID-19 pandemic, primary care quickly responded to the rising mental health care demands of their patients. Despite the numerous challenges they faced with the rapid transition to virtual care, primary care teams have persevered. It is essential that policy and decision-makers take note of the toll that these demands have placed on providers. There is an immediate need to enhance primary care's capacity for mental health care for the duration of the pandemic and beyond.


Subject(s)
COVID-19 , Delivery of Health Care, Integrated/organization & administration , Mental Health Services , Patient Care Team/organization & administration , Primary Health Care , Telemedicine , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Female , Focus Groups , Health Services Needs and Demand , Humans , Male , Mental Health/trends , Mental Health Services/standards , Mental Health Services/supply & distribution , Ontario/epidemiology , Practice Patterns, Physicians'/trends , Primary Health Care/methods , Primary Health Care/trends , Quality Improvement/organization & administration , SARS-CoV-2 , Telemedicine/methods , Telemedicine/statistics & numerical data
5.
Arch Psychiatr Nurs ; 35(4): 375-394, 2021 08.
Article in English | MEDLINE | ID: covidwho-1225125

ABSTRACT

CONTEXT: Globally, governments have introduced a variety of public health measures including restrictions and reducing face-to-face contact, to control the spread of COVID-19. This has implications for mental health services in terms of support and treatment for vulnerable groups such as people with pre-existent mental health conditions. However, there is limited evidence of the impact of COVID-19 and its related restrictions on people with pre-existent mental health conditions. OBJECTIVES: To identify the impact of COVID-19 and its related restrictions on people with pre-existent mental health conditions. METHODS: A scoping review of the literature was employed. Eight electronic databases (PsycINFO, Cochrane, Web of Science, MEDLINE, EMBASE, CINAHL, Scopus, Academic Search Complete) were searched and 2566 papers identified. 30 papers met the criteria for this review and findings were summarised under three key review questions. RESULTS: COVID-19 and its related restrictions have had a notable effect on people with pre-existent mental health conditions. Public health restrictions have contributed to increased levels of social isolation, loneliness, and reduced opportunities for people to connect with others. Reduced access to health services and treatments has compounded matters for those seeking support. Exacerbation and deterioration of symptoms are commonly reported and can lead to greater susceptibility to COVID-19 infection. IMPLICATIONS: The importance of proactive planning, alternative accessible healthcare services and supports for vulnerable and at-risk groups is illuminated. Increased monitoring, early intervention and individually tailored care strategies are advocated. Recommendations revolve around the need for enhanced provision of remote support strategies facilitated using technology enhanced resources. ACCESSIBLE SUMMARY.


Subject(s)
COVID-19/psychology , Mental Disorders/psychology , Mental Health Services/supply & distribution , Mental Health , COVID-19/epidemiology , Communicable Disease Control/methods , Health Services Accessibility , Humans , Mental Disorders/epidemiology , Mental Disorders/therapy , Pandemics/prevention & control , SARS-CoV-2
6.
Lancet Psychiatry ; 7(10): 845, 2020 10.
Article in English | MEDLINE | ID: covidwho-770907
7.
Int Rev Psychiatry ; 33(4): 394-403, 2021 06.
Article in English | MEDLINE | ID: covidwho-1165120

ABSTRACT

The following case series provides several examples from the Digital Clinic, an outpatient mental health program which uses smartphone technology to augment traditional mental health care. The themes highlighted in this piece, expanding emotional-awareness, symptom tracking, and medication management, provide real-clinical examples of how the Digital Clinic offered remote mental health care to a diverse group of people. Furthermore, the following piece demonstrates to practicing clinicians how digital technologies, like smartphone apps, can diversify methods of clinical engagement, assist with collecting health metrics in a safe and ethical manner, and promote person centred care. With the COVID-19 pandemic forcing re-evaluation of how mental health services are provided, it is critical to ensure that digitally infused systems of care, like the Digital Clinic, are effective, accessible, and scalable.


Subject(s)
Internet-Based Intervention , Mental Health Services/supply & distribution , Mobile Applications , Patient-Centered Care , Smartphone , Telemedicine , COVID-19 , Female , Health Services Accessibility , Humans , Male , Outpatients/psychology
8.
Rev Psiquiatr Salud Ment (Engl Ed) ; 14(2): 83-89, 2021.
Article in English, Spanish | MEDLINE | ID: covidwho-1111839

ABSTRACT

OBJECTIVE: In order to reduce distress associated with working with COVID-19 patients, several psychological intervention programmes for healthcare workers have been developed in Spain. We aimed to describe the main characteristics and components of these programmes for healthcare workers treating COVID-19 patients in Spanish hospitals. MATERIAL AND METHODS: An online survey was designed to evaluate the main characteristics of psychological intervention programmes for healthcare workers during the first wave of COVID-19 pandemic. RESULTS: Valid responses were received from 36 hospitals. Most of these programmes offered both in-person and online therapy. The most common aim of these interventions was emotional regulation, which was treated by psychoeducational and cognitive-behavioural techniques in individual interventions. Group interventions mainly used psychoeducation and mindfulness. Only half of the teams that offered in-person interventions received training in the proper use of personal protective equipment. CONCLUSIONS: Several hospitals in Spain have developed mental health interventions for healthcare workers during the COVID-19 pandemic, deploying a wide range of therapeutic modalities and techniques. The rapid implementation of these programmes during the pandemic suggests that safety may not have received sufficient attention. The planning and development of interventions for healthcare workers during pandemics merits greater attention by national and regional authorities and institutions.


Subject(s)
COVID-19 , Health Personnel/psychology , Mental Health Services/supply & distribution , Mental Health , Occupational Health , Occupational Stress/etiology , Occupational Stress/prevention & control , Psychological Distress , COVID-19/epidemiology , Humans , Spain/epidemiology
10.
Epidemiol Prev ; 44(5-6 Suppl 2): 383-393, 2020.
Article in Italian | MEDLINE | ID: covidwho-1068161

ABSTRACT

The area of mental health is directly affected by the pandemic and its consequences, for various reasons: 1-the pandemic triggered a global lockdown, with dramatic socioeconomic and therefore psychosocial implications; 2-mental health services, which treat by definition a fragile population from the psychological, biological and social points of view, have a complex organizational frame, and it was expected that this would be affected (or overwhelmed) by the pandemic; 3-mental health services should, at least in theory, be able to help guide public health policies when these involve a significant modification of individual behaviour. It was conducted a narrative review of the publications produced by European researchers in the period February-June 2020 and indexed in PubMed. A total of 34 papers were analyzed, which document the profound clinical, organizational and procedural changes introduced in mental health services following this exceptional and largely unforeseen planetary event.Among the main innovations recorded everywhere, the strong push towards the use of telemedicine techniques should be mentioned: however, these require an adequate critical evaluation, which highlights their possibilities, limits, advantages and disadvantages instead of simple triumphalist judgments. Furthermore, should be emphasized the scarcity of quantitative studies conducted in this period and the absence of studies aimed, for example, at exploring the consequences of prolonged and forced face-to-face contact between patients and family members with a high index of "expressed emotions".


Subject(s)
Bibliometrics , COVID-19/epidemiology , Mental Health Services , Pandemics , SARS-CoV-2 , Adolescent , Adolescent Health Services/statistics & numerical data , Adolescent Health Services/supply & distribution , COVID-19/prevention & control , COVID-19/psychology , Child , Child Health Services/statistics & numerical data , Child Health Services/supply & distribution , Europe/epidemiology , Expressed Emotion , Feeding and Eating Disorders/epidemiology , Forensic Psychiatry/organization & administration , Health Policy , Health Services Needs and Demand , Health Services for the Aged/statistics & numerical data , Health Services for the Aged/supply & distribution , Humans , Interpersonal Relations , Mental Disorders/epidemiology , Mental Disorders/etiology , Mental Health Services/statistics & numerical data , Mental Health Services/supply & distribution , Observational Studies as Topic , Procedures and Techniques Utilization , PubMed , Quarantine , Telemedicine/organization & administration , Telemedicine/statistics & numerical data
12.
Encephale ; 46(3S): S81-S84, 2020 Jun.
Article in French | MEDLINE | ID: covidwho-1065055

ABSTRACT

OBJECTIVES: The sudden changes of healthcare system due to COVID-19 particularly affect the organization of psychiatry. The objective of this review is to examine the adaptations of psychiatric care in France during this pandemic. METHOD: This narrative review is based on the observation of changes made in French psychiatric hospitals and on an analysis of the literature. RESULTS: Regarding psychiatric hospitalization, the COVID-19 epidemic required rapid measures that profoundly modified the conditions of patients' reception, forcing the medical staffs to adapt their methods of care. The authors noted the creation of at least 89 wards specifically dedicated to patients with COVID-19 needing psychiatric hospitalization, allowing dual care of general medicine and psychiatry. Regarding ambulatory care, maintaining patients with long-term follow-up was a priority. Patients recalling and teleconsultation have been precious resources but cannot entirely replace face-to-face consultations. DISCUSSION: COVID-19 epidemic created unprecedented situation of large-scale upheavals in the healthcare system and in society. Despite the absence of previous recommendations on the subject, French psychiatry has shown great adaptability. Some changes could inspire post-COVID-19 care.


Subject(s)
Betacoronavirus , Coronavirus Infections , Hospital Restructuring , Hospitals, Psychiatric/organization & administration , Mental Health Services/organization & administration , Pandemics , Pneumonia, Viral , Psychotherapy/organization & administration , Ambulatory Care/organization & administration , Bed Conversion , COVID-19 , France/epidemiology , Health Personnel/psychology , Health Services Accessibility , Humans , Mental Disorders/epidemiology , Mental Disorders/therapy , Mental Health Services/statistics & numerical data , Mental Health Services/supply & distribution , Occupational Health , Patients' Rooms , Psychotherapy/statistics & numerical data , SARS-CoV-2 , Social Change , Stress, Psychological/etiology , Stress, Psychological/therapy , Telemedicine
13.
Encephale ; 46(3S): S3-S13, 2020 Jun.
Article in French | MEDLINE | ID: covidwho-1065044

ABSTRACT

OBJECTIVE: The lack of ressources and coordination to face the epidemic of coronavirus raises concerns for the health of patients with mental disorders in a country where we keep in memory the dramatic experience of famine in psychiatric hospitals during the Second World War. This article aims at proposing guidance to ensure mental health care during the SARS-CoV epidemy in France. METHODS: Authors performed a narrative review identifying relevant results in the scientific and medical literature and local initiatives in France. RESULTS: We identified four types of major vulnerabilities in patients suffering from mental disorders during this pandemic: (1) medical comorbidities that are more frequently found in patients suffering from mental disorders (cardiovascular and pulmonary pathologies, diabetes, obesity, etc.) which represent risk factors for severe infections with Covid-19; (2) age (the elderly constituting the population most vulnerable to coronavirus); (3) cognitive and behavioral troubles which can hamper compliance with confinement and hygiene measures and finally and (4) psychosocial vulnerability due to stigmatization and/or socio-economic difficulties. Furthermore, the mental health healthcare system is more vulnerable than other healthcare systems. Current government plans are poorly adapted to psychiatric establishments in a context of major shortage of organizational, material and human resources. In addition, a certain number of structural aspects make the psychiatric institution particularly vulnerable: many beds are closed, wards have a high density of patients, mental health community facilities are closed, medical teams are understaffed and poorly trained to face infectious diseases. We could also face major issues in referring patients with acute mental disorders to intensive care units. To maintain continuity of psychiatric care in this pandemic situation, several directions can be considered, in particular with the creation of Covid+ units. These units are under the dual supervision of a psychiatrist and of an internist/infectious disease specialist; all new entrants should be placed in quarantine for 14 days; the nurse staff should benefit from specific training, from daily medical check-ups and from close psychological support. Family visits would be prohibited and replaced by videoconference. At the end of hospitalization, in particular for the population of patients in compulsory ambulatory care situations, specific case-management should be organized with the possibility of home visits, in order to support them when they get back home and to help them to cope with the experience of confinement, which is at risk to induce recurrences of mental disorders. The total or partial closure of mental health community facilities is particularly disturbing for patients but a regular follow-up is possible with telemedicine and should include the monitoring of the suicide risk and psychoeducation strategies; developing support platforms could also be very helpful in this context. Private psychiatrists have also a crucial role of information with their patients on confinement and barrier measures, but also on measures to prevent the psychological risks inherent to confinement: maintenance of sleep regularity, physical exercise, social interactions, stress management and coping strategies, prevention of addictions, etc. They should also be trained to prevent, detect and treat early warning symptoms of post-traumatic stress disorder, because their prevalence was high in the regions of China most affected by the pandemic. DISCUSSION: French mental healthcare is now in a great and urgent need for reorganization and must also prepare in the coming days and weeks to face an epidemic of emotional disorders due to the containment of the general population.


Subject(s)
Betacoronavirus , Continuity of Patient Care/organization & administration , Coronavirus Infections/epidemiology , Mental Disorders/therapy , Mental Health Services/organization & administration , Pandemics , Pneumonia, Viral/epidemiology , Aftercare , Age Factors , Aged, 80 and over , Antiviral Agents/pharmacokinetics , Antiviral Agents/therapeutic use , COVID-19 , Child , Cognition Disorders/epidemiology , Cognition Disorders/therapy , Comorbidity , Coronavirus Infections/psychology , Drug Interactions , France/epidemiology , Hospital Units/organization & administration , Hospitals, Psychiatric/organization & administration , Humans , Infection Control/methods , Mental Disorders/epidemiology , Mental Disorders/etiology , Mental Health Services/supply & distribution , Patient Care Team , Patient Compliance , Pneumonia, Viral/psychology , Prisoners/psychology , SARS-CoV-2 , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/therapy , Stress, Psychological/etiology , Stress, Psychological/therapy , Substance-Related Disorders/epidemiology , Substance-Related Disorders/therapy , Suicide/prevention & control , Vulnerable Populations
15.
Int Rev Psychiatry ; 33(4): 424-434, 2021 06.
Article in English | MEDLINE | ID: covidwho-1066100

ABSTRACT

The goals of this scoping literature review are to (1) aggregate the current research involving socially assistive robots in the setting of geriatric psychiatry and (2) examine the outcome measures used in these studies and determine where the gaps and needs are. In light of the global COVID-19 pandemic, the geriatric psychiatric population in particular is vulnerable to both the physical and mental toll COVID-19 may cause. Recently, socially assistive robots have gained attention for their ability to aid in the care of the geriatric psychiatry population and are being explored as a realistic way to deliver certain elements of psychiatric care that have the potential to be safe even in the setting of COVID-19. The results of this review indicate that robots are in the early stages of clinical applicability, they display usability for a range of psychiatric indications, and their impact on clinical care is notable. We project that in the next few years, robotic applications will be tailored to address clinical outcomes with a greater degree of precision and efficacy.


Subject(s)
COVID-19 , Geriatrics , Mental Health Services/supply & distribution , Outcome Assessment, Health Care , Robotics/instrumentation , Aged , Humans
16.
Healthc Q ; 23(4): 9-11, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1040179

ABSTRACT

As the population ages, more Canadians need home care to help manage their health conditions and live safely at home. For Canadians of all ages, timely access to mental health and addictions services is an area of growing concern. The impact of the COVID-19 pandemic and its strain on health system resources have further highlighted the need to improve services in these areas. The Canadian Institute for Health Information (CIHI) is working with governments across Canada to bridge data gaps, develop indicators and publicly report results as part of a collective effort to improve access in these two sectors. Results for three new indicators were released by CIHI in 2020.


Subject(s)
Community Health Services/supply & distribution , Health Services Accessibility/statistics & numerical data , Home Care Services/supply & distribution , Mental Health Services/supply & distribution , Substance-Related Disorders/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Canada , Caregivers/psychology , Child , Community Mental Health Services/supply & distribution , Female , Humans , Male , Middle Aged , Substance Abuse Treatment Centers/supply & distribution , Suicide/prevention & control , Young Adult
17.
Pan Afr Med J ; 36: 366, 2020.
Article in English | MEDLINE | ID: covidwho-976569

ABSTRACT

The novel coronavirus pandemic has undoubtedly emerged as a serious public health threat in many societies across the world. Due to the sporadic and unpredictable nature of the pandemic, it is important to admit that the virus can cause psychological distress and emotional instability that might impact on people in diverse ways at the individual, community and national levels, with serious mental health implications (e.g. depression, mood disorders, obsessive-compulsive disorder, other anxiety disorders). Due to the weak healthcare challenges inherent in Africa, these mental health challenges require urgent redress to ensure mental health well-being for all, especially COVID-19-positive patients who have recovered (i.e. survivors). This essay outlines some of these challenges and offers strategies to address them. Broader mental health training for facility and community-based health workers are urgently required and should be coordinated within countries with specific guidelines for psychosocial support during outbreaks such as the current pandemic. A framework that promotes reintegration for COVID-19 survivors could also be designed based on context-specific needs through individualized protocols such as the "RAPID-Psychological First Aid [PFA]". This tool kit, if effectively employed, would help facilitate optimal well-being of the people devoid of any psychological challenges created by the pandemic.


Subject(s)
COVID-19/psychology , Mental Health , Pandemics , SARS-CoV-2 , Social Integration , Survivors/psychology , Africa/epidemiology , COVID-19/epidemiology , COVID-19/rehabilitation , Health Services Needs and Demand , Humans , Illness Behavior , Mental Health Services/supply & distribution
18.
Australas Psychiatry ; 29(2): 157-162, 2021 04.
Article in English | MEDLINE | ID: covidwho-838698

ABSTRACT

OBJECTIVE: A spreadsheet-based model for supporting equitable mental health resource distribution in Australia was developed, based on the Australian Health Survey (AHS) psychological distress findings associated with area socio-economic disadvantage (SED). An illustrative application is presented. METHOD: Stratum-specific psychological-distress rates for area SED quintiles are applied to local government areas, catchment areas and local health networks (LHNs). A case study applies the model to Victoria, including examining recommendations in the Royal Commission into Victoria's Mental Health Services (RCVMHS) 2019 interim report for increases to bed stock in two LHNs. RESULTS: Need-adjusted demand estimates considered as a ratio of raw population proportions for catchments range between 0.6 to 1.4 in Victoria. Applying the formula to the Royal Commission recommendations suggests the proposed distribution of beds is a reasonable correction for these two LHNs and indicates next expansion priorities for more equitable distribution to other LHNs. CONCLUSIONS: The spreadsheet, adaptable for other states and territories, could complement National Mental Health Services Planning Framework outputs and assist in evaluation, for instance, determining potential supply shortages in the tele-mental-health response to COVID-19. We outline research directions including consideration of the moral bases of value judgements and identification of other variables including their use in parameterisation and calibration.


Subject(s)
Health Services Accessibility/organization & administration , Healthcare Disparities/organization & administration , Mental Health Services/supply & distribution , Poverty Areas , Social Determinants of Health , Stress, Psychological , Vulnerable Populations/psychology , Adult , Health Surveys , Humans , Models, Organizational , Social Class , Social Justice , Stress, Psychological/economics , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Stress, Psychological/therapy , Victoria
19.
J Adolesc Health ; 67(4): 603-605, 2020 10.
Article in English | MEDLINE | ID: covidwho-812080

ABSTRACT

PURPOSE: This study provides information on how the coronavirus disease 2019 (COVID-19) outbreak is affecting emerging adults currently or recently homeless in terms of engagement in protective behaviors, mental health, substance use, and access to services. METHODS: Ninety participants in an ongoing clinical trial of a risk reduction program for homeless, aged 18-25 years, were administered items about COVID-19 between April 10 and July 9, 2020. RESULTS: Most participants reported engaging in COVID-19 protective behaviors. Past week mental health symptoms were reported by 38%-48% of participants, depending on symptoms. Among those who used substances before the outbreak, 16%-28% reported increased use of alcohol, tobacco, and marijuana. More than half of the participants reported increased difficulty meeting basic needs (e.g., food), and approximately 32%-44% reported more difficulty getting behavioral health services since the outbreak. CONCLUSIONS: Innovative strategies are needed to address the increased behavioral health needs of young people experiencing homelessness during events such as the COVID-19 outbreak.


Subject(s)
Coronavirus Infections , Health Services Accessibility , Homeless Persons , Mental Health Services/statistics & numerical data , Pandemics , Patient Acceptance of Health Care/statistics & numerical data , Pneumonia, Viral , Adolescent , Adult , Betacoronavirus , COVID-19 , California , Female , Homeless Persons/psychology , Humans , Male , Mental Health Services/supply & distribution , SARS-CoV-2 , Surveys and Questionnaires , Young Adult
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