[COVID-19 Pandemic-Related Effects on Psychiatric and Psychosocial Care in Urban and Rural Areas - Two Studies Implementing the Questionnaire PandA-Psy]. / Corona-Pandemie-bedingte Auswirkungen auf die psychiatrische und psychosoziale Versorgung im städtischen und ländlichen Raum ­ Zwei Untersuchungen mit dem Fragebogen PandA-Psy.

OBJECTIVE: To assess COVID-19 pandemic-related changes in psychiatric and psychosocial services and their impact on the care of people with severe mental illness in two contrasting regions. METHODS: Development and use of an online questionnaire (PandA-Psy) in Leipzig (N=50) and Mecklenburg-Western Pomerania (N=126). RESULTS: In community psychiatric care, mostly comparable changes caused by the COVID-19 pandemic were observed in the two selected regions. These mainly concern the decrease in face-to-face contacts and group services, the increase in digital and telephone services, as well as the increasing constraints of staff. Differences between the regions are discussed. CONCLUSION: PandA-Psy was successfully used to map changes caused by the COVID-19 pandemic in psychiatric and psychosocial services in two areas. In addition to the predominantly negative consequences of the pandemic situation, we also found opportunities arising from the crisis.

[Psychological Burden in Relatives of People with Mental Illness During the COVID-19 Pandemic]. / Psychische Belastungen bei Angehörigen von Menschen mit psychischen Erkrankungen während der COVID-19 Pandemie.

CONCERN: The COVID-19 pandemic is a burden for most people - particular for those with mental illness and their families. The aim of the present study was to investigate specific burdens as well as coping strategies among relatives of people with mental illness. METHODS: A questionnaire to assess Corona pandemic-related influences on burdens of relatives of people with mental illness was developed. A total of 228 relatives participated in the survey between March and June 2021. RESULTS: More than 87% of the relatives surveyed reported that they were burdened by the mental illness of their ill relatives. Many of the respondents subjectively described helpful coping strategies such as appreciation of healthy parts. CONCLUSION: In times of crisis, such as the COVID-19 pandemic, care structures and support services should also be sensitively aligned and continuously provided for relatives of people with mental illness.

StäB - besonders geeignet für die Gerontopsychiatrie?

Die stationsäquivalente psychiatrische Behandlung (StäB) ist eine Behandlung im häuslichen Umfeld des Patienten durch multiprofessionelle, ärztlich geleitete Behandlungsteams. Unterfüttert mit einer hohen wissenschaftlichen Evidenz und einer guten Akzeptanz der gerontopsychiatrischen Patienten ist StäB insbesondere auch in Krisenzeiten wie der COVID-19-Pandemie eine geeignete Option.

Global impact of the COVID-19 pandemic on mental health services: A systematic review.

The purpose of the review was to investigate the changes in mental health services during the COVID-19 pandemic. A systematic review of qualitative, quantitative and mixed-methods studies was conducted from February 2021 to March 2022 using four databases and five languages. 29 studies reporting on mental health services in 63 countries were included. Findings were organised according to nine major topics: (1) lack of preparedness vs. timely response and flexible solutions, (2) changes in access, referrals, and admission, (3) impacts on outpatient, community and psychosocial services, (4) inpatient: reorganisation of hospital psychiatric units/acute wards, (5) diagnostic and therapeutic adaptations, (6) effects on medication, (7) infection control measures, (8), changes in patients' demands, engagement, and mental health, and (9) impacts on staff and team. Many services were closed intermittently or considerably reduced while telepsychiatric services were extensively expanded. Face-to-face services decreased, as did the work with therapeutic groups. Many inpatient units restructured their services to accommodate COVID-19 patients. While the digitalisation of services allowed for better access to services for some, restrictive measures hindered access for most. Staff experienced changes such as heightened impacts on their own mental health, burdens on patients and the pausing of professional training. Clearly, diverse findings of studies relate to different (national) contexts, type of service offered, but also to the time of the investigation, as studies noted several distinct phases of change during the pandemic. This review suggests directions for policy and service development, such as fostering community services and providing support services for particularly vulnerable populations.

LeiP#netz 2.0: mapping COVID-19-related changes in mental health services in the German city of Leipzig.

PURPOSE: The purpose of the study was to investigate the changes in psychosocial and psychiatric services in the German city of Leipzig during the COVID-19-pandemic. METHODS: A participatory, mixed-methods study was used involving a quantitative online survey and qualitative semi-structured interviews with professionals. Quantitative findings were reported with descriptive statistics, and thematic analysis was conducted for qualitative data. RESULTS: Fifty professionals from various mental health services participated in the survey and eleven professionals were interviewed. Quantitative findings showed that some services were closed intermittently and that there was a stiff increase in use of digital/telephonic service and a decrease in face-to-face services. Staff or funding did not change considerably during the pandemic. Psychosocial groups were suspended or reduced, while access to services became more difficult and professional training for staff was stopped. Thematic analysis of the interviews showed that professionals experienced different phases and levels of change during the pandemic, including changes on a structural level, on the users' level, and on the staff' level. Professionals particularly criticised the equivocality of COVID-19 regulations, a defective flow of information and lack of attention for mental healthcare in public policies. They also saw positive aspects, such as the capacity of users and the outpatient care system to adapt to the new situation. CONCLUSION: This study suggests directions for policy and service development, such as communicating clearly in infection-control measures, fostering outpatient care and networks between services.

[Psychiatric Emergency Admissions and Inpatient Length of Stay Before and During the COVID-19 Pandemic in Germany]. / Psychiatrische Notfallaufnahmen und stationäre Aufenthaltsdauer vor und während der COVID-19-Pandemie in Deutschland.

OBJECTIVE: The impact of the COVID-19 year on the number of daily psychiatric emergency admissions and length of stay was compared with previous years. METHODS: In a retrospective study, the four quarters of 2020 of several psychiatric hospitals in Germany were statistically compared with the respective quarters of 2018 and 2019. RESULTS: A total of 73,412 cases was analyzed. In the 2nd quarter of 2020, the number of daily admissions was significantly lower as compared to the control period (59.1 vs. 70.7; incidence rate ratio [95 % confidence interval] 0.81 [0.69; 0.96]; p = 0.012). Length of stay was numerically but not significantly different as compared to the control periods. CONCLUSION: The COVID-19 pandemic had a strong impact on inpatient psychiatric care. In the future, multimodal care structures must ensure the care of severely mentally ill people in crisis situations.

[Ward-Equivalent Psychiatric Treatment (StäB) for Patients with Severe Obsessive Compulsive Disorder in Times of COVID-19 - A Case Report]. / Stationsäquivalente psychiatrische Behandlung für Patienten mit schweren Zwangserkrankungen in Zeiten von COVID-19 ­ ein Fallbericht.

The ward-equivalent psychiatric treatment (StäB) is an intensive form of treatment and offers patients with severe and/or chronic illnesses the opportunity to take advantage of guideline-oriented treatment.This case description is intended to show the extent to which this form of community-based care - with psychiatric as well as psychotherapeutic treatment in the familiar home context - should be considered as a treatment option for patients with severe obsessive-compulsive disorders, not only in times of the COVID-19-Pandemic.

[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.

Impact of COVID-19 pandemic on involuntary and urgent inpatient admissions for psychiatric disorders in a German-wide hospital network.

The impact of COVID-19 on urgent and involuntary inpatient admissions, as well as coercive measures, has not been assessed so far. A retrospective study was performed analyzing claims data for inpatient psychiatric admissions between 2018 and 2020 (total n = 64,502) from a large German Hospital network. Whilst the total number of urgent admissions decreased in 2020 (12,383) as compared to 2019 (13,493) and 2018 (13,469), a significant increase in the percentage of urgent admissions was observed in 2020 (62.9%) as compared to 2019 (60.6%) and 2018 (59.7%). Compared to this study period, Odds ratio (OR) for proportion were 0.87 (0.84, 0.91) and 0.91 (0.87, 0.95) for 2018 and 2019, respectively (both p < 0.00001). Percentage of involuntary psychiatric admissions also significantly increased in 2020 and OR compared to this study period ranged from 0.86 (0.81, 0.93) in 2019 (p < 0.0001) to 0.88 (0.82, 0.95) in 2018 (p < 0.001). Proportion of coercive measures significantly increased in 2020 as compared to 2019 (p = 0.004). Taken together, the present study shows an increase in the proportion of involuntary and urgent psychiatric admissions during the whole pandemic year 2020 as compared to 2018 and 2019. The long-term impact of these COVID-19 pandemic-related trends on psychiatric health care needs to be assessed in further studies.

Emergency hospital admissions for psychiatric disorders in a German-wide hospital network during the COVID-19 outbreak.

PURPOSE: Psychiatric emergency hospital admissions for distinct psychiatric disorders and length of inpatient stay in the hospital during the Coronavirus disease 2019 (COVID-19) outbreak have not been thoroughly assessed. METHODS: A retrospective study was performed analyzing claims data from a large German Hospital network during the COVID-19 outbreak (study period: March 13-May 21, 2020) as compared to periods directly before the outbreak (same year control: January 1-March 12, 2020) and one year earlier (previous year control: March 13-May 21, 2019). RESULTS: A total of 13,151 emergency hospital admissions for psychiatric diagnoses were included in the analysis. For all psychiatric diagnoses combined, emergency admissions significantly decreased during the study period with mean (interquartile range) incidence rate ratios (IRRs) of 0.68 (0.65, 0.71) and 0.70 (0.67, 0.73) as compared to the same and previous year controls, respectively (both p < 0.00001). IRR ranged from 0.56 for mood affective disorders (F30-F39) to 0.75 for mental disorders due to psychoactive substance use (F10-F19; all p < 0.00001). Mean (standard deviation) length of hospital stay for all psychiatric diagnoses was significantly shorter during the study period [9.8 (11.6) days] as compared to same [14.7 (18.7) days] and previous [16.4 (23.9) days] year controls (both p < 0.00001). CONCLUSION: Both emergency hospital admissions and length of hospital stay significantly decreased for psychiatric disorders during the COVID-19 outbreak. It needs to be assessed in further studies whether healthcare systems will face increased demand for the provision of mental health care in the nearer future.

[COVID-19 Pandemic and Psychiatry - How much have the Interests of People with Psychiatric Disorders been Considered in German Laws?] / COVID-19-Pandemie und Versorgung schwer psychisch erkrankter Menschen ­ Inwieweit wurden die Interessen psychisch erkrankter Menschen in den Schutzverordnungen des Bundes und der Länder berücksichtigt?

OBJECTIVE: Official regulations during the first COVID-19 lockdown in Germany were analyzed concerning their impact on patients with psychiatric disorders. METHODS: All regulations valid between March 1, 2020 and June 30, 2020 with a link to health were included in the analysis. RESULTS: A total of 344 regulations was identified. Psychiatric health care structures were severely limited with significant heterogeneity concerning extent and duration between the different Federal states. In four Federal states, psychiatric hospitals were exempted from providing capacities towards intensive care. Three Federal states loosened visiting limitations for psychiatric patients. CONCLUSION: During the first lockdown, a broad range of regulations concerning the health care system was adopted often without specifically addressing psychiatric disorders. In the future, the needs of psychiatric patients have to be considered more thoroughly.