Early impacts of the COVID-19 pandemic on mental health care and on people with mental health conditions: framework synthesis of international experiences and responses

Luke Sheridan Rains, Sonia Johnson*, Phoebe Barnett, Thomas Steare, Justin J. Needle, Sarah Carr, Billie Lever Taylor, Francesca Bentivegna, Julian Edbrooke-Childs, Hannah Rachel Scott, Jessica Rees, Prisha Shah, Jo Lomani, Beverley Chipp, Nick Barber, Zainab Dedat, Sian Oram, Nicola Morant, Alan Simpson, The COVID-19 Mental Health Policy Research Unit GroupAlexia Papamichail, Anna Moore, Annie Jeffery, Blanca Sanz Magallón Duque De Estrada, Brendan Hallam, Brynmor Lloyd-Evans, Carolina Yanez Contreras, Celia Esteban Serna, Chukwuma Ntephe, Daphne Lamirel, Eleanor Cooke, Eiluned Pearce, Frederike Lemmel, Freya Koutsoubelis, Guendalina Cragnolini, Jasmine Harju-Seppänen, Jingyi Wang, Joseph Botham, Karima Abdou, Karolin Krause, Kati Jane Turner, Konstantina Poursanidou, Lisa Gruenwald, Louisa Jagmetti, Lucia Mazzocchi, Magdalena Tomaskova, Marcella Montagnese, Mélanie Mahé, Qian Gao, Una Foye, Vasiliki Tzouvara

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

143 Citations (Scopus)
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Purpose: The COVID-19 pandemic has many potential impacts on people with mental health conditions and on mental health care, including direct consequences of infection, effects of infection control measures and subsequent societal changes. We aimed to map early impacts of the pandemic on people with pre-existing mental health conditions and services they use, and to identify individual and service-level strategies adopted to manage these. 

Methods: We searched for relevant material in the public domain published before 30 April 2020, including papers in scientific and professional journals, published first person accounts, media articles, and publications by governments, charities and professional associations. Search languages were English, French, German, Italian, Spanish, and Mandarin Chinese. Relevant content was retrieved and summarised via a rapid qualitative framework synthesis approach. 

Results: We found 872 eligible sources from 28 countries. Most documented observations and experiences rather than reporting research data. We found many reports of deteriorations in symptoms, and of impacts of loneliness and social isolation and of lack of access to services and resources, but sometimes also of resilience, effective self-management and peer support. Immediate service challenges related to controlling infection, especially in inpatient and residential settings, and establishing remote working, especially in the community. We summarise reports of swiftly implemented adaptations and innovations, but also of pressing ethical challenges and concerns for the future. 

Conclusion: Our analysis captures the range of stakeholder perspectives and experiences publicly reported in the early stages of the COVID-19 pandemic in several countries. We identify potential foci for service planning and research.

Original languageEnglish
Pages (from-to)13-24
Number of pages12
JournalSocial Psychiatry and Psychiatric Epidemiology
Issue number1
Early online date17 Aug 2020
Publication statusPublished - 1 Jan 2021


  • Coronavirus
  • COVID-19
  • Framework synthesis mental health services
  • Mental health
  • Pandemic
  • Service user experiences


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