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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

Research output: Contribution to journalArticlepeer-review

The COVID-19 Mental Health Policy Research Unit Group

Original languageEnglish
Pages (from-to)13-24
Number of pages12
JournalSocial Psychiatry and Psychiatric Epidemiology
Volume56
Issue number1
Early online date17 Aug 2020
DOIs
Accepted/In press1 Jan 2020
E-pub ahead of print17 Aug 2020
Published1 Jan 2021

Bibliographical note

Funding Information: This paper presents independent research commissioned and funded by the National Institute for Health Research (NIHR) Policy Research Programme, conducted by the NIHR Policy Research Unit (PRU) in Mental Health. The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care or its arm's length bodies, or other government departments. Acknowledgements Funding Information: This paper presents independent research commissioned and funded by the National Institute for Health Research (NIHR) Policy Research Programme, conducted by the NIHR Policy Research Unit (PRU) in Mental Health. The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care or its arm's length bodies, or other government departments. The COVID-19 Mental Health Policy Research Unit Group: Annie Jeffery, Brynmor Lloyd-Evans, Chukwuma Ntephe, Daphne Lamirel, Eleanor Cooke, Eiluned Pearce, Frederike Lemmel, Freya Koutsoubelis, Jasmine Harju-Sepp?nen, Karima Abdou, Lisa Gruenwald, Louisa Jagmetti, Magdalena Tomaskova, Merle Schlief, Monica Leverton, Natasha Lyons, Sarah Ledden, Sofia Orlando, Tamara Ondru?kov?, Theodora Stefanidou: NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust; Celia Esteban Serna, Jasmine Harju-Sepp?nen: Division of Psychology and Language Sciences, University College London, London, UK; Centre for Health Services Research, School of Health Sciences, City, University of London, London, UK; School of Social Policy/Institute for Mental Health, University of Birmingham, Birmingham, UK; Raza Griffiths, Tamar Jeynes: Division of Psychiatry (NIHR Mental Health Policy Research Unit Covid-19 Co-Production Group), University College London, London, UK; Anna Moore, Karolin Krause, Rebecca Lane: Evidence-Based Practice Unit, University College London and Anna Freud National Centre for Children and Families, London, UK; Kati Jane Turner, Marcella Montagnese, Steve Gillard: Population Health Research Institute, St George?s, University of London, London, UK; Alexia Papamichail, Carolina Yanez Contreras, Joseph Botham, Norha Vera, Qian Gao, Scarlett Mac-Ginty, Selina Hardt, Una Foye, Victoria Cavero: NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King?s College London, London, UK; Vasiliki Tzouvara: Department of Mental Health Nursing, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, London, UK; Blanca Sanz-Magall?n Duque De Estrada: UCL Medical School, University College London, London, UK; Brendan Hallam: Department of Primary Care & Population Health, University College London, London, UK; Jingyi Wang: Department of Social Medicine, School of Public Health, Fudan University, Shanghai 200032, China; Konstantina Poursanidou: Independent Service User Researcher; Lucia Mazzocchi, M?lanie Mah?, Riccardo Busato: Independent Researcher; Mia Maria G?nak: Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, Netherlands; Guendalina Cragnolini Publisher Copyright: © 2020, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

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King's Authors

Abstract

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.

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