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Impact on mental health care and on mental health service users of the COVID-19 pandemic: a mixed methods survey of UK mental health care staff

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The COVID-19 Mental Health Policy Research Unit Group, Sonia Johnson, Christian Dalton-Locke, Norha Vera San Juan, Una Foye, Sian Oram, Alexandra Papamichail, Sabine Landau, Rachel Rowan Olive, Tamar Jeynes, Prisha Shah, Luke Sheridan Rains, Brynmor Lloyd-Evans, Sarah Carr, Helen Killaspy, Steve Gillard, Alan Simpson, Andy Bell, Francesca Bentivegna, Joseph Botham & 24 more Julian Edbrooke-Childs, Lucy Goldsmith, Lisa Grünwald, Jasmine Harju-Seppänen, Stephani Hatch, Claire Henderson, Louise Howard, Rebecca Lane, Sarah Ledden, Monica Leverton, Jo Lomani, Natasha Lyons, Paul McCrone, Chukwuma U. Ntephe, Josephine Enyonam Ocloo, David Osborn, Steve Pilling, Konstantina Poursanidou, Hannah Rachel Scott, Thomas Steare, Ruth Stuart, André Tomlin, Kati Turner, Vasiliki Tzouvara

Original languageEnglish
Pages (from-to)25-37
JournalSocial Psychiatry and Psychiatric Epidemiology
Volume56
Issue number1
Early online date28 Aug 2020
DOIs
Accepted/In press6 Aug 2020
E-pub ahead of print28 Aug 2020
PublishedJan 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 Publisher Copyright: © 2020, The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

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Abstract

Purpose
The COVID-19 pandemic has potential to disrupt and burden the mental health care system, and to magnify inequalities experienced by mental health service users.

Methods
We investigated staff reports regarding the impact of the COVID-19 pandemic in its early weeks on mental health care and mental health service users in the UK using a mixed methods online survey. Recruitment channels included professional associations and networks, charities, and social media. Quantitative findings were reported with descriptive statistics, and content analysis conducted for qualitative data.

Results
2,180 staff from a range of sectors, professions, and specialties participated. Immediate infection control concerns were highly salient for inpatient staff, new ways of working for community staff. Multiple rapid adaptations and innovations in response to the crisis were described, especially remote working. This was cautiously welcomed but found successful in only some clinical situations. Staff had specific concerns about many groups of service users, including people whose conditions are exacerbated by pandemic anxieties and social disruptions; people experiencing loneliness, domestic abuse and family conflict; those unable to understand and follow social distancing requirements; and those who cannot engage with remote care.

Conclusion
This overview of staff concerns and experiences in the early COVID-19 pandemic suggests directions for further research and service development: we suggest that how to combine infection control and a therapeutic environment in hospital, and how to achieve effective and targeted tele-health implementation in the community, should be priorities. The limitations of our convenience sample must be noted.

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