The Medium-Term Impact of COVID-19 Lockdown on Referrals to Secondary Care Mental Health Services: A Controlled Interrupted Time Series Study
To date, there is a paucity of information regarding the effect of COVID-19 or lockdown on mental disorders. We aimed to quantify the medium-term impact of lockdown on referrals to secondary care mental health clinical services. We conducted a controlled interrupted time series study using data from...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-11-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2020.585915/full |
| _version_ | 1818854737876877312 |
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| author | Shanquan Chen Rui She Pei Qin Anne Kershenbaum Anne Kershenbaum Emilio Fernandez-Egea Emilio Fernandez-Egea Jenny R. Nelder Chuoxin Ma Jonathan Lewis Chaoqun Wang Rudolf N. Cardinal Rudolf N. Cardinal |
| author_facet | Shanquan Chen Rui She Pei Qin Anne Kershenbaum Anne Kershenbaum Emilio Fernandez-Egea Emilio Fernandez-Egea Jenny R. Nelder Chuoxin Ma Jonathan Lewis Chaoqun Wang Rudolf N. Cardinal Rudolf N. Cardinal |
| author_sort | Shanquan Chen |
| collection | DOAJ |
| description | To date, there is a paucity of information regarding the effect of COVID-19 or lockdown on mental disorders. We aimed to quantify the medium-term impact of lockdown on referrals to secondary care mental health clinical services. We conducted a controlled interrupted time series study using data from Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), UK (catchment population ~0.86 million). The UK lockdown resulted in an instantaneous drop in mental health referrals but then a longer-term acceleration in the referral rate (by 1.21 referrals per day per day, 95% confidence interval [CI] 0.41–2.02). This acceleration was primarily for urgent or emergency referrals (acceleration 0.96, CI 0.39–1.54), including referrals to liaison psychiatry (0.68, CI 0.35–1.02) and mental health crisis teams (0.61, CI 0.20–1.02). The acceleration was significant for females (0.56, CI 0.04–1.08), males (0.64, CI 0.05–1.22), working-age adults (0.93, CI 0.42–1.43), people of White ethnicity (0.98, CI 0.32–1.65), those living alone (1.26, CI 0.52–2.00), and those who had pre-existing depression (0.78, CI 0.19–1.38), severe mental illness (0.67, CI 0.19–1.15), hypertension/cardiovascular/cerebrovascular disease (0.56, CI 0.24–0.89), personality disorders (0.32, CI 0.12–0.51), asthma/chronic obstructive pulmonary disease (0.28, CI 0.08–0.49), dyslipidemia (0.26, CI 0.04–0.47), anxiety (0.21, CI 0.08–0.34), substance misuse (0.21, CI 0.08–0.34), or reactions to severe stress (0.17, CI 0.01–0.32). No significant post-lockdown acceleration was observed for children/adolescents, older adults, people of ethnic minorities, married/cohabiting people, and those who had previous/pre-existing dementia, diabetes, cancer, eating disorder, a history of self-harm, or intellectual disability. This evidence may help service planning and policy-making, including preparation for any future lockdown in response to outbreaks. |
| first_indexed | 2024-12-19T07:57:28Z |
| format | Article |
| id | doaj.art-0e6d85846a4f4838a5831ec38c8549c1 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-19T07:57:28Z |
| publishDate | 2020-11-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Psychiatry |
| spelling | doaj.art-0e6d85846a4f4838a5831ec38c8549c12022-12-21T20:29:57ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402020-11-011110.3389/fpsyt.2020.585915585915The Medium-Term Impact of COVID-19 Lockdown on Referrals to Secondary Care Mental Health Services: A Controlled Interrupted Time Series StudyShanquan Chen0Rui She1Pei Qin2Anne Kershenbaum3Anne Kershenbaum4Emilio Fernandez-Egea5Emilio Fernandez-Egea6Jenny R. Nelder7Chuoxin Ma8Jonathan Lewis9Chaoqun Wang10Rudolf N. Cardinal11Rudolf N. Cardinal12Department of Psychiatry, University of Cambridge, Cambridge, United KingdomThe Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, ChinaDepartment of Biostatistics and Epidemiology, Shenzhen University Health Science Center, Shenzhen, ChinaDepartment of Psychiatry, University of Cambridge, Cambridge, United KingdomCambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United KingdomDepartment of Psychiatry, University of Cambridge, Cambridge, United KingdomCambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United KingdomDepartment of Psychiatry, University of Cambridge, Cambridge, United KingdomDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, United KingdomCambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United KingdomCollege of Public Administration, Central China Normal University, Wuhan, ChinaDepartment of Psychiatry, University of Cambridge, Cambridge, United KingdomCambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United KingdomTo date, there is a paucity of information regarding the effect of COVID-19 or lockdown on mental disorders. We aimed to quantify the medium-term impact of lockdown on referrals to secondary care mental health clinical services. We conducted a controlled interrupted time series study using data from Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), UK (catchment population ~0.86 million). The UK lockdown resulted in an instantaneous drop in mental health referrals but then a longer-term acceleration in the referral rate (by 1.21 referrals per day per day, 95% confidence interval [CI] 0.41–2.02). This acceleration was primarily for urgent or emergency referrals (acceleration 0.96, CI 0.39–1.54), including referrals to liaison psychiatry (0.68, CI 0.35–1.02) and mental health crisis teams (0.61, CI 0.20–1.02). The acceleration was significant for females (0.56, CI 0.04–1.08), males (0.64, CI 0.05–1.22), working-age adults (0.93, CI 0.42–1.43), people of White ethnicity (0.98, CI 0.32–1.65), those living alone (1.26, CI 0.52–2.00), and those who had pre-existing depression (0.78, CI 0.19–1.38), severe mental illness (0.67, CI 0.19–1.15), hypertension/cardiovascular/cerebrovascular disease (0.56, CI 0.24–0.89), personality disorders (0.32, CI 0.12–0.51), asthma/chronic obstructive pulmonary disease (0.28, CI 0.08–0.49), dyslipidemia (0.26, CI 0.04–0.47), anxiety (0.21, CI 0.08–0.34), substance misuse (0.21, CI 0.08–0.34), or reactions to severe stress (0.17, CI 0.01–0.32). No significant post-lockdown acceleration was observed for children/adolescents, older adults, people of ethnic minorities, married/cohabiting people, and those who had previous/pre-existing dementia, diabetes, cancer, eating disorder, a history of self-harm, or intellectual disability. This evidence may help service planning and policy-making, including preparation for any future lockdown in response to outbreaks.https://www.frontiersin.org/articles/10.3389/fpsyt.2020.585915/fullCOVID-19/SARS-CoV-2 coronavirus pandemiclockdownsecondary care mental health servicescontrolled interrupted time series analysiscomorbidity |
| spellingShingle | Shanquan Chen Rui She Pei Qin Anne Kershenbaum Anne Kershenbaum Emilio Fernandez-Egea Emilio Fernandez-Egea Jenny R. Nelder Chuoxin Ma Jonathan Lewis Chaoqun Wang Rudolf N. Cardinal Rudolf N. Cardinal The Medium-Term Impact of COVID-19 Lockdown on Referrals to Secondary Care Mental Health Services: A Controlled Interrupted Time Series Study Frontiers in Psychiatry COVID-19/SARS-CoV-2 coronavirus pandemic lockdown secondary care mental health services controlled interrupted time series analysis comorbidity |
| title | The Medium-Term Impact of COVID-19 Lockdown on Referrals to Secondary Care Mental Health Services: A Controlled Interrupted Time Series Study |
| title_full | The Medium-Term Impact of COVID-19 Lockdown on Referrals to Secondary Care Mental Health Services: A Controlled Interrupted Time Series Study |
| title_fullStr | The Medium-Term Impact of COVID-19 Lockdown on Referrals to Secondary Care Mental Health Services: A Controlled Interrupted Time Series Study |
| title_full_unstemmed | The Medium-Term Impact of COVID-19 Lockdown on Referrals to Secondary Care Mental Health Services: A Controlled Interrupted Time Series Study |
| title_short | The Medium-Term Impact of COVID-19 Lockdown on Referrals to Secondary Care Mental Health Services: A Controlled Interrupted Time Series Study |
| title_sort | medium term impact of covid 19 lockdown on referrals to secondary care mental health services a controlled interrupted time series study |
| topic | COVID-19/SARS-CoV-2 coronavirus pandemic lockdown secondary care mental health services controlled interrupted time series analysis comorbidity |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2020.585915/full |
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