Impact of the COVID-19 pandemic on the global delivery of mental health services and telemental health: systematic review

<p><strong>Background:</strong></p> The COVID-19 pandemic required mental health services around the world to adapt quickly to the new restrictions and regulations put in place to reduce the risk of transmission. As face-to-face contact became difficult, virtual methods were...

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Main Authors: Zangani, C, Ostinelli, EG, Smith, KA, Hong, JSW, Macdonald, O, Reen, G, Reid, K, Vincent, C, Syed Sheriff, R, Harrison, PJ, Hawton, K, Pitman, A, Bale, R, Fazel, S, Geddes, JR, Cipriani, A
Format: Journal article
Language:English
Published: JMIR Publications 2022
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author Zangani, C
Ostinelli, EG
Smith, KA
Hong, JSW
Macdonald, O
Reen, G
Reid, K
Vincent, C
Syed Sheriff, R
Harrison, PJ
Hawton, K
Pitman, A
Bale, R
Fazel, S
Geddes, JR
Cipriani, A
author_facet Zangani, C
Ostinelli, EG
Smith, KA
Hong, JSW
Macdonald, O
Reen, G
Reid, K
Vincent, C
Syed Sheriff, R
Harrison, PJ
Hawton, K
Pitman, A
Bale, R
Fazel, S
Geddes, JR
Cipriani, A
author_sort Zangani, C
collection OXFORD
description <p><strong>Background:</strong></p> The COVID-19 pandemic required mental health services around the world to adapt quickly to the new restrictions and regulations put in place to reduce the risk of transmission. As face-to-face contact became difficult, virtual methods were implemented to continue to safely provide mental health care. However, it is unclear to what extent service provision transitioned to telemental health worldwide. <p><strong>Objective:</strong></p> We aimed to systematically review the global research literature on how mental health service provision adapted during the first year of the pandemic. <p><strong>Methods:</strong></p> We searched systematically for quantitative papers focusing on the impact of the COVID-19 pandemic on mental health services published until April 13, 2021, in the PubMed, Embase, medRxiv, and bioXriv electronic bibliographic databases, using the COVID-19 Open Access Project online platform. The screening process and data extraction were independently completed by at least two authors, and any disagreement was resolved by discussion with a senior member of the team. The findings were summarized narratively in the context of each country’s COVID-19 Stringency Index, which reflects the stringency of a government’s response to COVID-19 restrictions at a specific time. <p><strong>Results:</strong></p> Of the identified 24,339 records, 101 papers were included after the screening process. Reports on general services (n=72) showed that several countries’ face-to-face services reduced their activities at the start of the pandemic, with reductions in the total number of delivered visits and with some services forced to close. In contrast, telemental health use rapidly increased in many countries across the world at the beginning of the pandemic (n=55), with almost complete virtualization of general and specialistic care services by the end of the first year. Considering the reported COVID-19 Stringency Index values, the increased use of virtual means seems to correspond to periods when the Stringency Index values were at their highest in several countries. However, due to specific care requirements, telemental health could not be used in certain subgroups of patients, such as those on clozapine or depot treatments and those who continued to need face-to-face visits. <p><strong>Conclusions:</strong></p> During the pandemic, mental health services had to adapt quickly in the short term, implementing or increasing the use of telemental health services across the globe. Limited access to digital means, poor digital skills, and patients’ preferences and individual needs may have contributed to differences in implementing and accessing telemental health services during the pandemic. In the long term, a blended approach, combining in-person and virtual modalities, that takes into consideration the needs, preferences, and digital skills of patients may better support the future development of mental health services. It will be required to improve confidence with digital device use, training, and experience in all modalities for both clinicians and service users.
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spelling oxford-uuid:aed0d57a-dd90-4d39-98f8-b1ecf10b06892022-09-06T16:06:27ZImpact of the COVID-19 pandemic on the global delivery of mental health services and telemental health: systematic reviewJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:aed0d57a-dd90-4d39-98f8-b1ecf10b0689EnglishSymplectic ElementsJMIR Publications2022Zangani, COstinelli, EGSmith, KAHong, JSWMacdonald, OReen, GReid, KVincent, CSyed Sheriff, RHarrison, PJHawton, KPitman, ABale, RFazel, SGeddes, JRCipriani, A<p><strong>Background:</strong></p> The COVID-19 pandemic required mental health services around the world to adapt quickly to the new restrictions and regulations put in place to reduce the risk of transmission. As face-to-face contact became difficult, virtual methods were implemented to continue to safely provide mental health care. However, it is unclear to what extent service provision transitioned to telemental health worldwide. <p><strong>Objective:</strong></p> We aimed to systematically review the global research literature on how mental health service provision adapted during the first year of the pandemic. <p><strong>Methods:</strong></p> We searched systematically for quantitative papers focusing on the impact of the COVID-19 pandemic on mental health services published until April 13, 2021, in the PubMed, Embase, medRxiv, and bioXriv electronic bibliographic databases, using the COVID-19 Open Access Project online platform. The screening process and data extraction were independently completed by at least two authors, and any disagreement was resolved by discussion with a senior member of the team. The findings were summarized narratively in the context of each country’s COVID-19 Stringency Index, which reflects the stringency of a government’s response to COVID-19 restrictions at a specific time. <p><strong>Results:</strong></p> Of the identified 24,339 records, 101 papers were included after the screening process. Reports on general services (n=72) showed that several countries’ face-to-face services reduced their activities at the start of the pandemic, with reductions in the total number of delivered visits and with some services forced to close. In contrast, telemental health use rapidly increased in many countries across the world at the beginning of the pandemic (n=55), with almost complete virtualization of general and specialistic care services by the end of the first year. Considering the reported COVID-19 Stringency Index values, the increased use of virtual means seems to correspond to periods when the Stringency Index values were at their highest in several countries. However, due to specific care requirements, telemental health could not be used in certain subgroups of patients, such as those on clozapine or depot treatments and those who continued to need face-to-face visits. <p><strong>Conclusions:</strong></p> During the pandemic, mental health services had to adapt quickly in the short term, implementing or increasing the use of telemental health services across the globe. Limited access to digital means, poor digital skills, and patients’ preferences and individual needs may have contributed to differences in implementing and accessing telemental health services during the pandemic. In the long term, a blended approach, combining in-person and virtual modalities, that takes into consideration the needs, preferences, and digital skills of patients may better support the future development of mental health services. It will be required to improve confidence with digital device use, training, and experience in all modalities for both clinicians and service users.
spellingShingle Zangani, C
Ostinelli, EG
Smith, KA
Hong, JSW
Macdonald, O
Reen, G
Reid, K
Vincent, C
Syed Sheriff, R
Harrison, PJ
Hawton, K
Pitman, A
Bale, R
Fazel, S
Geddes, JR
Cipriani, A
Impact of the COVID-19 pandemic on the global delivery of mental health services and telemental health: systematic review
title Impact of the COVID-19 pandemic on the global delivery of mental health services and telemental health: systematic review
title_full Impact of the COVID-19 pandemic on the global delivery of mental health services and telemental health: systematic review
title_fullStr Impact of the COVID-19 pandemic on the global delivery of mental health services and telemental health: systematic review
title_full_unstemmed Impact of the COVID-19 pandemic on the global delivery of mental health services and telemental health: systematic review
title_short Impact of the COVID-19 pandemic on the global delivery of mental health services and telemental health: systematic review
title_sort impact of the covid 19 pandemic on the global delivery of mental health services and telemental health systematic review
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