Impacts of Covid-19 on mental health and mental health care, including the shift to telemental health [Project status - Complete]
At the onset of the COVID-19 pandemic in 2020, the MHPRU revised it work programme so as to be able to initiate a large programme of responsive work aimed at examining the impact of the COVID-19 pandemic on mental health care and people living with mental health conditions. We began by conducting a group of rapid projects during the early stages of the pandemic, including:
- A rapid review of literature of all types on the current and potential impacts of COVID-19 on mental health services and the people who use and work in them, and on what worked and did not worked in mitigating these impacts. This was conducted in the first three months of the pandemic and published in preprint in July 2020, making it one of the earlier sources of evidence on this topic.
- A report on an online survey of mental health staff from all sectors and professions in the UK about the impact of COVID-19 on services and the success or otherwise of innovations and adaptations to manage these impacts.
- A qualitative study conducted jointly with the UKRI Loneliness and Social Isolation in Mental Health Group to understand impacts of the pandemic and any potential strategies to mitigate negative impacts, from the perspective of people with lived experience of mental health problems. An initial series of interviews was followed by a further follow-up interview after around 6 months.
- Systematic review on the COVID-19 and the epidemiology of mental health problems. Following a request from policy makers, we have been are reviewing published literature on the impact of the COVID-19 pandemic on mental health in Europe.The focus is on three questions:
1) What changes have there been to the incidence or prevalence of mental health conditions?
2) What changes have there been to mental health symptoms, social functioning and quality of life among people already living with mental health conditions? and,
3) What changes have there been to mental health service use?
We are considering both changes at the onset of the pandemic, and as it continued, though most published research is from the first year (2020). This work has now been presented to policy makers and has been accepted for publication by Lancet Psychiatry.
The priority area identified by policy makers for further rapid work was telemental health: we therefore initiated a further programme of work to understand the impact of shifting to video and phone calls for mental health care delivery, both in the pandemic and in more usual circumstances. Major outputs included:
- An umbrella review summarising the pre-pandemic literature on the effectiveness of telemental health and on implementation outcomes.
- A systematic review of literature on telemental health in the first year of the pandemic, synthesising evidence on delivery, uptake, experiences and outcomes following the global shift towards remote mental health care in the COVID-19 global emergency.
- A systematic review of the implementation of telemental health (both before and during the pandemic), investigating evidence on the impact of planned strategies to optimise uptake and delivery of telemental health.
- An economic review of the evidence (both before and during the pandemic) on the costs and cost-effectiveness of telemental health
- A qualitative study on service user experiences of telemental health during the early phase of the pandemic
- A rapid realist review, drawing together our previous programmes of work, other published literature and stakeholder views (including both service users and clinicians) to develop theory on what works for whom in which contexts in telemental health.
Summaries of this work:
On COVID-19 Impact on mental health care:
- A blog reporting on our dissemination event in December 2020 on the impact of COVID on mental heath care with links to the slides from the event
- Brief overview slide set
Centre for Mental Health Briefing on Mental Health Services and COVID-19:
- This briefing contained a summary for policy makers of our early work on the COVID-19 pandemic’s impact on mental health care
Mental Elf blogs summarising this work:
Staff views on the impact of the COVID-19 pandemic on mental health services and service users
What impact has the COVID-19 pandemic had on people with mental health problems and the services they use?
Living with mental health problems during COVID-19: how does it feel?
Immediate impacts and future focus:
- Video of public event with Mental Elf to disseminate this programme of work
- Podcast on the experience of co-production in our qualitative work on the impact of COVID-19, made for the Institute of Mental Health conference at UCL
- Epidemiological review of Covid-19 associations with mental health: We have summarised our findings in these slides. A paper is under review.
On telemental health:
- Our summary slides on our telemental health programme of work
- Connected: Centre for Mental Health’s summary report based on our work on telemental health
- This Mental Elf blog by Pip Clery summarises the main publications of our telemental health programme
- Our infographic summarising top tips on telemental health for clinicians
MHPRU Podcasts on telemental health:
- Telemental health - the PRU pod
- Telemental health: the results episode - the PRU pod
- 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 - A rapid synthesis from both scientific and all other types of literature on the early impacts of the pandemic on people with pre-existing mental health conditions and services they use. We identified individual and service-level strategies adopted to manage these impacts, exploring initial evidence on their success
- 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 - Staff reports regarding the impact of the COVID-19 pandemic in its early months s on mental health care and mental health service users in the UK using a mixed methods online survey
- Exploring the experiences of loneliness in adults with mental health problems: a participatory qualitative interview study - In conjunction with the UKRI Loneliness and Social Isolation in Mental Health, in this paper we explored explore experiences of loneliness, as well as what contributes to or helps address it, among a diverse sample of adults living with mental health problems in the UK. Most interviews took place during the pandemic
- What has changed in the experiences of people with mental health problems during the COVID-19 pandemic: a coproduced, qualitative interview study - A qualitative interview follow-up study which sought to understand how the experiences of people in the UK with pre-existing mental health conditions had changed developed as the COVID-19 pandemic progressed
Experiences of living with mental health problems during the COVID-19 pandemic in the UK: a coproduced, participatory qualitative interview study - A qualitative interview study exploring experiences of the pandemic for people with pre-existing mental health conditions
Service user experiences and views regarding telemental health during the COVID-19 pandemic: A co-produced framework analysis - A qualitative investigation of mental health service user perspectives on the adoption of telemental health during the COVID-19 pandemic.
Implementation, Adoption, and Perceptions of Telemental Health During the COVID-19 Pandemic: Systematic Review - A systematic review to investigate the adoption and impacts of telemental health approaches during the COVID-19 pandemic, and facilitators and barriers to optimal implementation
What works for whom with telemental health? A rapid realist review - The aim of this rapid realist review was to develop theory about which telemental health approaches work, or do not work, for whom, in which contexts and through what mechanisms. We drew on our other telemental health work, other literature of varying types and stakeholder input from both service users and frontline clinicians.
Implementation strategies for telemental health: a systematic review - In this review, we investigated the impacts of pre-planned strategies designed to achieve more effective and/or sustained implementation of telemental health.
Variations in the uptake of telemental health technologies in community and crisis mental health services during the early pandemic: a survey of mental health professionals in the UK - In this paper we have explored variations in who made use of telemental health most and in which services and areas during the early pandemic.
Are remote mental health interventions cost-effective - This review examines the health economic evidence on telemental health
Challenges and opportunities of the COVID-19 pandemic for perinatal mental health care: a mixed-methods study of mental health care staff - MHPRU collaborators with specialist expertise in perinatal care have made use of data from our survey to report on specific impacts of the pandemic on women with perinatal mental health difficulties
Effects of the COVID-19 pandemic on mental healthcare and services: results of a UK survey on front-line staff working with people with intellectual disability and/or autism - MHPRU collaborators with specialist expertise in intellectual disability have made use of data from our survey to report on specific impacts of the pandemic on people with intellectual disabilities
How has COVID-19 affected mental health nurses and the delivery of mental health nursing care in the UK? Results of a mixed-methods study - in this study we examined the specific effects of the pandemic on the mental health of the nursing workforce
Impact of the COVID-19 pandemic on older adult's mental health services: A mixed methods study - MHPRU collaborators with specialist expertise in older adults have made use of data from our survey to report specific impacts of the pandemic on older people with mental health problems or dementia