Covid-19 and Telemental Health Projects

Impacts of Covid-19 on mental health and mental health care, including the shift to telemental health [Project status - Complete]

Project summary 

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:

  1. 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.
  2. 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.
  3. 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.
  4. 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:

  1. An umbrella review summarising the pre-pandemic literature on the effectiveness of telemental health and on implementation outcomes.
  2. 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.
  3. 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.
  4. An economic review of the evidence (both before and during the pandemic) on the costs and cost-effectiveness of telemental health
  5. A qualitative study on service user experiences of telemental health during the early phase of the pandemic
  6. 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 video of a public event with MQ on the Covid-19 systematic review
  • 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:

Immediate impacts and future focus:

  • Video of a 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

Tele-mental Health Infographic

MHPRU Podcasts on telemental health: