Changes in mental health services in response to the COVID-19 pandemic in high-income countries: a rapid review.

Publication date: Feb 06, 2024

Severe deterioration in mental health and disrupted care provision during the COVID-19 increased unmet needs for mental health. This review aimed to identify changes in mental health services for patients in response to the pandemic and understand the impact of the changes on patients and providers. Following the Cochrane guidance for rapid reviews, Cochrane CENTRAL, MEDLINE, Embase and PsycInfo were searched for empirical studies that investigated models of care, services, initiatives or programmes developed/evolved for patients receiving mental health care during COVID-19, published in English and undertaken in high-income countries. Thematic analysis was conducted to describe the changes and an effect direction plot was used to show impact on outcomes. 33 of 6969 records identified were included reporting on patients’ experiences (n = 24), care providers’ experiences (n = 7) and mixed of both (n = 2). Changes reported included technology-based care delivery, accessibility, flexibility, remote diagnostics and evaluation, privacy, safety and operating hours of service provision. These changes had impacts on: (1) care access; (2) satisfaction with telehealth; (3) comparability of telehealth with face-to-face care; (4) treatment effectiveness; (5) continuity of care; (6) relationships between patients and care providers; (7) remote detection and diagnostics in patients; (8) privacy; (9) treatment length and (10) work-life balance. A shift to telecommunication technologies had a significant impact on patients and care providers’ experiences of mental health care. Improvements to care access, flexibility, remote forms of care delivery and lengths of operating service hours emerged as crucial changes, which supported accessibility to mental health services, increased attendance and reduced dropouts from care. The relationships between patients and care providers were influenced by service changes and were vastly depending on technological literacy and context of patients and availability and care access ranging from regular contact to a loss of in-person contact. The review also identified an increase in care inequality and a feeling of being disconnected among marginalised groups including homeless people, veterans and ethic minority groups. Telehealth in mental care could be a viable alternative to face-to-face service delivery with effective treatment outcomes. Further research is needed to better understand the impact of the changes identified particularly on underserved populations.

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Concepts Keywords
Covid COVID-19
Dropouts Mental Health
Increased Telehealth


Type Source Name
disease MESH COVID-19 pandemic
disease VO effectiveness
drug DRUGBANK Isoxaflutole
disease VO viable
disease VO effective
drug DRUGBANK Tropicamide
pathway REACTOME Reproduction
disease MESH infection
disease MESH psychological distress
disease VO population
disease MESH mental illnesses
disease VO time
disease VO Gap
drug DRUGBANK Serine
disease VO protocol
drug DRUGBANK Trestolone
drug DRUGBANK Methionine
disease IDO country
disease IDO process
disease VO Canada
drug DRUGBANK Etoperidone
disease MESH substance abuse
disease MESH anxiety disorders
disease MESH suicide
disease MESH emergency
drug DRUGBANK Pentaerythritol tetranitrate
drug DRUGBANK Indoleacetic acid
disease MESH schizophrenia
disease MESH ARC
drug DRUGBANK 3 7 11 15-Tetramethyl-Hexadecan-1-Ol
disease VO report
disease VO organization
disease MESH Suicidal Ideation
drug DRUGBANK Bean
disease MESH dual diagnosis
drug DRUGBANK Timonacic
disease MESH Social Anxiety Disorder
disease MESH obsessive compulsive disorder
disease MESH mild cognitive impairment
disease MESH borderline personality disorder
disease MESH Personality Disorders
drug DRUGBANK Dihydrostreptomycin
drug DRUGBANK Minaprine
drug DRUGBANK Gold
disease VO efficiency
disease VO organ
disease MESH back pain

Original Article

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