Antidepressants, primary care, and adult mental health services in England during COVID-19

Armitage, Richard

doi:10.1016/s2215-0366(20)30530-7

Cited by 41 publications

(31 citation statements)

References 1 publication

(1 reference statement)

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“…This decline in referrals began approximately one week prior to lockdown and reached the maximum level within three weeks after the lockdown was announced, with a 74% reduction of referrals in 2020 compared to the same time in 2019. This appears somewhat consistent with regional reports as well as the national trend observed through the monitoring of activity in the patient management software used by a majority of IAPT services, where referrals dropped by approximately 70% early after lockdown was announced [ [10] , [11] , [12] , 21 ]. The use of primary care psychological therapies are similar to those observed in other health services, such as a reduced number of patients accessing Accident and Emergency Departments and General Practice [ 22 , 23 ].…”

Section: Discussionsupporting

confidence: 85%

“…Concerns have been raised about adequate service provision during the pandemic, with staff shortages and service reconfigurations as well as the pressures of implementing infection control measures posing challenges to mental health staff [ 4 , 9 ]. Research suggests that referrals to primary and secondary mental health services reduced after lockdown regionally and nationally, with an increase in remote mediums to conduct clinical contacts [10] , [11] , [12] . However, less is known about how the impact on psychological care provision varied by patient characteristics.…”

Section: Introductionmentioning

confidence: 99%

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The early impact of COVID-19 on primary care psychological therapy services: A descriptive time series of electronic healthcare records

et al. 2021

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Background: There are growing concerns about the impact of the COVID-19 pandemic on mental health. With government-imposed restrictions as well as a general burden on healthcare systems, the pandemic has the potential to disrupt the access to, and delivery of, mental healthcare. Methods: Electronic healthcare records from primary care psychological therapy services (Improving Access to Psychological Therapy) in England were used to examine changes in access to mental health services and service delivery during early stages of the COVID-19 pandemic. A descriptive time series was conducted using data from five NHS trusts to examine patterns in referrals to services (1st January 2019 to 24th May 2020) and appointments (1st January 2020 to 24th May 2020) taking place. Findings: The number of patients accessing mental health services dropped by an average of 55% in the early weeks after the March 2020 lockdown was announced, reaching a maximum reduction of 74% in the initial 3 weeks after lockdown in the UK, which gradually recovered to a 28% reduction by May. We found some evidence suggesting changes in the sociodemographic and clinical characteristics of referrals. Despite a reduction in access, the impact on appointments appeared limited with service providers shifting to remote delivery of care. Interpretation: Services appeared to adapt to provide continuity of care in mental healthcare. However, patients accessing services reduced, potentially placing a future burden on service. Despite the observational nature of the data, the present study can inform the planning of service provision and policy.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

The early impact of COVID-19 on primary care psychological therapy services: A descriptive time series of electronic healthcare records

et al. 2021

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“…This echoes existing literature, which underlines that individuals with mental health disorders rarely display help-seeking behaviours [50]. Moreover, both patients and primary-care practitioners largely experienced the NHS as over-stretched during the COVID-19 lockdowns, a perception compounded by media portrayals [51]. This has ramifications for the burden of mental health disorders in the UK post-pandemic, as well as for the management of mental health services nationally.…”

Section: Discussionsupporting

confidence: 61%

‘It’s Easily the Lowest I’ve Ever, Ever Got to’: A Qualitative Study of Young Adults’ Social Isolation during the COVID-19 Lockdowns in the UK

Dedryver

Knai

2021

IJERPH

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(1) Background: Social connectivity is key to young people’s mental health. Local assets facilitate social connection, but were largely inaccessible during the pandemic. This study consequently investigates the social isolation of young adults and their use of local assets during the COVID-19 lockdowns in the UK. (2) Methods: Fifteen semi-structured Zoom interviews were undertaken with adults aged 18–24 in the UK. Recruitment took place remotely, and transcripts were coded and analysed thematically. (3) Results: Digital assets were key to young people’s social connectivity, but their use was associated with stress, increased screen time and negative mental health outcomes. The lockdowns impacted social capital, with young people’s key peripheral networks being lost, yet close friendships being strengthened. Finally, young people’s mental health was greatly affected by the isolation, but few sought help, mostly out of a desire to not overburden the NHS. (4) Conclusions: This study highlights the extent of the impact of the pandemic isolation on young people’s social capital and mental health. Post-pandemic strategies targeting mental health system strengthening, social isolation and help-seeking behaviours are recommended.

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“…Nevertheless, data on psychotropic medications consumption during COVID-19, as a possible effect of the increased burden of psychological suffering, are still scarce and controversial. Some national and government agencies worldwide report a global growth of prescriptions of benzodiazepines (BZDs), mood stabilisers (MSs) and selective serotonin reuptake inhibitors (SSRIs) during the COVID-19 pandemic, 4 , 5 but it is still unclear the role of the different factors involved in this increase.…”

Section: Introductionmentioning

confidence: 99%

“…For example, Armitage 4 attributes the increased rate of antidepressant prescribing during the first COVID-19 lockdown measured by the National Health Service in England to the negative psychological impact of the pandemic, whereas Walker et al. 6 contested this hypothesis considering this increase as a consequence of the ongoing upward trend in antidepressants prescribing over the last years, independently from the COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Psychotropic medications sales during COVID-19 outbreak in Italy changed according to the pandemic phases and related lockdowns

et al. 2021

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Objectives We have investigated the psychotropic medications sales (i.e. benzodiazepines, mood stabilisers and selective serotonin reuptake inhibitors) during the COVID-19 pandemic in the period from March 2020 to February 2021 compared with the same period in the preceding year. Study design This was a retrospective and observational study. Methods Data were obtained from five pharmacies located in a working-class zone populated by approximately 150,000 people in the urban area of Rome (Italy). Results A general slight increase in psychotropic medications sales was observed during the whole pandemic period compared with the previous year. Conclusion Our data showed that (1) the percentage of sales seems to vary according to the pandemic phases and related lockdowns and (2) the sales differ between the classes of medications considered.

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Antidepressants, primary care, and adult mental health services in England during COVID-19

Cited by 41 publications

References 1 publication

The early impact of COVID-19 on primary care psychological therapy services: A descriptive time series of electronic healthcare records

The early impact of COVID-19 on primary care psychological therapy services: A descriptive time series of electronic healthcare records

‘It’s Easily the Lowest I’ve Ever, Ever Got to’: A Qualitative Study of Young Adults’ Social Isolation during the COVID-19 Lockdowns in the UK

Psychotropic medications sales during COVID-19 outbreak in Italy changed according to the pandemic phases and related lockdowns

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