COVID-19 and psychiatric admissions: An observational study of the first six months of lockdown in Melbourne

Jagadheesan, Karuppiah; Danivas, Vijay; Itrat, Quratulain; Sekharan, Lokesh; Lakra, Vinay

doi:10.1016/j.psychres.2021.113902

Cited by 22 publications

(26 citation statements)

References 8 publications

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“…As shown in Multimedia Appendix 3 , several studies reported a reduction in face-to-face visits [ 21 , 22 ] and emergency department presentations [ 23 ], with a reduction in the activity of specialized settings, such as electroconvulsive therapy clinics [ 24 - 27 ]. Data on hospitalizations were less clear, with some studies reporting evidence of a reduced number of admissions (eg, [ 28 , 29 ]), others reporting evidence of a rapid increase in admissions soon after the pandemic onset (eg, [ 23 , 30 ]), and still others reporting no differences compared to the same period in the previous year (eg, [ 31 , 32 ]).…”

Section: Resultsmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on the Global Delivery of Mental Health Services and Telemental Health: Systematic Review

Zangani¹,

Ostinelli²,

Smith³

et al. 2022

JMIR Ment Health

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Background 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. Objective We aimed to systematically review the global research literature on how mental health service provision adapted during the first year of the pandemic. Methods 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. Results 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. Conclusions 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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Section: Resultsmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on the Global Delivery of Mental Health Services and Telemental Health: Systematic Review

Zangani¹,

Ostinelli²,

Smith³

et al. 2022

JMIR Ment Health

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“…9 Admissions to four inpatient units across the region reduced by 12% after the onset of the pandemic. 10 Decreased admissions rates were likely related to fear of infection in hospitals, and higher clinical thresholds for admission.…”

Section: Acute Demand During the Pandemicmentioning

confidence: 99%

Real-world performance of Victorian hospitals during the COVID-19 lockdowns

Allison

Bastiampillai

Looi

et al. 2022

Australas Psychiatry

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Objective Victoria has low numbers of general adult psychiatric beds per capita by Australian and international standards. Hospital key performance indicators (KPIs) such as bed occupancy rates, emergency department waiting times and inpatient lengths of stay are proximal measures of the effects any shortfall in beds. We investigate the real-world performance of Victorian hospitals during the first year of the COVID-19 pandemic and the extended lockdowns in 2020. Conclusions The Victorian inpatient psychiatric system is characterised by high bed occupancies in many regions, extended stays in emergency departments awaiting a bed, and short inpatient lengths of stay, except for patients with excessively long stays on acute units (over 35 days) who are unable to be admitted to non-acute facilities. At the end of 2020, bed occupancies were high (above 90%) in 10 regions, with three regions having bed occupancies over 100%. However, state-wide average bed occupancy improved between 2019 (94%) and 2020 (88%). Other KPIs remained steady because acute hospitals did not experience the expected pandemic mental health demand-surge. For a more complete picture of the impact of the pandemic, Australia needs interconnected, centralised data systems.

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“… 15 In Melbourne, increases in presentations for psychosis, anxiety or substance use during the 2020 lockdown were matched by decreases in those for mood disorders or suicidal behaviour compared to control periods. 16 , 17 …”

Section: Research Evidencementioning

confidence: 99%

Rapid review and commentary on the clinical implications of the population mental health consequences of the COVID-19 pandemic in Australia

Looi

Allison

Bastiampillai

et al. 2022

Australas Psychiatry

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Objective To provide a rapid clinical review and commentary for psychiatrists on the population mental health consequences of the COVID-19 pandemic in Australia, including evidence-based findings and interventions. Conclusions Whilst there was evidence of collective psychological resilience during the first 2 years of the COVID-19 pandemic, younger women, carers for those with COVID-19, and those with more household chores, childcare needs and higher economic strain, were at more risk. Interventions should therefore target people with these socio-demographic risk factors, as well as severe COVID-19 survivors, their relatives and frontline workers. However, the rapid spread of the Omicron SARS-CoV-2 variant has the potential for greater impacts on population mental health. Innovations in telehealth and online therapy should be incorporated into standard care. Ongoing research is needed to assess who remains most vulnerable to negative mental health impacts of the current pandemic, and especially the longer term outcomes of mental ill health. Further research should also investigate evidence-based approaches to resilience and well-being. Prospective risk/benefit analyses of infection control measures, economic effects and mental health consequences are needed.

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COVID-19 and psychiatric admissions: An observational study of the first six months of lockdown in Melbourne

Cited by 22 publications

References 8 publications

Impact of the COVID-19 Pandemic on the Global Delivery of Mental Health Services and Telemental Health: Systematic Review

Impact of the COVID-19 Pandemic on the Global Delivery of Mental Health Services and Telemental Health: Systematic Review

Real-world performance of Victorian hospitals during the COVID-19 lockdowns

Rapid review and commentary on the clinical implications of the population mental health consequences of the COVID-19 pandemic in Australia

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