Impact of COVID‐19 social distancing measures on routine mental health care provision and treatment outcome for common mental disorders in the Netherlands

Beurs, Edwin de; Blankers, Matthijs; Peen, Jaap; Rademacher, Clara; Podgorski, Alicja; Dekker, Jack

doi:10.1002/cpp.2713

Cited by 9 publications

(10 citation statements)

References 58 publications

(76 reference statements)

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“…Similar to the existing research on the comparison between video conferencing treatment and in‐person treatment, there is convincing evidence for the effectiveness of video conferencing treatment in general (de Beurs et al, 2022) and for AUD in particular: Tarp et al (2017) found no differences in treatment outcome for AUD between regular in‐person treatment and in‐person treatment with some of the sessions conducted in video conferencing format (so called “blended treatment”). A systematic review supports these findings, by demonstrating that there is no difference in treatment outcome of alcohol consumption between in‐person treatment and video conferencing treatment (Byaruhanga et al, 2020).…”

Section: Introductionmentioning

confidence: 62%

“…An observational study can show whether video-conferencing treatment is non-inferior to in-person therapy in everyday clinical practice. In a previous Dutch observational study of the effectiveness of video conferencing treatment for common mental disorders, such as depression and anxiety disorders, no differences in outcomes were found (de Beurs et al, 2022). It is important to investigate whether this holds as well for the treatment of AUD.…”

Section: Introductionmentioning

confidence: 96%

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Alcohol use disorder treatment via video conferencing compared with in‐person therapy during COVID‐19 social distancing : A non‐inferiority comparison of three cohorts

de Beurs,

Rademacher,

Blankers

et al. 2023

Alcohol: Clinical and Experimental Research

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BackgroundSocial distancing measures during the COVID‐19 pandemic forced an abrupt transformation of treatment delivery for mental health care. In mid‐March 2020, nearly all in‐person contact was replaced with video conferencing. The pandemic thus offered a natural experiment and a unique opportunity to conduct an observational study of whether alcohol use disorder treatment through video conferencing is non‐inferior to in‐person treatment.MethodsIn a large urban substance use disorder treatment center in the Netherlands, treatment evaluation is routine practice. Outcome data are regularly collected to support shared decision making and monitor patient progress. For this study, pre‐test and post‐test data on alcohol use (Measurements in the Addictions for Triage and Evaluation), psychopathology (Depression Anxiety Stress Scales), and quality of life (Manchester Short Assessment of Quality of Life) were used to compare outcomes of cognitive behavioral therapy treatment for three cohorts: patients who received treatment for a primary alcohol use disorder performed prior to (n = 628), partially during (n = 557), and entirely during (n = 653) the COVID‐19 lockdown.ResultsOutcome was similar across the three cohorts: No inferior outcomes were found for treatments that were conducted predominantly through video conferencing during lockdown or treatments that started in‐person, but were continued through video conferencing, compared to in‐person treatments that were conducted prior to COVID‐19. The number of drop‐outs were also similar between cohorts. However, there was a difference in average treatment intensity between cohorts, with treatment partially or fully conducted during the COVID‐19 pandemic lasting longer.ConclusionsTreatment for a primary alcohol use disorder, provided partially or predominantly through video conferencing during the COVID‐19 pandemic resulted in abstinence rates and secondary outcomes similar to traditional in‐person care, in spite of the potentially negative effects of the COVID‐related lockdown measures themselves. These results from everyday clinical practice corroborate findings of randomized controlled studies and meta‐analyses in which video conferencing appeared non‐inferior to in‐person care in clinical effectiveness.

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Section: Introductionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 96%

Alcohol use disorder treatment via video conferencing compared with in‐person therapy during COVID‐19 social distancing : A non‐inferiority comparison of three cohorts

de Beurs,

Rademacher,

Blankers

et al. 2023

Alcohol: Clinical and Experimental Research

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“…Although data availability and the organization of healthcare systems varied across countries, we aimed to collect as comparable measures of care utilization as possible. Previous studies suggest that among all mental disorders, CMD would belong to the most affected ( 11 , 16 , 17 ). Since, at least in Sweden and the UK, most individuals seeking care for CMD meet general practitioners rather than specialists [Flodin et al, n.d., ( 9 , 10 )], CMD counts in primary care would likely be among the most sensitive measures for changes in population mental health.…”

Section: Introductionmentioning

confidence: 99%

Differential impact of the COVID-19 pandemic on primary care utilization related to common mental disorders in four European countries: A retrospective observational study

Flodin

Wallin²,

Tarantino³

et al. 2023

Front. Psychiatry

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BackgroundThe COVID-19 pandemic is commonly believed to have increased common mental disorders (CMD, i.e., depression and anxiety), either directly due to COVID-19 contractions (death of near ones or residual conditions), or indirectly by increasing stress, economic uncertainty, and disruptions in daily life resulting from containment measure. Whereas studies reporting on initial changes in self-reported data frequently have reported increases in CMD, pandemic related changes in CMD related to primary care utilization are less well known. Analyzing time series of routinely and continuously sampled primary healthcare data from Sweden, Norway, Netherlands, and Latvia, we aimed to characterize the impact of the pandemic on CMD recorded prevalence in primary care. Furthermore, by relating these changes to country specific time-trajectories of two classes of containment measures, we evaluated the differential impact of containment strategies on CMD rates. Specifically, we wanted to test whether school restrictions would preferentially affect age groups corresponding to those of school children or their parents.MethodsFor the four investigated countries, we collected time-series of monthly counts of unique CMD patients in primary healthcare from the year 2015 (or 2017) until 2021. Using pre-pandemic timepoints to train seasonal Auto Regressive Integrated Moving Average (ARIMA) models, we predicted healthcare utilization during the pandemic. Discrepancies between observed and expected time series were quantified to infer pandemic related changes. To evaluate the effects of COVID-19 measures on CMD related primary care utilization, the predicted time series were related to country specific time series of levels of social distancing and school restrictions.ResultsIn all countries except Latvia there was an initial (April 2020) decrease in CMD care prevalence, where largest drops were found in Sweden (Prevalence Ratio, PR = 0.85; 95% CI 0.81–0.90), followed by Netherlands (0.86; 95% CI 0.76–1.02) and Norway (0.90; 95% CI 0.83–0.98). Latvia on the other hand experienced increased rates (1.25; 95% CI 1.08–1.49). Whereas PRs in Norway and Netherlands normalized during the latter half of 2020, PRs stayed low in Sweden and elevated in Latvia. The overall changes in PR during the pandemic year 2020 was significantly changed only for Sweden (0.91; 95% CI 0.90–0.93) and Latvia (1.20; 95% CI 1.14–1.26). Overall, the relationship between containment measures and CMD care prevalence were weak and non-significant. In particular, we could not observe any relationship of school restriction to CMD care prevalence for the age groups best corresponding to school children or their parents.ConclusionCommon mental disorders prevalence in primary care decreased during the initial phase of the COVID-19 pandemic in all countries except from Latvia, but normalized in Norway and Netherlands by the latter half of 2020. The onset of the pandemic and the containment strategies were highly correlated within each country, limiting strong conclusions on whether restriction policy had any effects on mental health. Specifically, we found no evidence of associations between school restrictions and CMD care prevalence. Overall, current results lend no support to the common belief that the pandemic severely impacted the mental health of the general population as indicated by healthcare utilization, apart from in Latvia. However, since healthcare utilization is affected by multiple factors in addition to actual need, future studies should combine complementary types of data to better understand the mental health impacts of the pandemic.

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“…Although such investigations present significant methodological challenges, access to real‐world outcome data derived from routine outcome measurement (McAleavey & Moltu, 2021) offers a practical way to explore the question. A large‐scale study from the Netherlands used routine outcome monitoring assessments to examine the effectiveness of treatment via videoconferencing in everyday practice, which replaced in‐person therapy during the pandemic in the Netherlands (de Beurs et al, 2022). The results showed that therapeutic outcomes were robust under COVID‐19 conditions.…”

Section: Introductionmentioning

confidence: 99%

Mental health of help‐seeking outpatients pre and post COVID‐19: A real‐world data, multicentre study

Probst,

Miller,

Bargmann

et al. 2023

Clin Psychology and Psychoth

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ObjectiveA great deal of research addresses the mental health implications of the COVID‐19 pandemic for the general population. Little is known about the implications for mental health of help‐seeking outpatients and for the effectiveness of mental health services. The present study investigated the mental health and treatment response of help‐seeking outpatients before and during the COVID‐19 pandemic.MethodRoutine outcome monitoring data from 3706 clients in the United States and Northern Europe was analysed using multilevel modelling with global subjective well‐being as the dependent variable.ResultsAs opposed to before the pandemic, during the pandemic, well‐being scores were significantly higher at intake and improvement throughout treatment was significantly smaller in the US sample, while both were comparable in the EU sample.ConclusionAlthough there is also evidence of less effective treatments since the pandemic, no conclusive picture emerges that portrays the impact of the pandemic on mental health as uniform. More research is needed to elucidate the impact of the pandemic on the help‐seeking population.

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Impact of COVID‐19 social distancing measures on routine mental health care provision and treatment outcome for common mental disorders in the Netherlands

Cited by 9 publications

References 58 publications

Alcohol use disorder treatment via video conferencing compared with in‐person therapy during COVID‐19 social distancing : A non‐inferiority comparison of three cohorts

Alcohol use disorder treatment via video conferencing compared with in‐person therapy during COVID‐19 social distancing : A non‐inferiority comparison of three cohorts

Differential impact of the COVID-19 pandemic on primary care utilization related to common mental disorders in four European countries: A retrospective observational study

Mental health of help‐seeking outpatients pre and post COVID‐19: A real‐world data, multicentre study

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