Impact of the first COVID-19 outbreak on mental health service utilisation at a Dutch mental health centre: retrospective observational study

Abstract

Background Previous studies into mental health service utilisation during the COVID-19 pandemic are limited to a few countries or specific type of service. In addition, data on changes in telepsychiatry are currently lacking. Aims We aimed to investigate whether the COVID-19 pandemic is associated with changes in mental health service utilisation, including telepsychiatry, and how these changes were distributed among patients with mental illness during the first COVID-19 outbreak. Method This retrospective study obtained routinely assessed healthcare data from a large Dutch mental healthcare institute. Data from the second quarter of 2020 (the first COVID-19 outbreak period) were compared with the pre-pandemic period between January 2018 and March 2020. Time-series analyses were performed with the quasi-Poisson generalised linear model, to examine the effect of the COVID-19 lockdown and the overall trend of mental health service utilisation per communication modality and diagnostic category. Results We analysed 204 808 care contacts of 28 038 patients. The overall number of care contacts in the second quarter of 2020 remained the same as in the previous 2 years, because the number of video consultations significantly increased (B = 2.17, P = 0.488 × 10−3) as the number of face-to-face out-patient contacts significantly decreased (B = −0.98, P = 0.011). This was true for all different diagnostic categories, although this change was less pronounced in patients with psychotic disorders. Conclusions Diminished face-to-face out-patient contacts were well-compensated by the substantial increase of video consultations during the first COVID-19 outbreak in The Netherlands. This increase was less pronounced for psychotic disorders. Further research should elucidate the need for disorder-specific digital mental healthcare delivery.

The early impact of the COVID-19 pandemic on patients with severe mental illness: An interrupted time-series study in South-East England

“…The overall patterns of resource use found in this study confirm those reported elsewhere in the literature. In our study, community and outpatient contacts shifted rapidly to remote provision with no detectable negative impact on contact rates or waiting times, a result reported in other secondary mental healthcare settings [19]. The rate of inpatient admissions was reduced (although not significantly) despite a reduction in contacts with at-home crisis teams.…”

Psychiatric emergencies during, after, and before the COVID-19 lockdown; what happened to our patients? A naturalistic observational study

“…Even if most of the present ndings might be related to the government restrictions to movement and to the fear of contagion, our results are consistent with evidence from other countries, suggesting a plausible general effect of the COVID-19 crisis on severe mental illnesses; while a severe mental health crisis was expected [28,29], a general reduction in help-seeking behaviors [28][29][30][31] and psychiatric emergencies were found [14][15][16]27]. In line with previous Italian studies [22,23], although the described reduction in EDs psychiatric consultations was higher in the lockdown period, there was a persisting reduction in the post-lockdown period as well.…”

“…In line with these results and despite rising concerns of increased mental health problems during the pandemic, several studies highlighted a reduction of help-seeking behavior for psychiatric problems [12]; also, psychiatric hospitalizations appeared to be reduced during the lockdown period [13]. Recent reports on the impact of the COVID-19 pandemic on psychiatric admissions to emergency departments (ED) revealed a reduction in psychiatric admissions during the lockdown period compared with the previous year in several countries [14][15][16][17][18][19].…”

Psychiatric emergencies during, after, and before the COVID-19 lockdown: what happened to our patients? A naturalistic observational study

“…In line with these results and despite rising concerns of increased mental health problems during the pandemic, several studies highlighted a reduction of help-seeking behavior for psychiatric problems [ 12 ]; also, psychiatric hospitalizations appeared to be reduced during the lockdown period [ 13 ]. Recent reports on the impact of the COVID-19 pandemic on psychiatric admissions to Emergency Departments (ED) revealed a reduction in psychiatric admissions during the lockdown period compared with the previous year in several countries [ 14 – 19 ].…”