Impact on mental health care and on mental health service users of the COVID-19 pandemic: a mixed methods survey of UK mental health care staff

Abstract

Purpose: The COVID-19 pandemic has potential to disrupt and burden the mental health care system, and to magnify inequalities experienced by mental health service users. Methods: We investigated staff reports regarding the impact of the COVID-19 pandemic in its early weeks on mental health care and mental health service users in the UK using a mixed methods online survey. Recruitment channels included professional associations and networks, charities and social media. Quantitative findings were reported with descriptive statistics, and content analysis conducted for qualitative data. Results: 2,180 staff from a range of sectors, professions and specialties participated. Immediate infection control concerns were highly salient for inpatient staff, new ways of working for community staff. Multiple rapid adaptations and innovations in response to the crisis were described, especially remote working. This was cautiously welcomed but found successful in only some clinical situations. Staff had specific concerns about many groups of service users, including people whose conditions are exacerbated by pandemic anxieties and social disruptions; people experiencing loneliness, domestic abuse and family conflict; those unable to understand and follow social distancing requirements; and those who cannot engage with remote care. Conclusion: This overview of staff concerns and experiences in the early COVID-19 pandemic suggests directions for further research and service development: we suggest that how to combine infection control and a therapeutic environment in hospital, and how to achieve effective and targeted tele-health implementation in the community, should be priorities. The limitations of our convenience sample must be noted.

Remote working in mental health services: a rapid umbrella review of pre-COVID-19 literature

“…Mental health care and treatment utilising remote technologies such as video or phone (tele-mental health) has become an important tool in recent months, taking a central role internationally in maintaining mental health services during the COVID-19 pandemic (1). Policy makers and mental health professionals, along with mental health service users now express interest in continuing some use of these technologies long-term, even in the absence of pandemic-related social distancing requirements (1)(2)(3). Potential benefits of remote technologies extend beyond adaptation to government social distancing guidelines, allowing the efficiency and flexibility of mental health services to be maximised.…”

Impact of the COVID-19 pandemic on Older Adults Mental Health Services: a mixed methods study

“…There are several similarities between the experiences of staff working in older adult settings and those of staff working across the range of mental health services [15]. Infection control in inpatient settings was seen as a significant concern while remote working was positively received.…”

“…Further, respondents may overly represent those who had strong feelings about the impact of the COVID-19 pandemic and therefore wished to have a platform to voice these. As in the broader survey, non-white mental health staff would appear to be underrepresented [15].…”

“…The NIHR Mental Health Policy Research Unit (MHPRU) developed an online questionnaire to collect cross sectional quantitative and qualitative data from mental health care staff working across settings and sub-specialties. They rapidly disseminated the questionnaire through professional networks, social media and relevant mental health-focused bodies, collecting data between 22 nd April 2020 and 12 May 2020 [15]. More detailed information on questionnaire design and dissemination is reported in the earlier paper [15].…”

“…They rapidly disseminated the questionnaire through professional networks, social media and relevant mental health-focused bodies, collecting data between 22 nd April 2020 and 12 May 2020 [15]. More detailed information on questionnaire design and dissemination is reported in the earlier paper [15].…”