Negative impacts of COVID-19 lockdown on mental health service access and follow-up adherence for immigrants and individuals in socio-economic difficulties

Abstract

Objectives Lockdown measures in response to the coronavirus disease 2019 (COVID-19) pandemic can have serious mental health effects on the population, especially in vulnerable groups, such as those living in poor socio-economic conditions, those who are homeless, migrant workers and asylum seekers/refugees. In addition, these vulnerable groups frequently have greater difficulty accessing health services and in treatment adherence. The aim of this study is to estimate the impact of the COVID-19–related lockdown on service utilisation and follow-up adherence in an Italian mental health outpatient service for migrants and individuals in socio-economic difficulties. Study design The design of this study is a retrospective cross-sectional study. Methods All patients who visited the mental health outpatient service in the months of February and March in the years 2017–2020 were included in the study. To compare service utilisation before and after the lockdown, the number of patients who visited the mental health outpatient service for psychiatric interview were recorded. Follow-up adherence was calculated as the percentage of patients who visited in February and subsequently attended a follow-up visit in March of the same year. Results The number of patients who visited the outpatient service between February 2017 and February 2020 was continuously increasing. In March 2020, fewer patients visited the service for psychiatric interview, in line with the introduction of lockdown measures. In addition, the number of the patients who visited in February 2020 and returned for their follow-up visits in March 2020 declined from approximately 30% over the same months in 2017–2019 to 17.53% in March 2020. Conclusions The lockdown-related reduction in numbers of patients accessing the mental health service makes it difficult to help vulnerable populations during a period of time in which their mental health needs are expected to increase. Moreover, the reduction seen in follow-up compliance increases the risk of treatment discontinuation and possible relapse. Proactive alternative strategies need to be developed to reach these vulnerable populations.

Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review

“…For example, somatic symptoms in youth may be related to their new social reality due to COVID-19, which possibly introduced new challenges to young people in addition to the developmental challenges of their age. Furthermore, this new situation with the imposed social and physical restrictions may have also introduced additional barriers to accessing informal and formal help-seeking for mental health problems in youths, similarly to adults [ 53 , 54 ]. In addition, young people may now have restricted exposure to elements that operate as protective agents against mental health difficulties.…”

Digital Interventions to Support Population Mental Health in Canada During the COVID-19 Pandemic: Rapid Review

“…Stressors created by enforced social distancing and isolation measures have applied further pressure on an already overburdened, strained, and limited Canadian mental health care system [10]. Despite the recognizable need for increased mental health supports, available mental health services are not adequate to support this increased volume of need through conventional services such as face-to-face care [15,16]. In addition, due to constraints posed by COVID-19, it is no longer feasible or appropriate to provide in-person mental health care services under many circumstances [15,16].…”

“…Despite the recognizable need for increased mental health supports, available mental health services are not adequate to support this increased volume of need through conventional services such as face-to-face care [15,16]. In addition, due to constraints posed by COVID-19, it is no longer feasible or appropriate to provide in-person mental health care services under many circumstances [15,16]. Where face-to-face interventions are offered, these currently address acute and severe decompensation of mental health.…”

COVID-19 Pandemic Outbreak: An Analysis of the Healthcare, Socio-Economic Challenges in Pakistan

“…One more issue in keeping social distancing in religious rituals, which people often recur in difficult lives. People tend to participate in religious gatherings because religion gives people courage and an intellect of public consonance (Aragona et al, 2020). After lockdown, we observed two serious openings.…”

“…The condition is more complex when individuals move in crowded transportation during vacations and carnivals. Due to lack of access to appropriate information and public awareness, social distancing may also become a problem (Aragona et al, 2020). One more issue in keeping social distancing in religious rituals, which people often recur in difficult lives.…”