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

Abstract

Background Deterioration in general population mental health since the start of the COVID-19 pandemic has been reported, but the impact of the pandemic on people with severe mental illness (SMI) has received less attention. Aims To understand the impact of the early stages of the pandemic on the patients with SMI, in terms of provision of mental health care and patient outcomes. Method We examined records of 34,446 patients with SMI in Oxford Health Foundation Trust between March 2016 and July 2020. We used interrupted time-series analysis to estimate the immediate and subsequent changes in weekly rates of the use of community mental health services, hospitalization, and patient outcomes (as measured by Health of the Nation Outcome Scales, or HoNOS, scores) during the weeks of lockdown between March 23, 2020 and July 3, 2020. Results Mean total HoNOS scores for all patients deteriorated in the weeks subsequent to lockdown (0.060 per week; 95%CI: 0.033, 0.087). Scores for patients with a history of psychosis deteriorated immediately (0.63; 95% CI: 0.26, 1.0). There was an immediate decrease in weekly referrals to community and outpatient services (−196; 95%CI: −300, −91) and no immediate change in weekly inpatient admissions (−4.2; 95%CI: −9.9, 1.5) or weekly total contacts (−26; 95%CI: −475, 423). Conclusions Patients with SMI were negatively impacted during the early stages of the COVID-19 pandemic. Patients with a history of psychosis experienced distinct and immediate impacts. During the same period, referrals to community and outpatient services fell with no consequent impact on inpatient admissions.

Provision of community mental health care before and during the COVID-19 pandemic: A time series analysis in Peru

“…One study in South Africa found that the levels of hospital admissions and outpatient consultations were reduced from the COVID-19 blocking measures, and during the pandemic there was a gradual recovery process in the number of hospital admissions (Wettstein et al, 2022). In other study performed in South-East England, the trend was similar to the previous study, outpatient and community care in mental health services decreased since the application of COVID-19 confinement, followed by a gradual recovery of care (Penington et al, 2022).…”

The anxiety response of patients with severe psychiatric disorders to the recent public health crisis

“…However, due to the spread of epidemics and pandemics in the past years, infectious diseases have also been addressed as one of the vulnerabilities in these patients [ 9 ]. Six large-scale studies from Sweden ( N = 195,565), Denmark ( N = 144,321), Israel ( N = 125,273), the UK ( N = 447,296), England ( N = 34,446), and the US ( N = 7,348) showed an increased risk of the COVID-19 infection, hospitalization, and mortality for patients with SPDs, with no increased risk for other psychiatric disorders such as anxiety disorders [ 3 , 9 , 11 – 14 ]. A South Korean cohort study found that patients with SPDs had a slightly higher risk for severe clinical outcomes of COVID-19 than patients without psychiatric disorders [ 15 ].…”

Erfassung direkter (COVID-19-bezogener) und kollateraler, psychosozialer Folgen für vulnerable Gruppen am Beispiel schwerer psychischer Erkrankungen

“…Darüber hinaus sind psychosoziale Stressoren während der Pandemie bislang nicht systematisiert worden. Psychosoziale Vulnerabilität und Stressoren zu definieren, zu systematisieren und zu operationalisieren wären wichtige Voraussetzungen, um neben den Risiken direkter Gesundheitsfolgen durch COVID- 19…”

“…Hierbei hatten diese im Mittel im Vergleich zu gesunden Kontrollstichproben während der Pandemie deutlich erhöhte Angst-, Depressions-und Stresswerte.Dabei fiel jedoch die Belastung für Menschen mit schweren depressiven Erkrankungen gravierender aus als für Personen mit einer Schizophrenie. Zudem wurde aufgezeigt, dass ein jüngeres Alter mit gravierenderen Symptomen assoziiert war[19]. Eine neuere, Zeitreihen-basierte Studie wertete Routinedaten des Oxford Health Foundation Trusts von insgesamt 34.446 Patient*innen mit SMI aus.…”