The next pandemic: impact of COVID-19 in mental healthcare assistance in a nationwide epidemiological study

Abstract

Background Studies have reported the worsening of psychiatric symptoms during the COVID-19 pandemic. However, few studies have evaluated the impact on the access to mental health services during COVID-19. Our aim was to analyze temporal trends and prediction of appointments held in Brazil's public health system, to compare the observed and expected number of mental healthcare appointments during the COVID-19 pandemics. Methods An ecological time-series study was performed, analyzing mental health appointments before and during the pandemic (from 2016 and 2020) from the Brazilian governmental database. The structural break in the data series was assessed using the Chow test, with the break considered in March 2020. Bayesian structural time-series models were used to estimate current average appointments and the predicted expectation if there was no pandemic. Findings Compared to the expected, between March and August 2020 about 28% less outpatient appointments in mental health were observed, totaling 471,448 individuals with suspended assistance. Group appointments and psychiatric hospitalizations were also severely impacted by the pandemic (decreased of 68% and 33%, respectively). On the other hand, mental health emergency consultations and home care increased during this period (36% and 52%, respectively). Interpretation Our findings demonstrate a dramatic change in mental health assistance during the COVID-19 pandemic, which corroborates a recent WHO survey. This phenomenon can aggravate the mental health crisis and generate a parallel pandemic that may last for a longer time than the COVID-19 pandemic. Funding This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.

Trends in non-COVID-19 hospitalizations prior to and during the COVID-19 pandemic period, United States, 2017 – 2021

“…eating and sleep disorders); however, researchers at a children's hospital did describe an increase in restrictive eating disorders during the first year of the pandemic [29]. Contrary to our results, psychiatric hospitalizations in Brazil decreased between March and August 2020 by 33%, demonstrating the complex relationship between physiological disturbances, schizophrenia, and behavioral syndromes incidence and hospitalization incidence [30]. Interestingly, schizophrenia is noted as a risk factor for COVID-19 mortality, but our study was limited by its inability to explore mortality information [31].…”

The Moderating Effect of Resilience on Mental Health Deterioration among COVID-19 Survivors in a Mexican Sample

“…Given the experience gained from the pandemic outbreaks of Severe Acute Respiratory Syndrome (SARS) [ 2 ] and Middle East Respiratory Syndrome (MERS) [ 3 ], clearly showing that the mental health sequelae in survivors can be catastrophic and long-lasting, it is necessary to study the mental health of patients that have recovered from SARS-CoV-2 infection in order to plan, in advance, how to manage and mitigate the psychological consequences of the disease through timely interventions. In this respect, several experts have reported the possibility of a subsequent pandemic of mental disorders flowing from COVID-19 [ 4 , 5 ].…”

Demandas Em Saúde Mental: Comparação De Registros Antes E Durante a Pandemia De Covid-19

“…O estudo de Ornell e col aboradores 25 , que avaliou a repercussão da pandemia de cov id-19 no total de consultas em saúde mental no Brasil, demonstrou um declínio no número de registros em saúde mental, de modo semelhante ao que foi descr ito nas macror regiões de saúde maranhenses no ano de 2020 (Tabel a 1). A implementação do isol amento soc ial, em uma perspec t iva de retardar a propagação do v írus, desencadeou inúmeras consequênc ias econômicas e soc iais, além da cr iação de bar reiras para o acesso aos cuidados de saúde mental, levando a uma diminuição na procura por assistênc ia, muitas vezes necessár ia 26 .…”