LeiP#netz 2.0: mapping COVID-19-related changes in mental health services in the German city of Leipzig

[COVID-19 Pandemic-Related Effects on Psychiatric and Psychosocial Care in Urban and Rural Areas - Two Studies Implementing the Questionnaire PandA-Psy]

OBJECTIVE

To assess COVID-19 pandemic-related changes in psychiatric and psychosocial services and their impact on the care of people with severe mental illness in two contrasting regions.

METHODS

Development and use of an online questionnaire (PandA-Psy) in Leipzig (N=50) and Mecklenburg-Western Pomerania (N=126).

RESULTS

In community psychiatric care, mostly comparable changes caused by the COVID-19 pandemic were observed in the two selected regions. These mainly concern the decrease in face-to-face contacts and group services, the increase in digital and telephone services, as well as the increasing constraints of staff. Differences between the regions are discussed.

CONCLUSION

PandA-Psy was successfully used to map changes caused by the COVID-19 pandemic in psychiatric and psychosocial services in two areas. In addition to the predominantly negative consequences of the pandemic situation, we also found opportunities arising from the crisis.

["Psychiatry on Tour": what Remains, what Must Change - Now?]

Spätestens seit der Corona-Pandemie hat das Thema Krise in der Versorgungslandschaft in Deutschland, so auch in der Psychiatrie, Konjunktur. Und wir erkennen, an welchen Stellen die Psychiatrie eher robust oder eher „anfällig“ aufgestellt war – und heute noch ist.

Governance in mental healthcare policies during the COVID-19 pandemic in Mexico

The COVID-19 pandemic has become the greatest burden of disease worldwide and in Mexico, affecting more vulnerable groups in society, such as people with mental disorders (MD). This research aims to analyze the governance processes in the formulation of healthcare policies for people with MD in the face of the COVID-19 pandemic. An analytical qualitative study, based on semi-structured interviews with key informants in the healthcare system was conducted in 2020. The study followed the theoretical-methodological principles of the Governance Analytical Framework (GAF). The software ATLAS.ti-V.9 was used for inductive thematic analysis, classifying themes and their categories. To ensure the proper interpretation of the data, a process of triangulation among the researchers was carried out. The findings revealed that in Mexico, the federal Secretary of Health issued guidelines for mental healthcare, but there is no defined national policy. Decision-making involved multiple actors, with different strategies and scopes, depending on the type of key-actor and their level of influence. Majority of informants described a problem of implementation in which infection control policies in the psychiatric population were the same as in the general populations which decreased the percentage of access to healthcare during the pandemic, without specific measures to address this vulnerable population. The results suggest that there is a lack of specific policies and measures to address the needs of people with mental disorders during the COVID-19 pandemic in Mexico. It also highlights the importance of considering the role of different actors and their level of influence in the decision-making process.

Psychiatrisch-psychotherapeutische Versorgung in der Krise: Ergebnisse des Pilotprojekts LeiP#netz

Ziel der StudieAnalyse von psychiatrisch-psychotherapeutischen Krisenangeboten im Leipziger Psychiatrie Netzwerk (LeiP#netz), unter Zuordnung der Angebote zum Funktionalen Basismodell (FBM) nach Steinhart und Wienberg.

MethodikEine standardisierte Erhebung zur Krisenversorgung (GEMPSY) erfolgte anhand der Funktionen „komplexe ambulante Behandlung“, „Zugang zu Akutpsychotherapie in der Krise“, und „24 h komplexe, intensive Behandlung“ mittels einrichtungsbezogener und funktionsspezifischer Instrumente.

ErgebnisseInsgesamt 31 Maßnahmen wurden für die drei Funktionen erfasst. Alle Angebote wurden in hohem Maße ausgelastet; in 12,50–30,00% der Fälle konnten keine Krisenangebote vorgehalten werden. Angebote ohne Voranmeldung und in einem 24/7-Zeitfenster sind in sehr geringem Umfang verfügbar.

SchlussfolgerungAngebote zur Krisenversorgung schwer psychisch erkrankter Menschen sind in der Studienregion in verschiedenen Konstellationen verfügbar. Insbesondere niedrigschwellige 24/7-Krisenangebote müssen ausgebaut werden.

Global impact of the COVID-19 pandemic on mental health services: A systematic review

The purpose of the review was to investigate the changes in mental health services during the COVID-19 pandemic. A systematic review of qualitative, quantitative and mixed-methods studies was conducted from February 2021 to March 2022 using four databases and five languages. 29 studies reporting on mental health services in 63 countries were included. Findings were organised according to nine major topics: (1) lack of preparedness vs. timely response and flexible solutions, (2) changes in access, referrals, and admission, (3) impacts on outpatient, community and psychosocial services, (4) inpatient: reorganisation of hospital psychiatric units/acute wards, (5) diagnostic and therapeutic adaptations, (6) effects on medication, (7) infection control measures, (8), changes in patients' demands, engagement, and mental health, and (9) impacts on staff and team. Many services were closed intermittently or considerably reduced while telepsychiatric services were extensively expanded. Face-to-face services decreased, as did the work with therapeutic groups. Many inpatient units restructured their services to accommodate COVID-19 patients. While the digitalisation of services allowed for better access to services for some, restrictive measures hindered access for most. Staff experienced changes such as heightened impacts on their own mental health, burdens on patients and the pausing of professional training. Clearly, diverse findings of studies relate to different (national) contexts, type of service offered, but also to the time of the investigation, as studies noted several distinct phases of change during the pandemic. This review suggests directions for policy and service development, such as fostering community services and providing support services for particularly vulnerable populations.