1
|
Sim CSL, Asharani PV, Subramaniam M, Yi H. Roles and Dynamics within Community Mental Health Systems During the COVID-19 Pandemic: A Qualitative Systematic Review and Meta-Ethnography. Health Syst Reform 2024; 10:2314525. [PMID: 38598726 DOI: 10.1080/23288604.2024.2314525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/01/2024] [Indexed: 04/12/2024] Open
Abstract
Globally, COVID-19 had an immense impact on mental health systems, but research on how community mental health (CMH) systems and services contributed to the pandemic mental health response is limited. We conducted a systematic review and meta-ethnography to understand the roles of CMH services, determinants of the quality of CMH care, and dynamics within CMH systems during COVID-19. We searched and screened across five databases and appraised study quality using the CASP tool, which yielded 27 qualitative studies. Our meta-ethnographic process used Noblit and Hare's approach for synthesizing findings and applying interpretive analysis to original research. This identified several key themes. Firstly, CMH systems played the valuable pandemic role of safety nets and networks for the broader mental health ecosystem, while CMH service providers offered a continuous relationship of trust to service users amidst pandemic disruptions. Secondly, we found that the determinants of quality CMH care during COVID-19 included resourcing and capacity, connections across service providers, customized care options, ease of access, and human connection. Finally, we observed that power dynamics across the CMH landscape disproportionately excluded marginalized groups from mainstream CMH systems and services. Our findings suggest that while the pandemic role of CMH was clear, effectiveness was driven by the efforts of individual service providers to meet demand and service users' needs. To reprise its pandemic role in the future, a concerted effort is needed to make CMH systems a valuable part of countries' disaster mental health response and to invest in quality care, particularly for marginalized groups.
Collapse
Affiliation(s)
- Cheryl Su Ling Sim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - P V Asharani
- Department of Research Division, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Department of Research Division, Institute of Mental Health, Singapore, Singapore
| | - Huso Yi
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
| |
Collapse
|
2
|
Kassam A, Beder M, Sediqzadah S, Levy M, Ritts M, Maher J, Kirwan N, Law S. Impact of COVID-19 on the lives of people with severe mental illness-front-line community psychiatry workers observation from a provincial survey of assertive community treatment teams in Ontario, Canada. Int J Ment Health Syst 2023; 17:18. [PMID: 37328776 DOI: 10.1186/s13033-023-00585-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 05/23/2023] [Indexed: 06/18/2023] Open
Abstract
Using an online survey distributed to members of the provincial organization that represents the 88 Assertive Community Treatment (ACT) and Flexible ACT teams in Ontario, Canada, this descriptive study relied on the unique vantage points and observations of the front-line community psychiatry workers who maintained contact with patients through outreach and telecommunication during the height of COVID-19. The patients who suffer from serious mental illness (SMI) were uniquely affected by COVID-19 due to the changes, reduction or shut down of many essential clinical and community support services. Thematic and quantitative analyses of the workers' observations highlighted 6 main areas of note, including significant social isolation and loneliness, clinical course deterioration and life disruption, increased hospital and ER use, police and legal contacts, and substance abuse and related deaths. There were also encouraging signs of positive adaptations in terms of independence and resilience. Reflections of these impacts and potential ameliorating approaches are further discussed.
Collapse
Affiliation(s)
- Aly Kassam
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Michaela Beder
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Saadia Sediqzadah
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Matthew Levy
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Madeleine Ritts
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - John Maher
- Canadian Mental Health Association, Barrie and Ontario Association of ACT and FACT, Barrie, ON, Canada
| | - Nicole Kirwan
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Samuel Law
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada.
| |
Collapse
|
3
|
Sekharan L, Jagadheesan K, Danivas V, Itrat Q, Lakra V. Community mental health services: Access for acute psychiatric care during the COVID-19 lockdown. J Affect Disord 2022; 311:371-372. [PMID: 35594976 PMCID: PMC9112614 DOI: 10.1016/j.jad.2022.05.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/12/2022] [Indexed: 10/25/2022]
Affiliation(s)
- Lokesh Sekharan
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Karuppiah Jagadheesan
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia; Department of Psychiatry, University of Melbourne, Australia.
| | - Vijay Danivas
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Quratulain Itrat
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Vinay Lakra
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia,Department of Psychiatry, University of Melbourne, Australia
| |
Collapse
|
4
|
Hamiduzzaman M, Siddiquee N, McLaren H, Tareque MI. The COVID-19 risk perceptions, health precautions, and emergency preparedness in older CALD adults in South Australia: A cross-sectional study. Infect Dis Health 2022; 27:149-158. [PMID: 35527217 PMCID: PMC9015960 DOI: 10.1016/j.idh.2022.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/31/2022] [Accepted: 04/05/2022] [Indexed: 11/16/2022]
Abstract
Background In Australia, the relationships of cultural contexts with health challenges in older culturally and linguistically diverse (CALD) adults during the COVID-19 remain under-investigated. This study explored the older CALD adults’ risk perceptions of COVID-19, and identified demographics and risk perceptions associated with their health precautions and emergency preparation in South Australia. Methods A cross-sectional online survey was conducted. 155 older adults aged 60 years and over from 28 CALD communities completed the surveys. We described demographics, risk perceptions, seven items of health precautions, and five items of emergency preparedness. Data were analyzed in Stata/MP version 13.0. Results Mean sum-score of fear was 7.3 [SD 1.9], signifying that the participants were afraid of being infected with COVID-19. Health precaution items presented a mean sum-score of 24.8, with a compliance in washing and disinfecting hands [M: 4.4], avoiding public places and events [M: 3.9] and transports [M: 3.8], but they did not present high-alignment with staying at home and avoiding meeting at risk population groups. Overall health precautions were positively influenced by ethnicity [Asian β 3.40; 95% CI 1.21, 5.59; African β 5.46; 95% CI 0.76, 10.16]; perceptions of long-term effects [β 1.82; 95% CI 0.65, 2.99]; and fear [β 0.55; 95% CI 0.08, 1.01]. Mean sum-score of emergency preparedness was 14.9, which indicated the participants’ responses, on average, did not prevent them from buying large quantities and storing essential goods. Conclusion A pandemic-related response plan is needed to ensure all older CALD adults receive and follow advice and care appropriately.
Collapse
Affiliation(s)
- Mohammad Hamiduzzaman
- The University of Newcastle Department of Rural Health, University of Newcastle, Taree, 2430 Australia; Faculty of Health, Southern Cross University, Gold Coast, NSW, 4225, Australia.
| | - Noore Siddiquee
- College of Business, Government & Law, Flinders University, Adelaide, South Australia, 5042, Australia.
| | - Helen McLaren
- College of Education, Psychology and Social Work, Flinders University, Adelaide, 5042, Australia.
| | - Md Ismail Tareque
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, 6205, Bangladesh.
| |
Collapse
|
5
|
Thomson S, Galletly C, Prener C, Garverich S, Liu D, Lincoln A. Associations between health literacy, cognitive function and general literacy in people with schizophrenia attending community mental health clinics in Australia. BMC Psychiatry 2022; 22:245. [PMID: 35392852 PMCID: PMC8986965 DOI: 10.1186/s12888-022-03901-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/24/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Health literacy (HL) has been defined as the ability of individuals to access, understand, and utilise basic health information. HL is crucial to patient engagement in treatment through supporting patient autonomy, informed consent and collaborative care. In people with physical disorders, poor HL is associated with poor health outcomes, but less is known about HL in people with severe mental illness. This study aimed to assess HL and investigate the associations between education, cognitive function, general literacy, and HL in participants with schizophrenia attending community mental health clinics. METHOD Fifty-two outpatients with schizophrenia attending a public community mental health clinic in Adelaide, Australia completed the Test of Functional Health Literacy in Adults-Short Form (S-TOFHLA) along with tests of cognition, aural and reading literacy and numeracy including Digit Symbol Coding (DSC), verbal fluency, the Wechsler Adult Intelligence Scale (WAIS-IV), Woodcock-Johnson III (Part 4 and 9) and the Lipkus numeracy scale. Sixty-one percent of participants were male. Participants had a mean age of 41.2 (SD 9.9) years and a mean of 11.02 (SD 1.5) years of education. RESULTS The majority of participants had very poor aural and verbal literacy and poorer literacy correlated with fewer years of education. On the S-TOFHLA, 81% of participants had adequate HL; 6% were marginal and 13% were inadequate. There was a positive correlation between education and HL, with those with more years of education scoring higher for HL. There was also a significant association between better HL and better working memory and attention. CONCLUSIONS Consistent with previous research in schizophrenia, our participants had reduced educational attainment, aural and reading literacy and cognitive function compared to population norms. However, HL was better than expected given that previous research has found that people with psychiatric disorders tend to have lower HL, compared to the general population. This may reflect effective case management of our participants whilst attending the community clinics and supports ongoing research and intervention regarding HL in people living with mental illness.
Collapse
Affiliation(s)
- Sumana Thomson
- Northern Adelaide Local Health Network, Adelaide, South, Australia. .,Adelaide Medical School, The University of Adelaide, Adelaide, South, Australia.
| | - Cherrie Galletly
- Northern Adelaide Local Health Network, Adelaide, South Australia ,grid.1010.00000 0004 1936 7304Adelaide Medical School, The University of Adelaide, Adelaide, South Australia ,Ramsay Health Care (SA) Mental Health Services, Adelaide, South Australia
| | - Christopher Prener
- grid.262962.b0000 0004 1936 9342 Department of Sociology and Anthropology, Saint Louis University, St. Louis, MO USA
| | - Suzanne Garverich
- grid.261112.70000 0001 2173 3359Institute for Health Equity and Social Justice Research, Northeastern University, Boston, MA USA
| | - Dennis Liu
- Northern Adelaide Local Health Network, Adelaide, South Australia ,grid.1010.00000 0004 1936 7304Adelaide Medical School, The University of Adelaide, Adelaide, South Australia
| | - Alisa Lincoln
- grid.261112.70000 0001 2173 3359Institute for Health Equity and Social Justice Research, Northeastern University, Boston, MA USA
| |
Collapse
|
6
|
Carvalho HM, Mota CP, Santos B, Costa M, Matos PM. From Chaos to Normalization and Deconfinement: What did the Pandemic Unveil in Youth Residential Care. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2022; 40:1-13. [PMID: 35095182 PMCID: PMC8782691 DOI: 10.1007/s10560-021-00808-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/08/2021] [Indexed: 05/23/2023]
Abstract
The conditions imposed by the Covid-19 outbreaks forced residential care (RC) facilities to experience new challenges and to adopt new practices. The aim of the current study is to analyze how RC facilities have experienced and managed confinement during the 1st wave of the pandemic. A thematic analysis of 20 semi-structured interviews were conducted with professionals responsible for managing crisis in RC facilities. The main implications of the confinement measures on RC dynamics and relations were organized in three major themes: Chaos, novelty and organization; reinventing normalization and deconfinement. The pandemic exposes the structural weaknesses of RC, namely mobility of human resources, scarcity of supportive networks, and fragilities in providing comprehensive and integrative care. These factors need to be considered when addressing risk/vulnerability and discussing best practices and policies on child/youth welfare domain. Future studies should explore representations of important key actors as youth, families and other professionals from youth care.
Collapse
Affiliation(s)
- Helena M. Carvalho
- Centre for Psychology, University of Porto, Porto, Portugal
- Faculty of Psychology and Education Sciences, University of Porto, Alfredo Allen Street, 4200-135 Porto, Portugal
| | - Catarina P. Mota
- Centre for Psychology, University of Porto, Porto, Portugal
- University of Tras-os-Montes and Alto Douro, Vila Real, Portugal
| | - Beatriz Santos
- Faculty of Psychology and Education Sciences, University of Porto, Alfredo Allen Street, 4200-135 Porto, Portugal
| | - Mónica Costa
- Centre for Psychology, University of Porto, Porto, Portugal
| | - Paula M. Matos
- Centre for Psychology, University of Porto, Porto, Portugal
- Faculty of Psychology and Education Sciences, University of Porto, Alfredo Allen Street, 4200-135 Porto, Portugal
| |
Collapse
|
7
|
Calhoun A, Zhong R, Wasser T. Community Reintegration During COVID-19 for Patients in Long-Term Inpatient and Residential Psychiatric Settings. Psychiatr Serv 2021; 72:1354-1357. [PMID: 34074144 DOI: 10.1176/appi.ps.202000787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
COVID-19 has devastated communities worldwide, and individuals with serious mental illness often experience poorer outcomes. The literature on psychiatric hospitals has mostly focused on controlling viral spread, and scant scholarship discusses the transition of patients with serious mental illness from the hospital back to their communities. This column proposes principles for developing safe discharge policies and identifies barriers patients face when infection prevention and recovery goals conflict.
Collapse
Affiliation(s)
- Amanda Calhoun
- Child Study Center (Calhoun) and Department of Psychiatry (Zhong, Wasser), Yale University, New Haven, Connecticut; Southwest Behavioral and Health Services, Kingman, Arizona (Zhong); Connecticut Department of Mental Health and Addiction Services, Middletown, Connecticut (Wasser). Marvin S. Swartz, M.D., and Steven Starks, M.D., are editors of this column
| | - Rocksheng Zhong
- Child Study Center (Calhoun) and Department of Psychiatry (Zhong, Wasser), Yale University, New Haven, Connecticut; Southwest Behavioral and Health Services, Kingman, Arizona (Zhong); Connecticut Department of Mental Health and Addiction Services, Middletown, Connecticut (Wasser). Marvin S. Swartz, M.D., and Steven Starks, M.D., are editors of this column
| | - Tobias Wasser
- Child Study Center (Calhoun) and Department of Psychiatry (Zhong, Wasser), Yale University, New Haven, Connecticut; Southwest Behavioral and Health Services, Kingman, Arizona (Zhong); Connecticut Department of Mental Health and Addiction Services, Middletown, Connecticut (Wasser). Marvin S. Swartz, M.D., and Steven Starks, M.D., are editors of this column
| |
Collapse
|
8
|
Chen Y, Zhang X, Chen S, Zhang Y, Wang Y, Lu Q, Zhao Y. Bibliometric analysis of mental health during the COVID-19 pandemic. Asian J Psychiatr 2021; 65:102846. [PMID: 34562753 PMCID: PMC8435062 DOI: 10.1016/j.ajp.2021.102846] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND As a global pandemic, coronavirus disease 2019 (COVID-19) has had a profound effect on public mental health. METHODS Publications related to mental health during the COVID-19 pandemic from December 1, 2019, to November 13, 2020, were extracted from the Web of Science database. Bibliometric indicator analysis was performed using VOSviewer 1.6.15. RESULTS In total, 1233 documents from 2020 were retrieved, of which 680 were original articles. The United States contributed the largest publication output (285, 23.1%). Huazhong University of Science and Technology published the most articles in this field (35), while Wuhan University received the most citations (1149). The United Kingdom had the strongest collaboration network. Four keyword clusters representing hotspots in this field were identified. CONCLUSIONS In addition to developed countries, countries seriously affected by the COVID-19 pandemic also made significant contributions to mental health research during the COVID-19 pandemic. This study focused on various aspects, such as mental health during isolation, mental health in healthcare workers, and public mental health issues during the COVID-19 pandemic. In the future, countries should strengthen global cooperation and pay more attention to the mental health of vulnerable groups during pandemics.
Collapse
Affiliation(s)
- Ying Chen
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Xiaojun Zhang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Shixiang Chen
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Yanwen Zhang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yulu Wang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Qi Lu
- School of Nursing, Tianjin Medical University, Tianjin, China.
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, Tianjin, China.
| |
Collapse
|
9
|
Further Adaptations and Reflections by an Assertive Community Treatment Team to Serve Clients with Severe Mental Illness During COVID-19. Community Ment Health J 2021; 57:1217-1226. [PMID: 34146189 PMCID: PMC8214380 DOI: 10.1007/s10597-021-00860-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/10/2021] [Indexed: 11/25/2022]
Abstract
In September of 2020, Guan and colleagues wrote about their experience of an Assertive Community Psychiatry Program responding to the COVID-19 pandemic. We describe our own experience as an Assertive Community Treatment team in Minnesota responding to challenges of effectively and safely delivering service to clients. As the pandemic has progressed since last year, so has the literature, and updated references are highlighted. Common threads are woven between our experience, the experience of Guan and colleagues, and others to suggest the beginnings of a template to adapt services to a new post-pandemic world.
Collapse
|
10
|
Mares S, Jenkins K, Lutton S, Newman Am L. Impact of Covid-19 on the mental health needs of asylum seekers in Australia. Australas Psychiatry 2021; 29:417-419. [PMID: 33818174 DOI: 10.1177/10398562211005445] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This paper highlights the significant mental health vulnerabilities of people who have sought asylum in Australia and their additional adversities as a result of the Covid-19 pandemic. CONCLUSIONS Australia's policies in relation to asylum seekers result in multiple human rights violations and add significantly to mental health vulnerabilities. Despite a majority being identified as refugees, people spend years in personal and administrative limbo and are denied resettlement in Australia. Social isolation and other restrictions associated with Covid-19 and recent reductions in welfare and housing support compound their difficulties. The clinical challenges in working with people impacted by these circumstances and the role of psychiatrists and the RANZCP in advocacy are identified.
Collapse
Affiliation(s)
- Sarah Mares
- School of Psychiatry, University of NSW, Annandale, NSW, Australia
| | - Kym Jenkins
- University of Melbourne, Monash University, Royal Australian New Zealand College of Psychiatrists, Melbourne, VIC, Australia; and Migrant and Refugee Health Partnership, Mental Health Australia
| | - Susan Lutton
- Association for Services to Torture and Trauma Survivors, Perth, WA, Australia
| | - Louise Newman Am
- Building Early Attachment and Resilience Research Group, Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
11
|
McKay R, Aquilina C, Wand A. Older Australians are the most vulnerable consumers of community mental health teams during the COVID-19 pandemic. Australas Psychiatry 2021; 29:472. [PMID: 33434045 DOI: 10.1177/1039856220984033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
12
|
Murphy JK, Khan A, Sun Q, Minas H, Hatcher S, Ng CH, Withers M, Greenshaw A, Michalak EE, Chakraborty PA, Sandanasamy KS, Ibrahim N, Ravindran A, Chen J, Nguyen VC, Lam RW. Needs, gaps and opportunities for standard and e-mental health care among at-risk populations in the Asia Pacific in the context of COVID-19: a rapid scoping review. Int J Equity Health 2021; 20:161. [PMID: 34253198 PMCID: PMC8274266 DOI: 10.1186/s12939-021-01484-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/28/2021] [Indexed: 12/23/2022] Open
Abstract
Background The COVID-19 pandemic is expected to have profound mental health impact, including in the Asia Pacific Economic Cooperation (APEC) region. Some populations might be at higher risk of experiencing negative mental health impacts and may encounter increased barriers to accessing mental health care. The pandemic and related restrictions have led to changes in care delivery, including a rapid shift to the use of e-mental health and digital technologies. It is therefore essential to consider needs and opportunities for equitable mental health care delivery to the most at-risk populations. This rapid scoping review: 1) identifies populations in the APEC region that are at higher risk of the negative mental health impacts of COVID-19, 2) identifies needs and gaps in access to standard and e-mental health care among these populations, and 3) explores the potential of e-mental health to address these needs. Methods We conducted a rapid scoping review following the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched Medline, Embase and PsychInfo databases and Google Scholar using a search strategy developed in consultation with a biomedical librarian. We included records related to mental health or psychosocial risk factors and COVID-19 among at-risk groups; that referred to one or more APEC member economies or had a global, thus generalizable, scope; English language papers, and papers with full text available. Results A total of 132 records published between December 2019 and August 2020 were included in the final analysis. Several priority at-risk populations, risk factors, challenges and recommendations for standard and e-mental health care were identified. Results demonstrate that e-mental health care can be a viable option for care delivery but that specific accessibility and acceptability considerations must be considered. Options for in-person, hybrid or “low-tech” care must also remain available. Conclusions The COVID-19 pandemic has highlighted the urgent need for equitable standard and e-mental health care. It has also highlighted the persistent social and structural inequities that contribute to poor mental health. The APEC region is vast and diverse; findings from the region can guide policy and practice in the delivery of equitable mental health care in the region and beyond.
Collapse
Affiliation(s)
- Jill K Murphy
- Department of Psychiatry, Faculty of Medicine; APEC Digital Hub for Mental Health, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada.
| | - Amna Khan
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 2255 Westbrook Mall, Vancouver, BC, V6T 2A1, Canada
| | - Qiumeng Sun
- Sol Price School of Public Policy, University of Southern California, 650 Childs Way, Los Angeles, CA, 90089, USA
| | - Harry Minas
- Global and Cultural Mental Health, Level 4, 207 Bouverie Street, Melbourne, Australia.,The University of Melbourne, Melbourne School of Population and Global Health, Carlton, Victoria, 3010, Australia
| | - Simon Hatcher
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada
| | - Chee H Ng
- Healthscope Chair of Psychiatry, Department of Psychiatry, The University of Melbourne, Carlton, Victoria, 3010, Australia
| | - Mellissa Withers
- USC Keck School of Medicine, USC Institute on Inequalities in Global Health, Los Angeles, USA.,APRU Global Health Program, 2001 N Soto Street SSB 318G, Los Angeles, CA, 90089, USA
| | - Andrew Greenshaw
- Department of Psychiatry, Scientific Director, APEC Digital Hub for Mental Health, Faculty of Medicine & Dentistry, 4-142M Katz Group Centre for Pharmacy and Health Research, University of Alberta, Edmonton, Alberta, T6G 2B7, Canada
| | - Erin E Michalak
- APEC Digital Hub for Mental Health, University of British Columbia, 420-5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Promit Ananyo Chakraborty
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Karen Sharmini Sandanasamy
- Mental Health, Substance Abuse and Violence Injury Prevention, Non-Communicable Disease Section, Disease Control Division, Ministry of Health, Level 2, Block E3, Putrajaya, Malaysia.,Precinct 1, Federal Government Administrative Complex, 62590, Putrajaya, Malaysia
| | - Nurashikin Ibrahim
- Mental Health, Substance Abuse and Violence Injury Prevention, Non-Communicable Disease Section, Disease Control Division, Ministry of Health, Level 2, Block E3, Putrajaya, Malaysia.,Precinct 1, Federal Government Administrative Complex, 62590, Putrajaya, Malaysia
| | - Arun Ravindran
- Global Mental Health Affairs & The Office of Fellowship Training, Department of Psychiatry, Graduate Faculty, Institute of Medical Sciences, University of Toronto, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 100 Stokes St, Toronto, ON, M6J 1H4, Canada
| | - Jun Chen
- Office for Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Xuhui District, Shanghai, China
| | - Vu Cong Nguyen
- Institute of Population, Health and Development, ICON4 Tower, 243a Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, 117222, Vietnam
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, Canada.,Mood Disorders Centre, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada.,APEC Digital Hub for Mental Health, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
| |
Collapse
|
13
|
Stok FM, Bal M, Yerkes MA, de Wit JBF. Social Inequality and Solidarity in Times of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6339. [PMID: 34208121 PMCID: PMC8296166 DOI: 10.3390/ijerph18126339] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 11/25/2022]
Abstract
The enormous public health burdens of the COVID-19 pandemic are not distributed equally. Inequalities are noticeable along socio-economic and socio-cultural fault lines. These social determinants of health affect both the prevalence and severity of COVID-19 infections as well as the magnitude of negative impacts of the measures taken to slow the spread of the virus. This perspective paper summarizes key inequalities in who is affected by SARS-CoV-2 infection and in who is affected by COVID-19 prevention measures, based on evidence presented in state-of-the-art literature, and discusses the scope of challenges that these inequalities pose to solidarity and social justice. Key challenges for solidarity are highlighted across three areas: challenges to intergenerational solidarity, to global solidarity, and to intergroup solidarity.
Collapse
Affiliation(s)
- F. Marijn Stok
- Department of Interdisciplinary Social Science, Utrecht University, 3584 CH Utrecht, The Netherlands; (M.B.); (M.A.Y.); (J.B.F.d.W.)
| | | | | | | |
Collapse
|