Impact of the COVID-19 pandemic on mental health and service use of people with severe mental illness

Introduction

The COVID-19 pandemic has a huge impact on the provision of mental health care. Particularly the limitations of face-to-face contacts and the access to treatment facilities can be expected to have significant negative effects on the practice of psychiatric treatment and outcomes. To date the extent and the severity of these effects in people with severe mental illnesses are rarely investigated in Germany.

Objectives

We investigated the impact of the COVID-19 pandemic on mental health and service use of people with severe mental illness in Germany.

Methods

As part of a pragmatic randomized trial on the effectiveness of an integrated community mental health care program that started immediately after the first COVID-19 wave in June 2020, 1000 people with severe mental illness from different regions in Germany have been asked for the effects of the COVID-19 pandemic on their mental health care and on their general living conditions. Multivariate regression models were computed to estimate the effects of the patients’ COVID-19 experiences on the outcome parameters empowerment (EPAS), psychosocial impairment (HoNOS) and unmet needs (CAN).

Results

Using prospective data in a large sample of people with mental illness, we will be able to examine the extent to which the pandemic has affected participants’ mental health, their social lives, but also the use of mental health care services.

Conclusions

The data will help to examine the impact of the pandemic on people with severe mental illness in a comprehensive way and will provide evidence where immediate action is needed to reduce further burdens and inequities.

Disclosure

No significant relationships.

A systematic review of influences on implementation of peer support work for adults with mental health problems

PURPOSE

The evidence base for peer support work in mental health is established, yet implementation remains a challenge. The aim of this systematic review was to identify influences which facilitate or are barriers to implementation of mental health peer support work.

METHODS

Data sources comprised online databases (n = 11), journal table of contents (n = 2), conference proceedings (n = 18), peer support websites (n = 2), expert consultation (n = 38) and forward and backward citation tracking. Publications were included if they reported on implementation facilitators or barriers for formal face-to-face peer support work with adults with a mental health problem, and were available in English, French, German, Hebrew, Luganda, Spanish or Swahili. Data were analysed using narrative synthesis. A six-site international survey [Germany (2 sites), India, Israel, Tanzania, Uganda] using a measure based on the strongest influences was conducted. The review protocol was pre-registered (Prospero: CRD42018094838).

RESULTS

The search strategy identified 5813 publications, of which 53 were included. Fourteen implementation influences were identified, notably organisational culture (reported by 53% of papers), training (42%) and role definition (40%). Ratings on a measure using these influences demonstrated preliminary evidence for the convergent and discriminant validity of the identified influences.

CONCLUSION

The identified influences provide a guide to implementation of peer support. For services developing a peer support service, organisational culture including role support (training, role clarity, resourcing and access to a peer network) and staff attitudes need to be considered. The identified influences provide a theory base to prepare research sites for implementing peer support worker interventions.