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Early impacts of the COVID-19 pandemic on mental health care and on people with mental health conditions: framework synthesis of international experiences and responses

  • Sheridan Rains, Luke1
  • Johnson, Sonia1, 2
  • Barnett, Phoebe1
  • Steare, Thomas1
  • Needle, Justin J.3
  • Carr, Sarah4, 1
  • Lever Taylor, Billie1
  • Bentivegna, Francesca1
  • Edbrooke-Childs, Julian5
  • Scott, Hannah Rachel1
  • Rees, Jessica1
  • Shah, Prisha1
  • Lomani, Jo1, 6
  • Chipp, Beverley1
  • Barber, Nick1
  • Dedat, Zainab1
  • Oram, Sian7
  • Morant, Nicola1
  • Simpson, Alan7, 8
  • Papamichail, Alexia
  • And 47 more
  • 1 University College London,
  • 2 Camden and Islington NHS Foundation Trust,
  • 3 City, University of London,
  • 4 University of Birmingham,
  • 5 University College London and Anna Freud National Centre for Children and Families,
  • 6 St George’s, University of London,
  • 7 King’s College London,
  • 8 Department of Mental Health Nursing, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, London, UK
Published Article
Social Psychiatry and Psychiatric Epidemiology
Springer Berlin Heidelberg
Publication Date
Aug 17, 2020
DOI: 10.1007/s00127-020-01924-7
PMID: 32804258
PMCID: PMC7429938
PubMed Central


Purpose The COVID-19 pandemic has many potential impacts on people with mental health conditions and on mental health care, including direct consequences of infection, effects of infection control measures and subsequent societal changes. We aimed to map early impacts of the pandemic on people with pre-existing mental health conditions and services they use, and to identify individual and service-level strategies adopted to manage these. Methods We searched for relevant material in the public domain published before 30 April 2020, including papers in scientific and professional journals, published first person accounts, media articles, and publications by governments, charities and professional associations. Search languages were English, French, German, Italian, Spanish, and Mandarin Chinese. Relevant content was retrieved and summarised via a rapid qualitative framework synthesis approach. Results We found 872 eligible sources from 28 countries. Most documented observations and experiences rather than reporting research data. We found many reports of deteriorations in symptoms, and of impacts of loneliness and social isolation and of lack of access to services and resources, but sometimes also of resilience, effective self-management and peer support. Immediate service challenges related to controlling infection, especially in inpatient and residential settings, and establishing remote working, especially in the community. We summarise reports of swiftly implemented adaptations and innovations, but also of pressing ethical challenges and concerns for the future. Conclusion Our analysis captures the range of stakeholder perspectives and experiences publicly reported in the early stages of the COVID-19 pandemic in several countries. We identify potential foci for service planning and research. Electronic supplementary material The online version of this article (10.1007/s00127-020-01924-7) contains supplementary material, which is available to authorized users.

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