Access to Mental Health Care during the First Wave of the COVID-19 Pandemic in Italy: Results from the COMET Multicentric Study.

Giulia Menculini,Gabriele Sani,Claudia Carmassi,Francesca Cirulli,Maurizio Pompili,Maria Giulia Nanni,Umberto Volpe,Mario Luciano,Bernardo Dell’Osso,Giuseppe Carrà,Umberto Albert,Gaia Sampogna,Alfonso Tortorella,Andrea Fiorillo

doi:10.3390/brainsci11111413

Abstract

The COVID-19 pandemic represents an unprecedented public health emergency, with consequences at the political, social, and economic levels. Mental health services have been called to play a key role in facing the impact of the pandemic on the mental health of the general population. In the period March–May 2020, an online survey was implemented as part of the Covid Mental Health Trial (COMET), a multicentric collaborative study carried out in Italy, one of the Western countries most severely hit by the pandemic. The present study aims to investigate the use of mental health resources during the first wave of the pandemic. The final sample consisted of 20,712 participants, mainly females (N = 14,712, 71%) with a mean age of 40.4 ± 14.3 years. Access to mental health services was reported in 7.7% of cases. Among those referred to mental health services, in 93.9% of cases (N = 1503 subjects) a psychological assessment was requested and in 15.7% of cases (N = 252) a psychiatric consultation. People reporting higher levels of perceived loneliness (OR 1.079, 95% CI 1.056–1.101, p < 0.001), practicing smart-working (OR 1.122, 95% CI 0.980–1.285, p = 0.095), using avoidant (OR 1.586, 95% CI 1.458–1.725, p < 0.001) and approach (OR 1.215, 95% CI 1.138–1.299, p < 0.001) coping strategies more frequently accessed mental health services. On the other hand, having higher levels of perceived social support (OR 0.833, 95% CI 0.795–0.873, p < 0.001) was associated with a reduced probability to access mental health services. The COVID-19 pandemic represents a new threat to the mental health and well-being of the general population, therefore specific strategies should be implemented to promote access to mental healthcare during the pandemic and afterwards.

Highlights

The COVID-19 pandemic represents an unprecedented public health emergency, with consequences at the political, social, and economic levels [1]
Since they did not answer the specific questions on the use of mental health services
Variables that showed a significant positive association with the use of mental health services during the pandemic were the UCLA total score, the COPE avoidant

Summary

Introduction

The COVID-19 pandemic represents an unprecedented public health emergency, with consequences at the political, social, and economic levels [1]. The effects of the COVID19 pandemic on mental health include the rise of anxiety and depressive symptoms, somatic complaints [6,15,16], disruption of circadian rhythms, with frequent sleep disorders [17], phobias, cognitive deficits, and traumatic experiences. In this scenario, mental health services have been called to play a key role in order to support people with mental disorders, and “new users” from the general population exposed to the impact of the pandemic [4,18,19]. Remote psychiatric consultations and online psychotherapies have been rapidly implemented, which have been found to be effective [24,25,26]; the use of web-based interventions poses major challenges due to disparities in internet access, abilities in using technology, and privacy concerns [21,27,28,29]

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