Abstract
PurposeThe COVID-19 pandemic has potential to disrupt and burden the mental health care system, and to magnify inequalities experienced by mental health service users.MethodsWe investigated staff reports regarding the impact of the COVID-19 pandemic in its early weeks on mental health care and mental health service users in the UK using a mixed methods online survey. Recruitment channels included professional associations and networks, charities, and social media. Quantitative findings were reported with descriptive statistics, and content analysis conducted for qualitative data.Results2,180 staff from a range of sectors, professions, and specialties participated. Immediate infection control concerns were highly salient for inpatient staff, new ways of working for community staff. Multiple rapid adaptations and innovations in response to the crisis were described, especially remote working. This was cautiously welcomed but found successful in only some clinical situations. Staff had specific concerns about many groups of service users, including people whose conditions are exacerbated by pandemic anxieties and social disruptions; people experiencing loneliness, domestic abuse and family conflict; those unable to understand and follow social distancing requirements; and those who cannot engage with remote care.ConclusionThis overview of staff concerns and experiences in the early COVID-19 pandemic suggests directions for further research and service development: we suggest that how to combine infection control and a therapeutic environment in hospital, and how to achieve effective and targeted tele-health implementation in the community, should be priorities. The limitations of our convenience sample must be noted.
Highlights
The WHO announced that COVID-19 infection was a pandemic on 11th March 2020
A branching structure was adopted, with initial questions asking all participants to rate the relevance of each item on lists of: In the absence of a measure of pandemic impact on mental health care and mental health service users, we rapidly developed an online questionnaire to collect cross-sectional
While many commentators have predicted a significant and widespread impact of COVID-19, we are able to provide a more detailed report that is rooted in direct experience of the effects of the pandemic on mental health care, albeit only in one country and only from the perspective of practitioners
Summary
The WHO announced that COVID-19 infection was a pandemic on 11th March 2020. Countries were advised to implement measures including social distancing, closure of schools and universities, home working, and avoidance of travel. Beyond the immediate changes to services seen in the early stages of the pandemic, there are many potential challenges that are specific to mental health care. These include difficulties in implementing infection control and social distancing guidance in settings where people may be very distressed or cognitively impaired [4], especially in mental health wards and the supported accommodation settings where many people with complex mental health problems live [5]. Our aim was to inform further research and service responses by conducting, in the early stages of the COVID19 pandemic, a survey of the perspectives and experiences of staff working in inpatient and community settings across the UK health and social care sectors
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