How mental health care should change as a consequence of the COVID-19 pandemic
Carmen Moreno
(1, 2)
,
Til Wykes
(3, 4)
,
Silvana Galderisi
(5)
,
Merete Nordentoft
(6)
,
Nicolas Crossley
(7)
,
Nev Jones
(8)
,
Mary Cannon
(9)
,
Christoph U Correll
(10, 11, 12)
,
Louise Byrne
(13)
,
Sarah Carr
(14)
,
Eric y H Chen
(15)
,
Philip Gorwood
(16, 17)
,
Sonia Johnson
(18)
,
Hilkka Kärkkäinen
(19)
,
John H Krystal
(20)
,
Jimmy Lee
(21, 22)
,
Jeffrey Lieberman
(23)
,
Carlos López-Jaramillo
(24)
,
Miia Männikkö
(25)
,
Michael R Phillips
(26)
,
Hiroyuki Uchida
(27)
,
Eduard Vieta
(28, 2)
,
Antonio Vita
(29, 30)
,
Celso Arango
(1, 2)
1
Hospital General Universitario "Gregorio Marañón" [Madrid]
2 CIBER-SAM - Centro de Investigación Biomédica en Red Salud Mental [Madrid]
3 King‘s College London
4 South London and Maudsley NHS Foundation Trust
5 University of Campania "Luigi Vanvitelli"
6 UCPH - University of Copenhagen = Københavns Universitet
7 UC - Pontificia Universidad Católica de Chile
8 USF - University of South Florida [Tampa]
9 RCSI - Royal College of Surgeons in Ireland
10 The Zucker Hillside Hospital
11 Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
12 Charité - UniversitätsMedizin = Berlin University Medicine
13 RMIT University - Royal Melbourne Institute of Technology University
14 University of Birmingham [Birmingham]
15 HKU - The University of Hong Kong
16 IPNP - U1266 Inserm - Institut de psychiatrie et neurosciences de Paris
17 CMME - Service de psychiatrie - Clinique des maladies mentales et de l'encéphale
18 UCL - University College of London [London]
19 Global Alliance of Mental Illness Advocacy Networks-Europe [Brussels]
20 Yale New Haven Hospital
21 Institute of Mental Health [Singapore]
22 NTU - Nanyang Technological University [Singapour]
23 Columbia University [New York]
24 Universidad de Antioquia = University of Antioquia [Medellín, Colombia]
25 EUFAMI [Leuven]
26 Shanghai Jiao Tong University School of Medicine
27 Keio University School of Medicine [Tokyo, Japan]
28 University of Barcelona
29 UniBs - Università degli Studi di Brescia = University of Brescia
30 Spedali Civili Hospital [Brescia]
2 CIBER-SAM - Centro de Investigación Biomédica en Red Salud Mental [Madrid]
3 King‘s College London
4 South London and Maudsley NHS Foundation Trust
5 University of Campania "Luigi Vanvitelli"
6 UCPH - University of Copenhagen = Københavns Universitet
7 UC - Pontificia Universidad Católica de Chile
8 USF - University of South Florida [Tampa]
9 RCSI - Royal College of Surgeons in Ireland
10 The Zucker Hillside Hospital
11 Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
12 Charité - UniversitätsMedizin = Berlin University Medicine
13 RMIT University - Royal Melbourne Institute of Technology University
14 University of Birmingham [Birmingham]
15 HKU - The University of Hong Kong
16 IPNP - U1266 Inserm - Institut de psychiatrie et neurosciences de Paris
17 CMME - Service de psychiatrie - Clinique des maladies mentales et de l'encéphale
18 UCL - University College of London [London]
19 Global Alliance of Mental Illness Advocacy Networks-Europe [Brussels]
20 Yale New Haven Hospital
21 Institute of Mental Health [Singapore]
22 NTU - Nanyang Technological University [Singapour]
23 Columbia University [New York]
24 Universidad de Antioquia = University of Antioquia [Medellín, Colombia]
25 EUFAMI [Leuven]
26 Shanghai Jiao Tong University School of Medicine
27 Keio University School of Medicine [Tokyo, Japan]
28 University of Barcelona
29 UniBs - Università degli Studi di Brescia = University of Brescia
30 Spedali Civili Hospital [Brescia]
Résumé
The unpredictability and uncertainty of the COVID-19 pandemic; the associated lockdowns, physical distancing, and other containment strategies; and the resulting economic breakdown could increase the risk of mental health problems and exacerbate health inequalities. Preliminary findings suggest adverse mental health effects in previously healthy people and especially in people with pre-existing mental health disorders. Despite the heterogeneity of worldwide health systems, efforts have been made to adapt the delivery of mental health care to the demands of COVID-19. Mental health concerns have been addressed via the public mental health response and by adapting mental health services, mostly focusing on infection control, modifying access to diagnosis and treatment, ensuring continuity of care for mental health service users, and paying attention to new cases of mental ill health and populations at high risk of mental health problems. Sustainable adaptations of delivery systems for mental health care should be developed by experts, clinicians, and service users, and should be specifically designed to mitigate disparities in health-care provision. Thorough and continuous assessment of health and service-use outcomes in mental health clinical practice will be crucial for defining which practices should be further developed and which discontinued. For this Position Paper, an international group of clinicians, mental health experts, and users of mental health services has come together to reflect on the challenges for mental health that COVID-19 poses. The interconnectedness of the world made society vulnerable to this infection, but it also provides the infrastructure to address previous system failings by disseminating good practices that can result in sustained, efficient, and equitable delivery of mental health-care delivery. Thus, the COVID-19 pandemic could be an opportunity to improve mental health services.