The DOI matches its Crossref record; 24 of the 27 references it cites were found in a registry or an index; none of the 7 sources its claims cite is checked for support yet.
The early impact of COVID-19 on mental health and community physical health services and their patients' mortality in Cambridgeshire and Peterborough, UK.
Open accessAbstract
Background COVID-19 has affected social interaction and healthcare worldwide.Methods We examined changes in presentations and referrals to the primary provider of mental health and community health services in Cambridgeshire and Peterborough, UK (population ~0·86 million), plus service activity and deaths. We conducted interrupted time series analyses with respect to the time of UK "lockdown", which was shortly before the peak of COVID-19 infections in this area. We examined changes in standardized mortality ratio for those with and without severe mental illness (SMI).Results Referrals and presentations to nearly all mental and physical health services dropped at lockdown, with evidence for changes in both supply (service provision) and demand (help-seeking). This was followed by an increase in demand for some services. This pattern was seen for all major forms of presentation to liaison psychiatry services, except for eating disorders, for which there was no evidence of change. Inpatient numbers fell, but new detentions under the Mental Health Act were unchanged. Many services shifted from face-to-face to remote contacts. Excess mortality was primarily in the over-70s. There was a much greater increase in mortality for patients with SMI, which was not explained by ethnicity.Conclusions COVID-19 has been associated with a system-wide drop in the use of mental health services, with some subsequent return in activity. "Supply" changes may have reduced access to mental health services for some. "Demand" changes may reflect a genuine reduction of need or a lack of help-seeking with pent-up demand. There has been a disproportionate increase in death among those with SMI during the pandemic.
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“to our knowledge, no previous observational study has reported the impact of the pandemic on clinical mental health services”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Introduction
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“The excess of deaths in 2020 was predominantly in the over-70s (Fig. 5B).”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > RESULTS > Deaths
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“Inpatient numbers fell”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Abstract > Results
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“which was not explained by ethnicity”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Abstract > Results
plain- Asserted: passes — The authors put it forward as true.
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- Rests on an assumption: Lifetime coded ICD-10 diagnoses adequately identify severe mental illness despite possible under-coding.
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“for example, referrals to crisis teams did not change for those with SMI”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > RESULTS > Presentations and referrals to MH services
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- Rests on an assumption: Lifetime coded ICD-10 diagnoses adequately identify severe mental illness despite possible under-coding.
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“There was no evidence for a change in the use of the MHA, either within the MH service or by police”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > RESULTS > Mental Health Act
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“Inter-ward transfers were reduced effectively”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > RESULTS > MH inpatient activity
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“apart from EIP services (for which there was no significant change)”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > RESULTS > Presentations and referrals to MH services
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“Likewise, no previous study has provided direct evidence of the impact of COVID-19 on mortality for those with severe mental illness (SMI;”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Introduction
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“Many services shifted from face-to-face to remote contacts.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Abstract > Results
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“Attendance at the MIU that remained open dropped dramatically at lockdown and increased slightly thereafter, despite the closure of two other MIUs”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > RESULTS > PH presentations, referrals, and contacts
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“There was a substantial reduction in LP referrals from the ED followed by a slow increase”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > RESULTS > Presentations and referrals to MH services
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“There was a much greater increase in mortality for patients with SMI”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Abstract > Results
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- Rests on an assumption: Lifetime coded ICD-10 diagnoses adequately identify severe mental illness despite possible under-coding.
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In the paper
“COVID-19 has been associated with a system-wide drop in the use of mental health services, with some subsequent return in activity.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Abstract > Conclusions
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“Both detained and voluntary inpatient numbers dropped sharply at lockdown”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > RESULTS > MH inpatient activity
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“All types of presentation dropped at lockdown and then increased towards normal levels, except presentation with psychosis/mood elevation (small sustained reduction) or eating disorders (no significant change)”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > RESULTS > Presenting MH problems
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“Face-to-face contacts fell across age groups, with an increase in non-face-to-face contacts”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > RESULTS > PH presentations, referrals, and contacts
plaincorrelational- Asserted: passes — The authors put it forward as true.
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“The same patterns were seen for patients with and without SMI, except that the admission rate did not drop significantly for those with SMI”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > RESULTS > MH inpatient activity
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Rests on an assumption: Lifetime coded ICD-10 diagnoses adequately identify severe mental illness despite possible under-coding.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“a small immediate drop in triage assessments by that service (p < 0·05) with no significant change thereafter”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > RESULTS > Presentations and referrals to MH services
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In the paper
“This pattern was seen for all major forms of presentation to liaison psychiatry services, except for eating disorders, for which there was no evidence of change.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Abstract > Results
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“LP referrals from wards dropped sharply then gradually increased back to normal”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > RESULTS > Presentations and referrals to MH services
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“These changes were substantial and sustained.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > RESULTS > MH contacts and documentation
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“None of these effects were observed.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Mental health presentations
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In the paper
“There was no evidence that suppression of demand in some services led to “redistribution” to any other service, with no increase in demand for MH emergency services (111, crisis teams, ED), even for services permitting self-referral and remote consultation (111).”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Summary
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In the paper
“The reduction in presentations to the open MIU was abrupt and dramatic, and occurred despite the closure of two others in the area.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Physical health presentations
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In the paper
“We show a reduction in demand as well as supply during the early phase of the pandemic for MH and community PH services covering a population of ~0·86 million.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Conclusions
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In the paper
“which has a population of ~0·86 million (Office for National Statistics, 2020a)”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > METHODS > Service overview
What the sources say
- Not checked yetcites Office for National Statistics, 2020a
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In the paper
“Service reorganization may therefore have contributed.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > RESULTS > Presentations and referrals to MH services
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In the paper
“We truncated the last 7 days of SystmOne death data, to allow for delays in death reporting to the NHS Spine (lag estimated), and 14 days of RiO death data, to allow for additional delays in Spine-to-RiO updates.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > METHODS > Dates
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“We truncated the last 7 days of RiO contact data, to allow for delays in recording appointment outcomes (lag estimated).”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > METHODS > Dates
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“Since Black, Asian, and minority ethnic (BAME) groups are at disproportionate hazard compared to White ethnic groups of contracting COVID-19, hospital admission, critical care admission, and death from COVID-19 (UK Government Office for Science, 2020)”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > METHODS > Analyses: mortality
What the sources say
- Not checked yetcites UK Government Office for Science, 2020
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In the paper
“suggesting higher acuity”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > RESULTS > MH inpatient activity
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In the paper
“with evidence for changes in both supply (service provision) and demand (help-seeking)”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Abstract > Results
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“We obtained data from four clinical records systems (RiO, SystmOne, PCMIS, and Epic; see Supplementary Methods), representing all clinical records systems for CPFT plus one for services provided by CPFT within another Trust (Epic).”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > METHODS > Data sources
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In the paper
““Demand” changes may reflect a genuine reduction of need or a lack of help-seeking with pent-up demand.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Abstract > Conclusions
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In the paper
“they do not prove causation.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Strengths and weaknesses
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In the paper
“The sustained reduction in admissions, at least for those without SMI, suggests also a changed threshold for admission—though not for detention and by inference probably therefore for voluntary admission.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Inpatient stays
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In the paper
“Changes in referrals to some services may have reflected changes to “demand” or “supply” or both, though activity in other services was more clearly led by patient help-seeking (demand).”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Strengths and weaknesses
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In the paper
“Given the lack of change in new MHA detentions, we suggest that Responsible Clinicians perceived an increase in the risk of being admitted (relating to COVID-19 transmission) that shifted the risk/benefit balance, near the end of a detained admission, towards earlier discharge.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Inpatient stays
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In the paper
“Mortality data was available via national reporting mechanisms for all MH patients, but only for PH patients with open referrals to CPFT, and mortality data may be incomplete if delays in national reporting exceeded 7 days.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Strengths and weaknesses
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In the paper
“a recommended approach for evaluating changes in routine data associated with a well-defined event (Bernal et al., 2017)”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Strengths and weaknesses
What the sources say
- Not checked yetcites Bernal et al., 2017
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“These data represent a relatively comprehensive view of NHS-provided MH services in one geographical area (because CPFT provides psychological therapy and all secondary MH care to the entire population of C&P), making it less likely that decreases were compensated for by help-seeking via another NHS service.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Strengths and weaknesses
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: CPFT provides psychological therapy and all secondary mental health care to the entire population of Cambridgeshire and Peterborough.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Whilst a reduction in help-seeking cannot be excluded (injuries still occurring but people not seeking medical attention or presenting to an ED instead)”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Physical health presentations
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“this suggests that there is patient need but that help-seeking has been transiently suppressed.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Conclusions
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“suggests a degree of temporal shift in mortality, i.e. that some patients died earlier within 2020 than they would otherwise have done.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Mortality
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The data are less comprehensive for PH services, but sufficient to allow some comparison of health-seeking and mortality in the two domains.”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Strengths and weaknesses
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In contrast, suicide rates fall during wars that increase social cohesion by uniting a population against a common foe (Pridmore et al., 2018).”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Mental health presentations
What the sources say
- Not checked yetcites Pridmore et al., 2018
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“For some services there were “unmeasured” alternatives (e.g. MH support from charities; support for children from the Local Authority).”
§ The early impact of COVID-19 on mental health and community physical health services and their patients’ mortality in Cambridgeshire and Peterborough, UK > Discussion > Strengths and weaknesses
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
CPFT is the sole provider of all secondary care mental health services to Cambridgeshire and Peterborough.
“CPFT) provides community PH services, psychological therapy services, and all secondary care MH services (including some embedded within primary care) to C&P”
The paper relies on this without support.
Lifetime coded ICD-10 diagnoses adequately identify severe mental illness despite possible under-coding.
“Any under-coding of diagnosis was unmeasured.”
The paper relies on this without support.
CPFT provides psychological therapy and all secondary mental health care to the entire population of Cambridgeshire and Peterborough.
“because CPFT provides psychological therapy and all secondary MH care to the entire population of C&P”
The paper relies on this without support.
For some services, activity is driven by patient self-presentation rather than service supply.
“For some services, though, activity is driven by patient self-presentation (e.g. 111 crisis calls, attendance at EDs/MIUs) yet activity dropped nonetheless.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“The studies showed either a reduction ( Chen et al., 2020; Hernandez-Calle et al., 2020; Smalley et al., 2021) or no change ( Sade et al., 2020; Titov et al., 2020) in presentations to health/mental health services or self-reported suicidal thoughts, with the majority making comparisons to the same time in 2019.”
From The impact of the COVID-19 pandemic on self-harm and suicidal behaviour: update of living systematic review (2021) · cites this paper as Chen et al., 2020
In the citing paper
“Eight studies reported a decrease in self-harm/suicide attempts during the first months of the COVID-19 pandemic ( Capuzzi et al., 2020; Chen et al., 2020; Goncalves-Pinho et al., 2021; Hewson et al., 2020; McIntyre et al., 2020; Pignon et al., 2020; Rajput et al., 2020; Walker et al., 2020).”
From The impact of the COVID-19 pandemic on self-harm and suicidal behaviour: update of living systematic review (2021) · cites this paper as Chen et al., 2020
In the citing paper
“Furthermore, this new situation with the imposed social and physical restrictions may have also introduced additional barriers to accessing informal and formal help-seeking for mental health problems in youths, similarly to adults [53,54].”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [53]
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“Furthermore, this new situation with the imposed social and physical restrictions may have also introduced additional barriers to accessing informal and formal help-seeking for mental health problems in youths, similarly to adults [53,54].”
BackgroundMental health of children and young people during pandemic
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“A UK study reported that the demand for mental health care decreased partly due to fears of becoming infected in health care settings (Chen et al., 2020).”
BackgroundAccessibility to Non-COVID Health Services in the World During the COVID-19 Pandemic: Review
Tuczyńska, M., Matthews‐Kozanecka, M., & Baum, E. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.760795 · Cited by 111
“This drop encompassed services accepting referrals from professionals (47).”
BackgroundHampshire, A., Hellyer, P. J., Soreq, E., Mehta, M. A., Ioannidis, K., Trender, W. R., Grant, J. E., & Chamberlain, S. R. (2021) · Nature Communications · doi:10.1038/s41467-021-24365-5 · Cited by 108
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Impact of the COVID-19 pandemic on child and adolescent mental health services
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Help-seeking behaviors for mental health problems during the COVID-19 pandemic: A systematic review
Yonemoto, N., & Kawashima, Y. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.11.043 · Cited by 70
“Chen et al. (2020) United Kingdom (UK) Presentations and referrals to the primary provider of mental health and community health services in Cambridgeshire and Peterborough, plus service activity and deaths Interrupted time-series analyses with respect to the time of lockdown in the UK March 23,…”
Hawton, K. E., Lascelles, K. M., Brand, F., Casey, D., Bale, L., Ness, J., Kelly, S., & Waters, K. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.03.028 · Cited by 65
The impact of COVID-19 on eating disorder referrals and admissions in Waikato, New Zealand
Hansen, S. J., Stephan, A., & Menkes, D. B. (2021) · Journal of Eating Disorders · doi:10.1186/s40337-021-00462-0 · Cited by 62
Viewpoint: Investing in strategies to support mental health recovery from the COVID-19 pandemic
McDaid, D. (2021) · European Psychiatry · doi:10.1192/j.eurpsy.2021.28 · Cited by 60
“The UK government’s recently published Covid-19 mental health and wellbeing recovery action plan for England provides a useful template for policy action [2].”
BackgroundLiberati, E. G., Richards, N., Parker, J., Willars, J., Scott, D. A. H., Boydell, N., Pinfold, V., Martin, G. P., Jones, P. B., & Dixon‐Woods, M. (2022) · Social Science & Medicine · doi:10.1016/j.socscimed.2022.114711 · Cited by 59
“…for in secondary mental healthcare settings (e.g. inpatient and community mental health services), have faced restrictions in availability of care (Chen et al., 2020; NHS Reset, 2020; Patel et al., 2020; Rethink Mental Illness, 2020), at the same time as the pandemic and associated control…”
Self-citationChen, S., She, R., Qin, P., Kershenbaum, A. D., Fernández-Egea, E., Nelder, J. R., Ma, C., Lewis, J. R., Wang, C., & Cardinal, R. N. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.585915 · Cited by 60
“For example, these effects may reflect both changes in supply (reduced provision of health services, and the prioritization of urgent over routine referrals with discouragement of routine referral) as well as changes in patientled demand (17).”
BackgroundInfluentialSelf-citationWang, D., Chen, H., Zhai, S., Zhu, Z., Huang, S., Zhou, X., Pan, Y., Meng, D., Yang, Z., Zhao, J., et al. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.03.035 · Cited by 57
“Impacts of COVID-19 on academic and social interactions were also observed to be linked to psychiatric symptoms, which aligns with findings in previous studies (Chen et al., 2020; Li et al., 2020a; Li et al., 2020b).”
ResultPatel, R., Irving, J., Brinn, A., Broadbent, M. T. M., Shetty, H., Pritchard, M., Downs, J. M., Stewart, R. J., Harland, R., & McGuire, P. K. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-046365 · Cited by 53
Experience of Healthcare Access in Australia during the First Year of the COVID-19 Pandemic
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Utilization of Inpatient Mental Health Care in the Rhineland During the COVID-19 Pandemic
Zielasek, J., Vrinssen, J., & Gouzoulis‐Mayfrank, E. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.593307 · Cited by 40
“Inpatient numbers were shown to be decreased due to reduced admissions and have a spike in discharges with the lockdown in the Cambridgeshire & Peterborough National Health Services Trust (6).”
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Effects of the COVID-19 pandemic on self-harm
Kapur, N., Clements, C., Appleby, L., Hawton, K. E., Steeg, S., Waters, K., & Webb, R. T. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30528-9 · Cited by 36
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COVID-19 and Pediatric Mental Health Hospitalizations
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The Early Impacts of the COVID-19 Pandemic on Mental Health Facilities and Psychiatric Professionals
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“Participants were categorised as residing in areas of very high (1, 2), high (3, 4), medium (5, 6), low (7, 8), or very low deprivation (9, 10).”
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Inequalities in access to mental health treatment by Australian youths during the COVID-19 pandemic
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Self-citationBortoletto, R., Gennaro, G. D., Antolini, G., Mondini, F., Passarella, L., Rizzo, V., Silvestri, M., Darra, F., Zoccante, L., & Colizzi, M. (2022) · Psychiatry Research Communications · doi:10.1016/j.psycom.2022.100023 · Cited by 24
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“This appears somewhat consistent with regional reports as well as the national trend observed through the monitoring of activity in the patient management software used by a majority of IAPT services, where referrals dropped by approximately 70% early after lockdown was announced [10-12,21].”
Perozziello, A., Sousa, D., Aubriot, B., & Masson, V. D. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-064305 · Cited by 19
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“…to secondary mental health services during the first outbreak in the UK decreased less for patients with severe mental illness than for patients without severe mental illness, 10 whereas the second study found elevated numbers of admissions for patients with psychotic and bipolar disorders.”
BackgroundHansen, J. P., Sas, T. Q. B., Fløjstrup, M., Brabrand, M., & Hvolby, A. (2021) · Brain and Behavior · doi:10.1002/brb3.2264 · Cited by 19
“There was a need for a time series analysis study of changes in number of mental health contacts during the lockdown of mental healthcare system (Chen et al., 2020a, 2020b).”
BackgroundResultCogan, N. A., Archbold, H., Deakin, K., Griffith, B., Berruga, I. S., Smith, S. G., Tanner, G., & Flowers, P. (2022) · International Journal of Mental Health · doi:10.1080/00207411.2022.2056386 · Cited by 17
“…health deteriorations, both among healthy individuals and those with preexisting mental health problems (Banks & Xu, 2020; Chatterjee et al., 2020; Chen et al., 2020; Cullen et al., 2020; McElroy et al., 2020; Odani et al., 2022; Robillard et al., 2021; Simblett CONTACT Nicola Cogan…”
BackgroundGriffith, B., Archbold, H., Berruga, I. S., Smith, S. G., Deakin, K., Cogan, N. A., Tanner, G., & Flowers, P. (2022) · Psychology Health & Medicine · doi:10.1080/13548506.2022.2148698 · Cited by 16
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COVID-19 and the Blitz compared: mental health outcomes in the UK
Jones, E. (2021) · The Lancet Psychiatry · doi:10.1016/s2215-0366(21)00118-8 · Cited by 11
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“mental illness, likely due to COVID-19 [31].”
Zielasek, J., Lehmann, I., Vrinssen, J., & Gouzoulis‐Mayfrank, E. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.957951 · Cited by 13
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Penington, E., Lennox, B., Geulayov, G., Hawton, K. E., & Tsiachristas, A. (2022) · European Psychiatry · doi:10.1192/j.eurpsy.2022.22 · Cited by 10
“This is similar to, for example, a study from Cambridgeshire and Peterborough which found an immediate reduction in both supply of and demand for secondary mental health care, followed by a gradual recovery [20].”
ResultCapobianco, L., Verbist, I. L., Heal, C., Huey, D., & Adrian Wells, A. (2022) · British Journal of Clinical Psychology · doi:10.1111/bjc.12410 · Cited by 15
One year of psychiatric presentations to a hospital emergency department during COVID-19
Hartnett, Y., Alshurafa, K., McAndrew, J., Daly, D., Alsaffar, M., Cotter, D., Cannon, M. D., MacHale, S., Murphy, K. C., & Barry, H. (2022) · Irish Journal of Psychological Medicine · doi:10.1017/ipm.2022.6 · Cited by 12
Li, H., Chen, X., Pan, J., Li, M., Wang, M., Wang, W., & Wang, Y. (2022) · Healthcare · doi:10.3390/healthcare10081402 · Cited by 11
Telepsychology in Europe since COVID-19: How to Foster Social Telepresence?
Haddouk, L., Milcent, C., Schneider, B., Daele, T. V., & Witte, N. A. J. D. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12062147 · Cited by 12
“Beyond the current health crisis, telepsychology is likely to remain a major component of mental healthcare, as it might help to improve access to mental healthcare and to reduce costs of service delivery [27].”
BackgroundHas COVID‐19 affected dementia diagnosis rates in England?
Hazan, J., Liu, K. Y., Isaacs, J. D., Burns, A. S., & Howard, R. J. (2023) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5976 · Cited by 9
The impact of COVID-19 on mental health service utilisation in England
Villaseñor, A., Gaughan, J., Aragón, M. J., Gutacker, N., Gravelle, H. S. E., Goddard, M. K., Mason, A., Castelli, A., & Jacobs, R. (2023) · SSM - Mental Health · doi:10.1016/j.ssmmh.2023.100227 · Cited by 8
“Local and regional analyses have found a reduction in supply and demand for mental health services, for example in Cambridgeshire and Peterborough (Chen et al., 2020), reduced referrals and admissions in Leicestershire with admitted patients more likely to be detained (Abbas et al., 2021; Tromans et al., 2020), and a…”
Inpatient Mental Healthcare before and during the COVID-19 Pandemic
McGuire, A. B., Flanagan, M., Kukla, M., Rollins, A. L., Myers, L. J., Bass, E., Garabrant, J. M., & Salyers, M. P. (2021) · Healthcare · doi:10.3390/healthcare9121613 · Cited by 9
Richter, D., Riedel-Heller, S. G., & Zürcher, S. J. (2020) · medRxiv · doi:10.1101/2020.12.03.20243196 · Cited by 8
Chen, S., Jones, P. B., Underwood, B. R., Fernández-Egea, E., Qin, P., Lewis, J. R., & Cardinal, R. N. (2020) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5610 · Cited by 7
Self-citationLarsson, P., Lloyd, R., Taberham, E., & Rosairo, M. (2022) · Mental Health Review Journal · doi:10.1108/mhrj-04-2022-0023 · Cited by 6
Al‐Jabr, H., Windle, K., Thompson, D. R., Jenkins, Z., Castle, D. J., & Ski, C. F. (2022) · JMIR Research Protocols · doi:10.2196/36673 · Cited by 9
“Attention to mental health is also important as restrictions associated with the pandemic limited the provision of mental health services [44-46].”
Background(2021) · doi:10.1192/bjo.2021.1046 · Cited by 8
Self-citationFehr, M., Köhler, S., Roth-Sackenheim, C., Geschke, K., Tüscher, O., Adorjan, K., Lieb, K., Hölzel, L. P., & Wiegand, H. F. (2024) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-024-01886-w · Cited by 7
“…services, nearly all from the UK, consistently showed significant reductions in referrals to primary and secondary mental health services and in incidence diagnoses of mental disorders during the first HIP [22–28], but some studies showed increases in referrals after this period [22, 24, 25].”
Service user and staff experiences of a new community enhanced rehabilitation team
Kidd, K., & Fenton, K. (2022) · Mental Health Practice · doi:10.7748/mhp.2022.e1593 · Cited by 7
“Further, Chen et al (2020) found increased rates of death of people who access mental health services – those with and without serious mental illness – during the early part of the COVID-19 pandemic in the UK.”
BackgroundTulk, C., Bartram, M. H., Leslie, K., Atanackovic, J., Chamberland-Rowe, C., & Bourgeault, I. L. (2023) · Human Resources for Health · doi:10.1186/s12960-023-00797-6 · Cited by 6
Remote consultations in community mental health: A qualitative study of clinical teams
McCarron, R. H., Moore, A., Foreman, I., Brewis, E., Clarke, O., Howes, A., Parkin, K., Luk, D., Hirst, M. S., Sach, E., et al. (2024) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.13044 · Cited by 7
Self-citation(2023) · doi:10.3390/jcm12072681 · Cited by 7
“The latter is particularly relevant nowadays since the COVID-19 pandemic has fueled a substantial healthcare system redeployment, often affecting outpatient psychiatric service availability [12] and increasing pressure on acute inpatient services [13,14], with important effects of the pandemic on mental health needs a…”
BackgroundMental Health Services during the COVID ‐19 pandemic in Abu Dhabi, UAE
Garhy, M. A., Dhufairi, A. A., Abdulrahman, H., Maskari, B. A., Ahmed, N., Khamashi, S. A., Kaid, A., & Shalash, H. (2021) · Progress in Neurology and Psychiatry · doi:10.1002/pnp.720 · Cited by 7
Gardiner, S.-A. L., & Martin, P. (2021) · Australian Health Review · doi:10.1071/ah21230 · Cited by 5
London, S., Chen, S., Sidhom, E., Lewis, J. R., Wolverson, E., Cardinal, R. N., Roalf, D. R., Mueller, C., & Underwood, B. R. (2024) · The British Journal of Psychiatry · doi:10.1192/bjp.2024.14 · Cited by 6
Self-citationCelona, C. A., Jackman, K., & Smaldone, A. M. (2023) · Journal of Emergency Nursing · doi:10.1016/j.jen.2023.04.006 · Cited by 6
“Conversely, some research demonstrated a decrease in hospitalizations for mental health conditions when patients received outpatient mental health care.(38,40) In our sample, most young adults who came to the emergency department during the pandemic for treatment of a mental health condition had only 1 ED encounter, s…”
Bethge, M., Fauser, D., Zollmann, P., & Streibelt, M. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04627-w · Cited by 4
Knipe, D. W., García, S. D. O., Salhi, L., Afzal, N., Sammut, S., Mainstone-Cotton, L., Sefi, A., Marchant, A. L., & John, A. M. (2025) · PLoS ONE · doi:10.1371/journal.pone.0316468 · Cited by 8
“Furthermore, it is likely that there was an increase of demand for face-to-face mental health service post-lockdown, with figures suggesting some return to pre-pandemic activity [58].”
Sturge, J. L., & Starrenburg, F. (2022) · HERD Health Environments Research & Design Journal · doi:10.1177/19375867221098982 · Cited by 4
“…that support healing and have positive impact on staff and patients, such as the spatial qualities of inpatient care, such as access to private rooms, open nursing stations, and access to nature (Chrysikou, 2014; Molin et al., 2021; Shepley & Pasha, 2017; Shepley et al., 2016; Wood et al., 2013).”
BackgroundThe roles of a psychiatrist in the COVID-19 pandemic
Baldwin, D. S., Gordon, R. C., & Marlowe, K. (2021) · Clinics in Integrated Care · doi:10.1016/j.intcar.2021.100036 · Cited by 4
The complex picture of self-harm during the COVID-19 pandemic
Chen, R. (2021) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2021.100123 · Cited by 6
Fluck, D. S., Fry, C. H., Robin, J. G., Bull, E., Lewis, A., Rees, J., JONES, G. L., Taylor, L., & Han, T. S. (2023) · International Journal of Mental Health Nursing · doi:10.1111/inm.13155 · Cited by 5
Online Therapy for Children: Yay or Nay? Clinicians’ Insights from the COVID-19 Era
Hagyari-Donaldson, P., & Scott, N. (2024) · Child & Youth Care Forum · doi:10.1007/s10566-024-09835-3 · Cited by 4
“However, the provision of remote psychological interventions for children was not always possible due to limited resources (Wilson et al., 2024), and many either lost access to mental healthcare services, or access became increasingly challenging (Allison & Levac, 2022; Chen et al., 2020).”
Horvitz-Lennon, M. V., Leckman‐Westin, E., Finnerty, M. T., Jeong, J., Tsuei, J., Zelevinsky, K., Chen, Q., & Normand, S. T. (2023) · Community Mental Health Journal · doi:10.1007/s10597-023-01105-1 · Cited by 4
“People with schizophrenia are more likely to experience poorer COVID-19 outcomes because of their higher rates of obesity, diabetes, and other pre-existing physical health conditions, and their profound social disadvantage, including higher rates of homelessness (Chen et al., 2020; Druss, 2020; Fond et al., 2021; Jege…”
BackgroundCataldo, I., Novotny, D., Carollo, A., & Esposito, G. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20136310 · Cited by 4
Challenges and adaptations of mental health services during the COVID-19 Pandemic in Uganda
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Simkin, L., Yung, P., Greig, F., Perera, G., Tsamakis, K., Rizos, E., Stewart, R. J., Velayudhan, L., & Mueller, C. (2022) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5834 · Cited by 3
Li, H., Zhang, X., Bu, L., Zhang, Y., Wang, X., Ye, H., Liu, W., Wang, D., & Fan, F. (2025) · Early Intervention in Psychiatry · doi:10.1111/eip.70090 · Cited by 4
“Impacts of COVID-19 on academic activities and social communication have been linked to alterations in depression and anxiety, consistent with results from prior studies (Chen et al. 2020; Wang, Chen, et al. 2021).”
Metadata
- Authors
- Chen, S., Jones, P. B., Underwood, B. R., Moore, A., Bullmore, E. T., Banerjee, S., Osimo, E. F., Deakin, J. B., Hatfield, C. F., Thompson, F. J., Artingstall, J. D., Slann, M. P., Lewis, J. R., & Cardinal, R. N.
- Affiliations
- University of Cambridge (GB)
- Fulbourn Hospital (GB)
- Corresponding author
- Cardinal, Rudolf N.
- ORCID
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2020-12
- Volume
- 131
- Pages
- 244-254
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC7508053
- OpenAlex
- W3087124467
- Cited by
- 127
- References
- 27
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 13 · 2023: 26 · 2022: 27 · 2021: 45 · 2020: 5
- FWCI
- 10.31
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Journal of Psychiatric Research (publishedVersion)
- SSRN Electronic Journal (acceptedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Apollo (University of Cambridge) (submittedVersion, cc-by-nc-nd)
- Apollo
- Funders
- National Institute for Health Research
- Medical Research Council
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- COVID-19 pandemic, mental health services, standardized mortality ratio, severe mental illness, help-seeking, service supply and demand, lockdown, psychosomatic medicine, eating disorders, Mental Health Act detention, remote care, excess mortality, older adults
- MeSH terms
- COVID-19, Adolescent, Adult, Aged, Aged, 80 and over, Mental Disorders, Community Health Services, Community Mental Health Services, Female, United Kingdom, Health Services Accessibility, Humans, Male, Middle Aged, Mortality, Patient Acceptance of Health Care, Pneumonia, Viral, Referral and Consultation, Infection Control, Coronavirus Infections, Young Adult, Pandemics
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