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
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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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“and referrals to CMHTs dropped less”
§ 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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“with a subsequent increase towards normal levels for secondary care services”
§ 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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“with the excess deaths occurring shortly after the rapid increase in COVID-19 infections in the region (Fig. 5E).”
§ 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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“The changes in referrals to secondary care were proportionally less for patients with SMI than for those without SMI recorded”
§ 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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“except presentation with psychosis/mood elevation (small sustained reduction)”
§ 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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“Referrals to PH services dropped across age groups”
§ 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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“new detentions under the Mental Health Act were unchanged”
§ 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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“PH ward occupancy decreased”
§ 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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“neither was there a change for subgroups with/without 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 > Mental Health Act
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“This was followed by an increase in demand for some services.”
§ 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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“Activity, as measured by clinical documentation, dropped”
§ 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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“This drop encompassed services accepting referrals from professionals (primary care MH service, IAPT, specialist MH teams).”
§ 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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“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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“There was a gradual decrease in telephone calls to the NHS 111 MH crisis service”
§ 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 sharp reduction at lockdown in referrals to primary care MH services, psychological therapy, and all secondary care MH teams 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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“and contacts shifted towards telephone consultations”
§ 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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“and readmission rates did not 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 > MH inpatient activity
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“However, the drop was also observed across services accepting patient self-referral, in part or exclusively (IAPT, 111, LP).”
§ 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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“and a spike in discharges beginning just before 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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“Prior to the pandemic, the proportion of detained patients (as opposed to voluntary or “informal” inpatients) was high compared to the local historical mean (Fig. 3 A)”
§ 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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“There was a clear and sustained increase in death amongst patients with open referrals to PH services at the time of lockdown (Fig. 5 A)”
§ 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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“There has been a disproportionate increase in death among those with SMI during the pandemic.”
§ 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
“Referrals and presentations to nearly all mental and physical health services dropped 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 > Abstract > Results
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In the paper
“Excess mortality was primarily in the over-70s.”
§ 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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“There was clear evidence of the shift to remote consultation.”
§ 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 2020, the SMR was greater in the SMI group than the non-SMI group (differences for each year: ***p < 0·001).”
§ 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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“There was stark excess mortality in the over-70s in 2020 to date”
§ 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
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“but with additional increases in other age bands, notably for those with SMI (Fig. 5D).”
§ 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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“There was no ethnicity-specific effect in 2020 (terms involving ethnicity × 2020, not significant)”
§ 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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In the paper
“Given the lack of change in new MHA detentions”
§ 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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“Service activity dropped less 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 > Discussion > Summary
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“Across all years, SMI conferred a greater additional risk of mortality in the ethnic minority/unrecorded ethnicity group (SMI × ethnicity, p < 0·05).”
§ 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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In the paper
“again, this was primarily in the over-70s”
§ 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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“There was no evidence of a compensatory “rebound” in demand beyond initial levels”
§ 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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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
“The increase in SMR from 2019 to 2020 was significantly greater in the SMI group than the non-SMI group (#p < 0·05 from ITS analysis; see Results).”
- Also stated in: § Deaths · plain
“increased significantly more for those with SMI than without (Fig. 5F; ITS analysis, SMI × 2020, p < 0·05).”
§ 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
plaincorrelational- 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.
- Also stated in: § Deaths · plain
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The baseline SMR in patients known to MH services was high”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The drop in the number of detained inpatients is particularly striking.”
§ 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
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.
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
“Referrals and self-presentations to health services dropped substantially at lockdown across the MH and community PH system in our 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 > Summary
plaindirect- 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.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The sustained reduction in admissions, at least for those without SMI”
§ 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
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.
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
“Deaths in patients known to MH services increased at this time for those with and without SMI (Fig. 5C and D)”
§ 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
plaindirect- 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.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“activity in a number of services is now increasing”
§ 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
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.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“For some services, though, activity is driven by patient self-presentation (e.g. 111 crisis calls, attendance at EDs/MIUs) yet activity dropped nonetheless.”
§ 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
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.
- Rests on an assumption: For some services, activity is driven by patient self-presentation rather than service supply.
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
“in patients without SMI (who were in the majority) a biphasic effect was seen, with a drop in mortality below the historical norm after the initial increase in deaths (Fig. 5C).”
§ 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
plaincorrelational- 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.
In the paper
“Population surveys of UK general mental health suggest a substantial deterioration following lockdown (Banks and Xu, 2020), but this has not translated (thus far) to an increase in presentation with mental disorder in our 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 > Mental health presentations
What the sources say
- Not checked yetcites Banks and Xu, 2020
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.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“the trend for some services is now upwards.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“there was a substantial and disproportionate increase in mortality amongst those with SMI during 2020.”
§ 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
plaincorrelational- 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.
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
“the increased mortality amongst those with SMI in 2020 (as above) was not explicable by ethnicity.”
- Also stated in: § Mortality · plain
“This 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 > RESULTS > Deaths
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.
- Also stated in: § Mortality · plain
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
“SMRs increased from 2019 to 2020 for the SMI group (†p < 0·05).”
- Also stated in: § Deaths · plain
“Mortality, measured by SMR, increased significantly from 2019 to 2020 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 > RESULTS > Deaths
plaindirect- 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.
- Also stated in: § Deaths · plain
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
“Across all data available from 2020 to date, the change in SMR for those without SMI was not significant”
§ 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
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.
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
““Supply” changes may have reduced access to mental health services for some.”
§ 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
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.
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
“The reduction in inpatient numbers was deliberate (Supplementary Methods).”
§ 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.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“likely reflecting CPFT's provision of MH care to those with life-limiting illnesses including dementia.”
§ 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: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“likely due to COVID-19”
§ 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: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“The changes in supply may have reduced access to mental health services for some.”
§ 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
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.
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
“our findings may not generalize to areas with different infection rates.”
§ 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: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Widespread travel out of CPFT's catchment area is not a plausible explanation for the changes, given the magnitude of change and national travel bans (Hancock, 2020).”
§ 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 Hancock, 2020
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“we do not have data on people who may have ended their life but were not known to our services.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“In some cases, these reflected service-led changes (e.g. closing some teams to non-urgent referrals; discharging patients to create inpatient capacity).”
§ 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
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“these data also provide strong (albeit observational) evidence that SMI is a major risk factor for death during the pandemic.”
§ 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
boosteddirect- 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.
In the paper
“Population surveys of UK general mental health suggest a substantial deterioration following lockdown (Banks and Xu, 2020)”
§ 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 Banks and Xu, 2020
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Our data do not identify the mechanisms conferring additional risk on 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 > Discussion > Mortality
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“the degree suggests that lockdown has reduced minor injury.”
§ 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
hedgeddirect- 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. 27
- The quote only partly states this claim. 1
- Probably not a substantial claim. 11
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
“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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether 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 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
“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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether 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 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
“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
plaincorrelational- 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.
The quote only partly states this claim.
- Rests on an assumption: Lifetime coded ICD-10 diagnoses adequately identify severe mental illness despite possible under-coding.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
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
plaincorrelational- 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 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
“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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether 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 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
“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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether 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 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
“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.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether 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 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
“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.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether 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: 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether 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 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
“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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether 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.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether 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 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
“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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether 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 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
“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
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.
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
“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
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.
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
“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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether 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 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
“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
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
“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
hedged- 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
“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
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.
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
“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
hedgeddirect- 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.
Probably not a substantial claim.
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
“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
hedgeddirect- 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.
Probably not a substantial claim.
In the paper
“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
plaincorrelational- 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.
Probably not a substantial claim. 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
“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
hedgedcorrelational- 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
“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
plaincorrelational- 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
“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
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.
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
““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
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
“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
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.
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
“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
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.
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
“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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether 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
“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
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: unclear — It is unclear whether it could 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
“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
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.
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
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.
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]
Citations
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COVID-19 pandemic and mental health consequences: Systematic review of the current evidence
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Interrupted time series regression for the evaluation of public health interventions: a tutorial
Lopez Bernal, J., Cummins, S., & Gasparrini, A. (2016) · International Journal of Epidemiology · doi:10.1093/ije/dyw098 · Cited by 3,049
Rogers, J. P., Chesney, E., Oliver, D., Pollak, T. A., McGuire, P., Fusar-Poli, P., Zandi, M. S., Lewis, G., & David, A. S. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30203-0 · Cited by 2,407 · cited 1×
“, 2020) and other neuropsychiatric complications, in which endothelial involvement and bradykinin dysregulation may be important (Varatharaj et al., 2020; Zubair et al., 2020; Romoli et al., 2020; Rogers et al., 2020; Garvin et al., 2020; Roche and Roche, 2020).”
BackgroundSuicide risk and prevention during the COVID-19 pandemic
Gunnell, D., Appleby, L., Arensman, E., Hawton, K., John, A., Kapur, N., Khan, M., O'Connor, R. C., Pirkis, J., Appleby, L., et al. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30171-1 · Cited by 1,513
Varatharaj, A., Thomas, N., Ellul, M. A., Davies, N. W. S., Pollak, T. A., Tenorio, E. L., Sultan, M., Easton, A., Breen, G., Zandi, M., et al. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30287-x · Cited by 1,246
Zubair, A. S., McAlpine, L. S., Gardin, T., Farhadian, S., Kuruvilla, D. E., & Spudich, S. (2020) · JAMA Neurology · doi:10.1001/jamaneurol.2020.2065 · Cited by 923
Introductory Statistics with R
Dalgaard, P. (2002) · Springer eBooks · doi:10.1007/b97671 · Cited by 743
Cited by
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Nearchou, F., Flinn, C., Niland, R., Subramaniam, S. S., & Hennessy, E. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17228479 · Cited by 577
“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
Ford, T., John, A., & Gunnell, D. (2021) · BMJ · doi:10.1136/bmj.n614 · Cited by 203
John, A., Eyles, E., Webb, R. T., Okolie, C., Schmidt, L., Arensman, E., Hawton, K., O'Connor, R. C., Kapur, N., Moran, P., et al. (2021) · F1000Research · doi:10.12688/f1000research.25522.2 · Cited by 189
The impact of the COVID-19 pandemic on self-harm and suicidal behaviour: a living systematic review
John, A., Okolie, C., Eyles, E., Webb, R. T., Schmidt, L., McGuinness, L. A., Olorisade, B. K., Arensman, E., Hawton, K., Kapur, N., et al. (2020) · F1000Research · doi:10.12688/f1000research.25522.1 · Cited by 178
Effects of the COVID-19 pandemic and lockdown on alcohol use disorders and complications
Murthy, P., & Narasimha, V. L. (2021) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000720 · Cited by 138
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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-06, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-06 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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