Negative impacts of COVID-19 lockdown on mental health service access and follow-up adherence for immigrants and individuals in socio-economic difficulties
Open accessAbstract
Objectives Lockdown measures in response to the coronavirus disease 2019 (COVID-19) pandemic can have serious mental health effects on the population, especially in vulnerable groups, such as those living in poor socio-economic conditions, those who are homeless, migrant workers and asylum seekers/refugees. In addition, these vulnerable groups frequently have greater difficulty accessing health services and in treatment adherence. The aim of this study is to estimate the impact of the COVID-19-related lockdown on service utilisation and follow-up adherence in an Italian mental health outpatient service for migrants and individuals in socio-economic difficulties.Study design The design of this study is a retrospective cross-sectional study.Methods All patients who visited the mental health outpatient service in the months of February and March in the years 2017-2020 were included in the study. To compare service utilisation before and after the lockdown, the number of patients who visited the mental health outpatient service for psychiatric interview were recorded. Follow-up adherence was calculated as the percentage of patients who visited in February and subsequently attended a follow-up visit in March of the same year.Results The number of patients who visited the outpatient service between February 2017 and February 2020 was continuously increasing. In March 2020, fewer patients visited the service for psychiatric interview, in line with the introduction of lockdown measures. In addition, the number of the patients who visited in February 2020 and returned for their follow-up visits in March 2020 declined from approximately 30% over the same months in 2017-2019 to 17.53% in March 2020.Conclusions The lockdown-related reduction in numbers of patients accessing the mental health service makes it difficult to help vulnerable populations during a period of time in which their mental health needs are expected to increase. Moreover, the reduction seen in follow-up compliance increases the risk of treatment discontinuation and possible relapse. Proactive alternative strategies need to be developed to reach these vulnerable populations.
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In light of the COVID-19 pandemic, there is an even higher need for psychosocial interventions for international migrant workers targeting symptoms of psychological distress such as anxiety, depression, and PTSD.
“In light of the COVID-19 pandemic, there is thus an even higher need for psychosocial interventions for IMWs targeting the most notable symptoms of psychological distress, such as anxiety, depression, and posttraumatic stress disorder (PTSD) [16, 17].”
From Effectiveness of a scalable, remotely delivered stepped-care intervention to reduce symptoms of psychological distress among Polish migrant workers in the Netherlands: study protocol for the RESPOND randomised controlled trial (2023) · cites this paper as [16]
The Discussion (page not available) says the pandemic may increase anxiety among migrants and calls for proactive assistance to address rising mental health needs. The Introduction also mentions PTSD and depressive symptoms in some asylum seekers. The paper does not specifically recommend psychosocial interventions for international migrant workers targeting anxiety, depression, and PTSD as a group. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe new situation with imposed social and physical restrictions may have introduced additional barriers to accessing informal and formal help-seeking for mental health problems in youths, similarly to adults.
“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 [54]
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“In light of the COVID-19 pandemic, there is thus an even higher need for psychosocial interventions for IMWs targeting the most notable symptoms of psychological distress, such as anxiety, depression, and posttraumatic stress disorder (PTSD) [16, 17].”
Background
- Authors
- Aragona, M., Barbato, A., Cavani, A., Costanzo, G., & Mirisola, C.
- Corresponding author
- Aragona, M.
- Venue
- Public Health
- Publisher
- Elsevier BV
- Published
- 2020-09
- Volume
- 186
- Pages
- 52-56
- ISSN
- 0033-3506 (ISSN-L)
- PMC
- PMC7409736
- OpenAlex
- W3047789373
- Cited by
- 173
- References
- 25
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 25 · 2023: 41 · 2022: 54 · 2021: 34 · 2020: 2
- FWCI
- 13.09
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Keywords
- COVID-19 lockdown, access to mental health care, follow-up adherence, immigrants, vulnerable populations, treatment discontinuation, homeless people
- MeSH terms
- Treatment Adherence and Compliance, Facilities and Services Utilization, COVID-19, Adult, Cross-Sectional Studies, Female, Health Services Accessibility, Ill-Housed Persons, Humans, Italy, Male, Mental Health Services, Middle Aged, Pneumonia, Viral, Poverty, Refugees, Retrospective Studies, Coronavirus Infections, Vulnerable Populations, Emigrants and Immigrants, Young Adult, Pandemics
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