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How mental health care should change as a consequence of the COVID-19 pandemic
Open accessAbstract
The unpredictability and uncertainty of the COVID-19 pandemic; the associated lockdowns, physical distancing, and other containment strategies; and the resulting economic breakdown could increase the risk of mental health problems and exacerbate health inequalities. Preliminary findings suggest adverse mental health effects in previously healthy people and especially in people with pre-existing mental health disorders. Despite the heterogeneity of worldwide health systems, efforts have been made to adapt the delivery of mental health care to the demands of COVID-19. Mental health concerns have been addressed via the public mental health response and by adapting mental health services, mostly focusing on infection control, modifying access to diagnosis and treatment, ensuring continuity of care for mental health service users, and paying attention to new cases of mental ill health and populations at high risk of mental health problems. Sustainable adaptations of delivery systems for mental health care should be developed by experts, clinicians, and service users, and should be specifically designed to mitigate disparities in health-care provision. Thorough and continuous assessment of health and service-use outcomes in mental health clinical practice will be crucial for defining which practices should be further developed and which discontinued. For this Position Paper, an international group of clinicians, mental health experts, and users of mental health services has come together to reflect on the challenges for mental health that COVID-19 poses. The interconnectedness of the world made society vulnerable to this infection, but it also provides the infrastructure to address previous system failings by disseminating good practices that can result in sustained, efficient, and equitable delivery of mental health-care delivery. Thus, the COVID-19 pandemic could be an opportunity to improve mental health services.
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“Cancer survivors, including YAs, rural or geographically distant, and economically distressed individuals, may find this modality inviting due to familiarity or enhanced access to care.9, 10, 11, 12”
From Cancer during a pandemic: A psychosocial telehealth intervention for young adults (2022) · cites this paper as [10]
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“It is also important to note that the model is informed by the COVID-19 pandemic, which has emphasized the urgent need for mental health-oriented interventions designed specifically for young people, given that 75 % of those aged 18–24 indicate at least one pandemic-related mental or behavioral health symptom, and one-quarter reporting suicidal ideation (Czeisler et al., 2020; Moreno et al., 2020”
From Intervention development to improve foster youth mental health by targeting coping self-efficacy and help-seeking (2023) · cites this paper as Moreno et al., 2020
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“Previous research has clearly shown that healthcare needs to adapt to the new demands put on the healthcare system, for instance, be able to deliver treatment on distance (46).”
From A systematic review on the efficacy of virtual reality and gamification interventions for managing anxiety and depression (2023) · cites this paper as [46]
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“These inequalities are likely to increase with the current COVID-19 pandemic”
From Preventive psychiatry: a blueprint for improving the mental health of young people (2021) · cites this paper as [286]
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“…of access to physical facilities for testing and treatment of underlying conditions, along with systems for online support [17,77], might prove indispensable when aiming to help disadvantaged families and vulnerable individuals, and thus mitigate disparities in healthcare provision [11,78,79].”
Duplaga, M., & Grysztar, M. (2021) · Healthcare · doi:10.3390/healthcare9010043 · Cited by 106
Digital Clinics and Mobile Technology Implementation for Mental Health Care
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“The need for digital navigators has become especially apparent during COVID-19, as grassroots efforts to train volunteers to support digital care have rapidly emerged to fill the current void in digital literacy education and resources [39 – 43].”
BackgroundChadi, N., Piano, C. S.-D., Osmanlliu, E., Gravel, J., & Drouin, O. (2021) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2021.07.036 · Cited by 104
“Nonetheless, the increase in visits for eating disorders revealed in our study suggests increased need for supportive services for adolescents with these conditions as the pandemic continues to unfold [20].”
BackgroundAssociations between periods of COVID-19 quarantine and mental health in Canada
Daly, Z., Slemon, A., Richardson, C. G., Salway, T., McAuliffe, C., Gadermann, A. M., Thomson, K. C., Hirani, S., & Jenkins, E. K. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2020.113631 · Cited by 102
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AI-Based and Digital Mental Health Apps: Balancing Need and Risk
Hamdoun, S., Monteleone, R., Bookman, T., & Michael, K. (2023) · IEEE Technology and Society Magazine · doi:10.1109/mts.2023.3241309 · Cited by 104
“Mental health crisis and limited access to services The COVID-19 pandemic brought into focus the immense need for mental health services around the world [2], [4].”
BackgroundSun, C.-F., Correll, C. U., Trestman, R. L., Lin, Y., Xie, H., Hankey, M. S., Uymatiao, R. P., Patel, R. T., Metsutnan, V., McDaid, E. C., et al. (2023) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2023.05.012 · Cited by 101
Self-citationSolé, B., Verdolini, N., Amoretti, S., Montejo, L., Rosa, A. R., Hogg, B., García‐Rizo, C., Mezquida, G., Bernardo, M., Martínez‐Arán, A., et al. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.11.099 · Cited by 100
Self-citationJohnson, M. S., Skjerdingstad, N., Ebrahimi, O. V., Hoffart, A., & Johnson, S. U. (2021) · Stress and Health · doi:10.1002/smi.3120 · Cited by 119
Self-citationBitan, D. T., Krieger, I., Kridin, K., Komantscher, D., Scheinman, Y., Weinstein, O., Cohen, A. D., Cicurel, A., & Feingold, D. (2021) · Schizophrenia Bulletin · doi:10.1093/schbul/sbab012 · Cited by 99
Salgado, T. A., Monteiro, G. M. C., Marcon, G., Roza, T. H., Zimerman, A., Hoffmann, M. S., Cao, B., Hauck, S., Brunoni, A. R., & Passos, I. C. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.04.044 · Cited by 103
Sadovyy, M., Gómez, M. S., & Bresó, E. (2021) · Personality and Individual Differences · doi:10.1016/j.paid.2021.110986 · Cited by 115
“…to those may generate an internal condition known as stress, which in spite of serving as an adaptive function in circumstances of hardship, may culminate in inducing emotions like fear and anxiety when persisting during a prolonged period of time (Drigas & Chara, 2020; Moreno et al., 2020).”
BackgroundCall for Action to Address Equity and Justice Divide During COVID-19
Bhaskar, S. M. M., Rastogi, A., Valsraj, K. M., Kunheri, B., Balakrishnan, S., & Howick, J. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.559905 · Cited by 100
“In the COVID-19 era, social distancing, increasing joblessness and limited access to mental health services, mental health burden is bound to aggravate during and beyond the pandemic (110).”
BackgroundConfirming validity of The Fear of COVID-19 Scale in Japanese with a nationwide large-scale sample
Midorikawa, H., Aiba, M., Lebowitz, A., Taguchi, T., Shiratori, Y., Ogawa, T., Takahashi, A., Takahashi, S., Nemoto, K., Arai, T., et al. (2021) · PLoS ONE · doi:10.1371/journal.pone.0246840 · Cited by 100
“These problems are due to fears of disease and to mitigation policies in many countries such as lockdowns, quarantines, and physical distancing [16].”
BackgroundEuropean Psychiatric Association guidance on assessment of cognitive impairment in schizophrenia
Vita, A., Gäebel, W., Mucci, A., Sachs, G., Erfurth, A., Barlati, S., Zanca, F., Giordano, G. M., Glenthøj, L. B., Nordentoft, M., et al. (2022) · European Psychiatry · doi:10.1192/j.eurpsy.2022.2316 · Cited by 103
Self-citationCOVID-19 and the compact city: Implications for well-being and sustainable urban planning
Mouratidis, K. (2021) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2021.152332 · Cited by 95
“and well-being due to COVID-19 is in line with previous findings from other contexts (Li et al., 2020; Moreno et al., 2020; Mouratidis & Yiannakou, 2021; Patrick et al., 2020; White & Van Der Boor, 2020).”
BackgroundResultSadeh‐Sharvit, S., Camp, T. D., Horton, S. E., Hefner, J. D., Berry, J. M., Grossman, E., & Hollon, S. D. (2023) · Journal of Medical Internet Research · doi:10.2196/46781 · Cited by 129
“Additionally, the therapists in community-based centers face unprecedented documentation and administrative burden [5,6], leading to frontline mental health workers’ work-life imbalance and compassion fatigue [7,8].”
COVID-19 Mental Health Disparities
Saltzman, L. Y., Lesen, A. E., Henry, V., Hansel, T. C., & Bordnick, P. S. (2021) · Health Security · doi:10.1089/hs.2021.0017 · Cited by 94
“5,6,53 The purpose of this study was to better understand early patterns of mental health problems related to the COVID-19 pandemic and to test whether social determinants of health and COVID-19–related experience”
Gual-Montolio, P., Jaén, I., Martínez-Borba, V., Castilla, D., & Suso-Ribera, C. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19137737 · Cited by 93
Foye, U., Dalton‐Locke, C., Harju‐Seppänen, J., Lane, R., Beames, L., Juan, N. V. S., Johnson, S., & Simpson, A. (2021) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.12745 · Cited by 109
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Caregiver Perceptions of Children’s Psychological Well-being During the COVID-19 Pandemic
Raviv, T., Warren, C. M., Washburn, J. J., Kanaley, M. K., Eihentale, L., Goldenthal, H., Russo, J. M., Martin, C. P., Lombard, L. S., Tully, J., et al. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.11103 · Cited by 92
Remote mental health care interventions during the COVID-19 pandemic: An umbrella review
Witteveen, A. B., Young, S. Y., Cuijpers, P. J., Ayuso‐Mateos, J. L., Barbui, C., Bertolini, F., Cabello, M., Cadorin, C., Downes, N., Franzoi, D., et al. (2022) · Behaviour Research and Therapy · doi:10.1016/j.brat.2022.104226 · Cited by 106
“Possibly, adaptations in mental health service provision may have buffered negative effects of the pandemic (Moreno et al., 2020; Yao et al., 2020).”
BackgroundBoldrini, T., Lomoriello, A. S., Corno, F. D., Lingiardi, V., & Salcuni, S. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.591170 · Cited by 105
Sklar, M., Ehrhart, M. G., & Aarons, G. A. (2021) · Psychiatric Rehabilitation Journal · doi:10.1037/prj0000480 · Cited by 85
Assessing the Psychological Impacts of COVID-19 in Undergraduate Medical Students
Guo, A. A., Crum, M., & Fowler, L. A. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18062952 · Cited by 84
“The higher percentage of stress attributed to COVID-19 is also expected given that people with mental health disorders have increased risk of infection and have worse outcomes than of those without [38].”
BackgroundLatikka, R., Koivula, A., Oksa, R., Savela, N., & Oksanen, A. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.114674 · Cited by 101
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“Virtual care With the onset of the pandemic, primary care teams quickly adapted by shifting their services online with little to no preparation [3, 8, 47].”
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“55,56 As staff employed by CTPs or other welfare programmes are in contact with recipients (either personally or via digital technologies), they are well-placed to share relevant information and resources.”
BackgroundPredictors and consequences of loneliness during the COVID-19 Pandemic
Rumas, R., Shamblaw, A. L., Jagtap, S., & Best, M. W. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.113934 · Cited by 90
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“Education, self-care, and family support should form part of mental health prevention strategies, which can involve multiagency collaboration among housing, education, and employment services, with support from the voluntary and mental health sectors [49].”
BackgroundEthics of Digital Mental Health During COVID-19: Crisis and Opportunities
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“To address this mental health crisis and provide physically distanced care, there has been a major, accelerated move toward adoption and implementation of digital tools for mental health care [15-17].”
BackgroundTourist Mental Health Drives Destination Choice, Marketing, and Matching
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National observation of death by suicide in the first 3 months under COVID‐19 pandemic
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“Considering the high prevalence of symptoms of psychiatric disorders during the pandemic and their high burden of disease, current international position papers point out a clear need to adapt and improve mental health services worldwide (Holmes et al., 2020; Moreno et al., 2020).”
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Machine Learning Techniques for Sentiment Analysis of COVID-19-Related Twitter Data
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“Categorization of the included studies according to the relevant social and behavioral science topics according to van Bavel et al. [1]. have to deal with in the upcoming future [119].”
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Metadata
- Authors
- Moreno, C., Wykes, T., Galderisi, S., Nordentoft, M., Crossley, N., Jones, N., Cannon, M., Correll, C. U., Byrne, L., Carr, S., Chen, E. Y. H., Gorwood, P., Johnson, S., Kärkkäinen, H., Krystal, J. H., Lee, J., Lieberman, J., López-Jaramillo, C., Männikkö, M., Phillips, M. R., Uchida, H., Vieta, E., Vita, A., & Arango, C.
- Affiliations
- Universidad Complutense de Madrid (ES)
- King's College London (GB)
- University of Campania "Luigi Vanvitelli" (IT)
- University of Copenhagen (DK)
- Pontificia Universidad Católica de Chile (CL)
- University of South Florida (US)
- Royal College of Surgeons in Ireland (IE)
- Northwell Health (US)
- Yale University (US)
- University of Birmingham (GB)
- University of Hong Kong (HK)
- Inserm (FR)
- University College London (GB)
- Global Alliance of Mental Illness Advocacy Networks-Europe (BE)
- Yale New Haven Hospital (US)
- Nanyang Technological University (SG)
- Columbia University (US)
- Shanghai Jiao Tong University (CN)
- Keio University (JP)
- Centro de Investigación Biomédica en Red de Salud Mental (ES)
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- Corresponding author
- Moreno, Carmen
- ORCID
- Moreno, Carmen
- Wykes, Til
- Galderisi, Silvana
- Nordentoft, Merete
- Crossley, Nicolas
- Jones, Nev
- Cannon, Mary
- Correll, Christoph U
- Byrne, Louise
- Carr, Sarah
- Chen, Eric Y H
- Gorwood, Philip
- Johnson, Sonia
- Kärkkäinen, Hilkka
- Krystal, John H
- Lee, Jimmy
- Lieberman, Jeffrey
- Phillips, Michael R
- Uchida, Hiroyuki
- Vieta, Eduard
- Vita, Antonio
- Arango, Celso
- Venue
- The Lancet Psychiatry
- Publisher
- Elsevier BV
- Published
- 2020-09
- Volume
- 7
- Issue
- 9
- Pages
- 813-824
- ISSN
- 2215-0366 (ISSN-L)
- PMC
- PMC7365642
- OpenAlex
- W3043299460
- Cited by
- 1,840
- References
- 144
- Citations by year
- 2026: 80 · 2025: 141 · 2024: 203 · 2023: 303 · 2022: 368 · 2021: 472 · 2020: 271
- FWCI
- 28.00
- Type
- journal article
- Language
- en
- Update notices
- erratum (2021-07-01)
- Open access
- bronze
- doi.org
- Locations
- The Lancet Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Institutional Repository University of Antioquia (University of Antioquia) (publishedVersion, cc-by-nc-nd)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
- HAL (submittedVersion)
- RMIT Research Repository (RMIT University Library) (submittedVersion)
- DR-NTU (Nanyang Technological University) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- European Commission
- European Research Council (724809)
- National Natural Science Foundation of China (81371502, 81761128031, PI15/00283, PI18/00805)
- Departament de Salut, Generalitat de Catalunya (SLT006/17/00357)
- National Institute for Health and Care Research (NF-SI-0514-10028)
- Innovative Medicines Initiative (115916, 777394)
- King's College London (IS-BRC-1215-20018)
- Fundación Mutua Madrileña
- Centro de Investigación Biomédica en Red de Salud Mental
- Fundación Alicia Koplowitz
- European Regional Development Fund
- Horizon 2020 Framework Programme
- Instituto de Salud Carlos III (PI16/02012, PI17/02227, PI19/024, SAM16PE07CP1)
- Ministerio de Ciencia e Innovación
- Seventh Framework Programme (FP7-4-HEALTH-2009-2.2.1-2-241909, FP7-HEALTH-2013-2.2.1-2-602478)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- COVID-19 pandemic, mental health services, mental health service delivery, health disparities, continuity of care, infection control, lockdown, economic impact, service user involvement
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Mental Disorders, Health Personnel, Humans, Mental Health Services, Pneumonia, Viral, Telemedicine, Coronavirus Infections, Pandemics
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