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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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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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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BackgroundPerceived urban green spaces and youth mental health in the post-COVID-19 era
Mollaesmaeili, M., Hakimian, P., & Lak, A. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1265682 · Cited by 14
Ding, W., Wang, M., Zeng, X., Liu, Z., Meng, Y., Hu, H., Zhang, Y., Guan, Y., Meng, F., Zhang, J., et al. (2024) · World Journal of Psychiatry · doi:10.5498/wjp.v14.i5.704 · Cited by 11
SARS-CoV-2 Psychiatric Sequelae: An Urgent Need of Prevention
Bottemanne, H., Delaigue, F., & Lemogne, C. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.738696 · Cited by 11
Li, J., Wang, G., Wang, Z., Wang, W. Y., Chen, H., & He, M. (2021) · International Journal of Geoheritage and Parks · doi:10.1016/j.ijgeop.2021.09.001 · Cited by 13
Ten Tips for the Facilitation of Virtual Groups
Guth, L. J., Pepper, E. L., Stephens, A. F., Pollard, B. L., & Garrow, J. (2021) · The Journal for Specialists in Group Work · doi:10.1080/01933922.2021.1984620 · Cited by 12
“…shift in treatment delivery will serve mental health workers well as they continue adapting to a world that is increasingly reliant on the use of technology and to the ever-evolving landscape of the mental health delivery system (Kopelovich et al., 2021; Moreno et al., 2020; Taylor et al., 2020).”
BackgroundSánchez-Guarnido, A. J., Huertas, P., Garcia-Solier, R., Solano, M., Díez, B., de León, M. S.-M., & Herruzo, J. (2021) · Healthcare · doi:10.3390/healthcare10010064 · Cited by 11
“It can therefore be concluded that the socio-economic disadvantages experienced by people with SMDs are particularly likely to put them at risk of suffering the direct and indirect effects of the pandemic [26,40].”
BackgroundCOVID-19 pandemic influence on self-reported health status and well-being in a society
Moniuszko-Malinowska, A. M., Czupryna, P., Dubatówka, M., Łapińska, M., Kazberuk, M., Szum-Jakubowska, A., Sołomacha, S., Sowa, P., Kiszkiel, Ł., Szczerbiński, Ł., et al. (2022) · Scientific Reports · doi:10.1038/s41598-022-12586-7 · Cited by 11
“It was also previously reported, that physical isolation from family members or loved ones during quarantine or hospital stay can produce psychological instability among people with COVID-19 18 .”
BackgroundLü, M., & Liao, X. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.946944 · Cited by 11
“Use video/voice calls Yes 13,836 (48) 2,049 (15) 11,740 (85) 9,248 (88) 1,409 (12) ***+++”
BackgroundNew‑onset neuropsychiatric sequelae and ‘long‑COVID’ syndrome (Review)
Efstathiou, V., Stefanou, M., Demetriou, M., Siafakas, N., Katsantoni, E. Z., Makris, M. P., Tsivgoulis, G. K., Zoumpourlis, V., Kympouropoulos, S. P., Tsoporis, J. N., et al. (2022) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2022.11641 · Cited by 12
Sheriff, R. S., Hong, J. S. W., Henshall, C. L., D’Agostino, A., Tomassi, S., Stein, H., Cerveri, G., Cibra, C., Bonora, S., Giordano, B., et al. (2023) · BMJ Mental Health · doi:10.1136/bmjment-2022-300646 · Cited by 12
Mihretu, A., Fekadu, W., Alemu, A. A., Amare, B., Assefa, D., Misganaw, E., Ayele, A. N., Esleman, O., Assefa, Z., Alem, A., et al. (2023) · International Journal of Mental Health Systems · doi:10.1186/s13033-023-00612-8 · Cited by 9
“COVID-19 prevention strategies are in stark opposition to what is recommended to facilitate recovery in people with mental health conditions [53].”
BackgroundAn Analysis of the Great Disruption of COVID-19 Pandemic
Richardson, K. (2024) · SocioEconomic Challenges · doi:10.61093/sec.8(1).219-239.2024 · Cited by 11
Ethical Considerations in Providing Electroconvulsive Therapy during the COVID-19 Pandemic
Robertson, J., Flint, A. J., Blumberger, D. M., & Bhat, V. (2021) · The Canadian Journal of Psychiatry · doi:10.1177/0706743721993617 · Cited by 11
“Careful ethical reflection about how service changes are to be managed or whether they can be avoided is imperative for mitigating harms to patients and moral injury among service providers.(1,9) The purpose of this article is to discuss key ethical issues that have arisen related to providing ECT during the COVID-19…”
BackgroundShapiro, P. A., Brahmbhatt, K., Caravella, R. A., Erickson, J. M., Everly, G. S., Giles, K., Gopalan, P. R., Greenspan, H. N., Huijon, R. M., Key, R. G., et al. (2021) · Journal of the Academy of Consultation-Liaison Psychiatry · doi:10.1016/j.jaclp.2021.05.001 · Cited by 12
Argento, E., Christie, D., Mackay, L., Callon, C., & Walsh, Z. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.716593 · Cited by 12
Mental Health Needs Assessment During the COVID-19 Pandemic: Consensus Based on Delphi Study
Makivić, I., Švab, V., & Selak, Š. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.732539 · Cited by 11
“Research about mental health services in this context is also an opportunity (36) for service organization improvements and to address mental health needs with the engagement of professional organizations, a political review of mental health plans and policies, and consultation with service users (37).”
BackgroundOnline mental health care during the COVID-19 pandemic
Guedes, A. D. C., Kantorski, L. P., Willrich, J. Q., Coimbra, V. C. C., Wünsch, C. G., Sperb, L. C. S. D. O., & Sperb, C. B. (2021) · Revista Brasileira de Enfermagem · doi:10.1590/0034-7167-2021-0554 · Cited by 15
“In addition, knowledge of countries with a history of deploying digital services to widely dispersed populations (such as Australia and Canada) can be useful (15) .”
Panariello, F., Longobardi, S., Cellini, L., Ronchi, D. D., & Atti, A. R. (2021) · World Journal of Psychiatry · doi:10.5498/wjp.v11.i11.1095 · Cited by 11
Going Virtual During a Pandemic: An Academic Psychiatry Department’s Experience with Telepsychiatry
Parikh, S. V., Taubman, D. S., Grambeau, M., Menke, R. A., Blazek, M. C., Sullivan, J., Severe, J., Patel, P. D., & Dalack, G. W. (2025) · Psychopharmacology Bulletin · doi:10.64719/pb.4392 · Cited by 11
Zhang, L., Li, N., Li, Y., Zhang, T., Li, D., Liu, Y., Liu, X., & Hao, W. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1027695 · Cited by 11
Bartram, T., Byrne, L., Wang, Y., & Jiang, Z. (2024) · Personnel Review · doi:10.1108/pr-07-2024-935 · Cited by 12
Self-citationWalter, N., Rupp, M., Hinterberger, T., & Alt, V. (2021) · PubMed Central · doi:10.1007/s00132-021-04088-7 · Cited by 10
“Da mit langanhaltenden Belastungen gerechnet werden muss, ist es dringend erforderlich, die Förderung der psychischen Gesundheit und die Prävention nicht nur in der Orthopädie und Unfallchirurgie, sondern auch global zu verstärken [18].”
BackgroundMitchell, S. B., Cartwright, L., Gude, A., Bethel, A. C., Hunt, H. A., Smith, J. R., Hayes, D., Bertotti, M., Jarvis-Beesley, P., Berry, V., et al. (2025) · BMC Public Health · doi:10.1186/s12889-025-24413-5 · Cited by 13
“In light of the recent pandemic, which has impacted upon demand and availability of services, understanding how pathways to care may need to be adapted is also an important consideration [27, 41].”
Giron‐Hernandez, C., Han, J. H., Alberio, R., Singh, A., García‐Portilla, M. P., Pompili, M., Knight, R. K., Richarz, U., Gopal, S., & Antunes, J. (2023) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s400342 · Cited by 10
Lee, S. K., Lim, Y., Jeong, S., & Han, H. W. (2023) · Annals of the Academy of Medicine Singapore · doi:10.47102/annals-acadmedsg.202331 · Cited by 10
Aymerich, C., Pedruzo, B., de Pablo, G. S., Olazabal, N., Catalán, A., & Torres, M. Á. G. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1380401 · Cited by 12
Progress in research on tourists with mental disorders: A critical review and the way forward
Jiang, Y., Lyu, C., & Balaji, M. S. (2024) · Tourism Management · doi:10.1016/j.tourman.2024.105083 · Cited by 10
Capturing Public Concerns About Coronavirus Using Arabic Tweets: An NLP-Driven Approach
Bahja, M., Hammad, R., & Kuhail, M. A. (2020) · IEEE/ACM International Conference on Utility and Cloud Computing (UCC) · doi:10.1109/ucc48980.2020.00049 · Cited by 10
“…impact of COVID-19 on socio-economic aspects, the focus on mental health of the people due to vast changes in lifestyles resulting out of lockdowns, physical distancing, and other containment strategies; and the resulting economic breakdown could increase the risk of mental health problems [7].”
BackgroundImpact of COVID-19 pandemic on emergency psychiatry-Millcreek community hospital, Erie, PA
Janoczkin, A., Kiers, S., Edara, N., He, P., & Li, Y. (2021) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2021.152255 · Cited by 9
Evidence of Stability in Patient-Reported Global Health During the COVID-19 Pandemic
Lapin, B. R., Tang, W. H. W., Honomichl, R. D., Hogue, O., & Katzan, I. L. (2021) · Value in Health · doi:10.1016/j.jval.2021.06.009 · Cited by 10
Climate change and mental health: time for action and advocacy
Power, E., McCarthy, N., Kelly, I., Cannon, M. D., & Cotter, D. (2022) · Irish Journal of Psychological Medicine · doi:10.1017/ipm.2021.70 · Cited by 11
“We have recently experienced the mental health impacts of the COVID-19 pandemic (Moreno et al. 2020).”
BackgroundSelf-citationPaniagua-Ávila, A., Ramírez, D. E., Barrera-Pérez, A., Calgua, E., Castro, C., Peralta-García, A., Mascayano, F., Susser, E., Alvarado, R., & Puac‐Polanco, V. (2022) · Revista Panamericana de Salud Pública · doi:10.26633/rpsp.2022.79 · Cited by 11
Barlati, S., Nibbio, G., Bianchi, F. P., Gigli, E. B. L., Calzavara‐Pinton, I., Cerati, C., Fiori, J., Lisoni, J., Deste, G., & Vita, A. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114878 · Cited by 10
“an interesting finding, particularly in light of the fact that the COVID-19 pandemic strongly accentuated the barriers to access mental health care for many patients (Moreno et al., 2020; Spagnolo et al., 2022; World Health Organization, 2020).”
Self-citationImpact of COVID-19 on the Italian Mental Health System: A Narrative Review
Carpiniello, B., & Vita, A. (2022) · Schizophrenia Bulletin Open · doi:10.1093/schizbullopen/sgac038 · Cited by 11
Self-citationGamoran, A., & Doron, G. (2023) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2023.100782 · Cited by 10
Telepsychology in Europe since COVID-19: How to Foster Social Telepresence?
Haddouk, L., Milcent, C., Schneider, B., Daele, T. V., & Witte, N. A. J. D. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12062147 · Cited by 12
“The pandemic context constrained people to being isolated, unemployed, inactive, and with low social support which increased patients’ exposure to factors known to exacerbate mental health disorders [2].”
Background
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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