Table 1.
Disruptions, changes and adaptations in mental health care delivery during COVID-19 pandemic for each half year in the pandemic.
| Author, year | Disruption in access and availability MH care | Changes and adaptations synchronous TMH and asynchronous VMH care | Q | |
|---|---|---|---|---|
| Search up to first half year of 2020 | ||||
| Cabrera et al. (2020) | Less outpatient appointments and shorter inpatient stays. | Telepsychiatry (videoconferencing) | 6 | |
| Meloni et al. (2020) | Reduction psychiatric hospitalization and consultations psychiatric emergency departments. Reorganization of psychiatric departments for COVID-19 patients. Total/partial mental health services closures, home visits, (early) exit permits. | Telepsychiatry (videoconferencing, telephone) and digital health utilization (online, websites) | 4 | |
| Raphael et al. (2021) | Inpatient: increased outdoor visits; external and group activities suspended, early discharge with intensive telephone follow-up, remote risk assessment and face-to-face only for high risk. | Outpatient: online self-help (websites, apps) and telepsychiatry (videoconferencing, telephone). Inpatient: remote triaging, virtual visits by staff. | 7 | |
| Thenral and Annamalai (2020) | Not reported | Synchronous (videoconference, telephone) to asynchronous (e.g. social media, games) care using artificial intelligence. | 2 | |
| Yue et al. (2020) | Hospitals: early discharge, suspension of visits. Community and outpatient: in person visits for psychiatric emergencies only. |
Psychoeducational and self-help material distributed online (e.g. e-mails or Alihealth platforms, text-messages, WeChat) and community- (e.g. hotline) and outpatient telepsychiatry (e.g. through telephone or Zoom) | 5 | |
| Search up to second half of 2020 | ||||
| Abd-Alrazaq et al. (2021) | Not reported | Synchronous delivery and adaptations most common (77%): mostly telemedicine (85%) most often telepsychiatry (60%) and follow-up consultations (40%) (e.g. videoconferencing, telephone) and clinical decision support tools (9%; desktop or mobile apps). | 5 | |
| Abraham, Chaabna, et al. (2021) | Not reported | Telemental health (telephone, videoconferencing e.g. CBT by psychologists and psychiatrists) and digital mental health technologies (e.g. applications smartphone, websites). | 7 | |
| Ali, Khoja, and Kazim (2021) | Reduction in face-to-face mental health consultations and care. | Remote (audiovisual) telemental health (telephone and television-based technology) with trained health professionals and in internet-based mental health assessment and management of anxiety and depression. | 2 | |
| Appleton et al. (2021) | Face-to-face models of care transitioned to remote delivery | Studies report high uptake of telemental health delivery by service and care providers (videoconferencing, telephone, videos most common; email, text-messaging, online forums less common). | 6 | |
| Baumgart et al. (2021) | Reorganizing psychiatric facilities: reduced staff and outpatient appointments, less admissions, screening to discharge more easily. | Developed mental health programs to prevent onset mental health disorders (in GP, HCW, psychiatric patients) and implementation of telemental health consultations and counseling for private practice and community services. | 5 | |
| Chiesa et al. (2021) | Lower availability and postponed face-to-face services and hospital access. | Tele-psychotherapy and meetings for clinical decisions and team care (online/videoconferencing). | 4 | |
| Clemente-Suárez et al. (2021) | Closure of psychiatric services; face-to-face care only for high-risk patients; shortened inpatient stay and reduced outpatient visits. | Telepsychiatry (video or telephone calls), enhanced hotline use, psychoeducation material distributed (online). | 3 | |
| Drissi et al. (2021) | Number of patients treated by personal contact decreased significantly. | Remote psychotherapy and appointments (telephone) and internet-based mental health (e-learning content, mobile phone applications, social media platforms). | 2 | |
| Filho, Araújo, Fernandes, and Pillon (2021) | Increased demand from psychiatric institutions and restriction of visits. Reduction of hospital admission, exclusion of patients without serious mental health state, more isolation units, earlier hospital discharge, activities only for hospitalized. | Not reported. Adoption of remote services for care and visits recommended. | 3 | |
| John et al. (2021) | Reduced or same levels of presentation to services with suicidal thoughts. Higher proportion of emergency department presentations of suicide attempts (because other causes decreased). Calls for suicidal threats inversely correlated with rates of infections. | Not reported. | 8 | |
| Kane et al. (2022) | Remote care to reduce COVID-19 infection risks. | Mental health care adopted new digital technologies and integrated them for remote monitoring and assessment (online – videoconferencing and telephone assessment and care). | 2 | |
| Lemieux et al. (2020) | Release or home detention of inmates with mental health issues. Fewer and slower admission process, fewer group activities or only outdoors, suspension of therapeutic and recreational activities and more isolation. | Communication of staff online and virtual visits to patients (videoconferencing); telepsychiatry for assessment and intervention (videoconferencing, telephone). | 4 | |
| Li et al. (2021) | Not reported. | Telepsychiatry (videoconferencing, telephone): initially a decrease in service use and more no-shows, later an increase even from pre-pandemic levels and decreased no-shows. | 3 | |
| Minozzi, Saulle, Amato, and Davoli (2021) | Reduction of volunteer admissions to psychiatric hospital and reduced access to emergency department for self-harm/suicide attempts and psychiatric problems. | Not reported. | 6 | |
| Murphy et al. (2021) | Lack of access to usual care. | New online programmes, hotlines, courses through online platforms, videoconferencing and apps (esp. for HCWs). | 4 | |
| Soklaridis et al. (2020) | Not reported. | Rapidly developed new psychological interventions and support and referral systems for HCWs and COVID-19 patients (e.g. hotlines-telephone, internet-based self-help psychosocial support program). | 9 | |
| Tuczyńska et al., 2021 | Decrease in psychiatric emergency admissions, in referrals from primary care to specialized mental health care services and in mental health consultations. | No reported. | 2 | |
| Search up to first half year of 2021 | ||||
| Ardekani et al. (2021) | Not reported | Fully online services and support groups switched to online videoconferencing and group chats. Short videos addressing issues and coping strategies. Near peer monitoring through social media platforms. | 7 | |
| Bertuzzi et al. (2021) | Not reported | Telehealth delivery of mental health care strategies for caregivers (phone vs. videoconferencing). | 10 | |
| Fornaro et al. (2021) | Higher hospitalization rates | Telepsychiatry (telephone, videoconference) and online assessment of mental health (survey). | 7 | |
| Gao, Bagheri, and Furuya-Kanamori (2022) | Reduced access face-to-face treatment and support networks; reduced admissions; treatment suspension, cancellation non-urgent treatment. | Online treatment (teletherapy, videoconferencing); | 5 | |
| Keyes et al. (2022) | Not reported | Increased use of telemedicine (telephone and videoconferencing) and digital interventions in mental health care internationally. Assessment of effectiveness and feasibility of digital (online) mental health interventions. | 3 | |
| Samji et al. (2021) | Mixed findings: increase and decrease in pediatric emergency department presentation. Same or decreased levels of secondary mental healthcare referral. Higher hospitalization rates but shorter stay. | Not reported | 8 | |
| Selick et al. (2021) | Decreased service use (of virtual care) compared to in person prior to the pandemic. | Telepsychiatry (videoconferencing and telephone). | 5 | |
| Search up to second half year of 2021/early 2022 | ||||
| Devoe et al. (2022) | Increased hospital admissions (48%) in admissions for eating disorders; treatments shortened, delayed, lack of professional assistance for mental problems. | Telemental health care (videoconferencing, telephone) and VMH (instant chat-messaging) | 8 | |
| Hatami et al. (2022) | Not reported | Development of and transition to tele-medicine services (videoconference) and digital mental health care (online apps). | 5 | |
| Lignou, 2022 | Reduction in use primary care; difficulties in accessing medication. Children with neurodevelopmental conditions: restrictions to face-to-face clinician contacts. Non-urgent new referrals on hold, significantly increased waiting lists. | Increased use telemedicine within universal children's services (mainly telephone consultation or videoconferencing 98%). Increase in digital healthcare psycho-educational resources (webinars, online videos). | 6 | |
| Linardon et al. (2022) | Increased demand eating disorder services. Significant disrupted or negatively impacted treatment. | Transitioning to online treatment (telehealth, videoconferencing). | 5 | |
| Mohammadzadeh, Maserat, and Davoodi (2022) | Not reported | Some existing infrastructure was upgraded and used to provide COVID-19 adapted mental health services or new systems (online parenting tips; TMH measurement-based care and protocols) were developed. | 7 | |
| Narvaez (2022) | Not reported | Not reported | 3 | |
| Segenreich (2022) | Changes in medication treatment patterns (dosage lower or stopped) and difficulties in purchasing ADHD medication. Difficulties of evaluating and diagnosing new symptoms or comorbidities. | Videoconferencing for ADHD medication and psychotherapy and for remote monitoring of vital functions through smart-phones in ADHD medication users. | 4 | |
| Siegel et al. (2021) | Decrease in missed and cancelled appointments. | Telepsychiatry (Zoom, telephone, MyChat). | 2 | |
| Steeg et al. (2022) | High-moderate quality studies: decrease in service utilization (first months) and decrease in frequency of presentation for self-harm episodes. | Not reported. | 9 | |