Negative impacts of COVID-19 lockdown on mental health service access and follow-up adherence for immigrants and individuals in socio-economic difficulties
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...
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| Veröffentlicht in: | Public health (London) 2020-09, Vol.186, p.52-56 |
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| description | 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.
The design of this study is a retrospective cross-sectional study.
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.
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.
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.
•Lockdown can have serious mental health effects on vulnerable groups.•These population subgroups also have greater difficulties in accessing health services and maintaining treatment adherence.•Access to mental health services and follow-up compliance dramatically dropped as a consequence of lockdown.•Vulnerable groups are at risk of unmet mental health needs, treatment disc |
| doi_str_mv | 10.1016/j.puhe.2020.06.055 |
| format | Article |
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The design of this study is a retrospective cross-sectional study.
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.
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.
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.
•Lockdown can have serious mental health effects on vulnerable groups.•These population subgroups also have greater difficulties in accessing health services and maintaining treatment adherence.•Access to mental health services and follow-up compliance dramatically dropped as a consequence of lockdown.•Vulnerable groups are at risk of unmet mental health needs, treatment discontinuation and possible relapse.•Proactive alternative strategies need to be developed to reach these vulnerable populations.</description><identifier>ISSN: 0033-3506</identifier><identifier>EISSN: 1476-5616</identifier><identifier>DOI: 10.1016/j.puhe.2020.06.055</identifier><identifier>PMID: 32771661</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject><![CDATA[Adherence ; Adult ; Coronavirus ; Coronavirus Infections - epidemiology ; Coronavirus Infections - prevention & control ; Coronaviruses ; COVID-19 ; Cross-Sectional Studies ; Discontinued ; Economic conditions ; Economics ; Emigrants and Immigrants - psychology ; Emigrants and Immigrants - statistics & numerical data ; Facilities and Services Utilization - statistics & numerical data ; Female ; Health needs ; Health services ; Health Services Accessibility - statistics & numerical data ; Homeless ; Homeless people ; Homeless Persons - psychology ; Homeless Persons - statistics & numerical data ; Homelessness ; Humans ; Immigrants ; Interviews ; Italy - epidemiology ; Male ; Mental disorders ; Mental health ; Mental health services ; Mental Health Services - statistics & numerical data ; Middle Aged ; Migrant workers ; Migrants ; Noncitizens ; Original Research ; Pandemics ; Pandemics - prevention & control ; Patients ; Pneumonia, Viral - epidemiology ; Pneumonia, Viral - prevention & control ; Political asylum ; Populations ; Poverty ; Reduction ; Refugees ; Refugees - psychology ; Refugees - statistics & numerical data ; Relapse ; Retrospective Studies ; Risk reduction ; Service utilisation ; Shelter in place ; Socioeconomic factors ; Socioeconomics ; Treatment Adherence and Compliance - statistics & numerical data ; Treatment compliance ; Viral diseases ; Vulnerability ; Vulnerable Populations ; Young Adult]]></subject><ispartof>Public health (London), 2020-09, Vol.186, p.52-56</ispartof><rights>2020 The Royal Society for Public Health</rights><rights>Copyright © 2020 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. Sep 2020</rights><rights>2020 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved. 2020 The Royal Society for Public Health</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-fff025fdfee13480ca1a0dd5bc40ba961f57b38933f3780fd21d491a2864d67e3</citedby><cites>FETCH-LOGICAL-c483t-fff025fdfee13480ca1a0dd5bc40ba961f57b38933f3780fd21d491a2864d67e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.puhe.2020.06.055$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,777,781,882,3537,27905,27906,30980,33755,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32771661$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aragona, M.</creatorcontrib><creatorcontrib>Barbato, A.</creatorcontrib><creatorcontrib>Cavani, A.</creatorcontrib><creatorcontrib>Costanzo, G.</creatorcontrib><creatorcontrib>Mirisola, C.</creatorcontrib><title>Negative impacts of COVID-19 lockdown on mental health service access and follow-up adherence for immigrants and individuals in socio-economic difficulties</title><title>Public health (London)</title><addtitle>Public Health</addtitle><description>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.
The design of this study is a retrospective cross-sectional study.
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.
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.
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.
•Lockdown can have serious mental health effects on vulnerable groups.•These population subgroups also have greater difficulties in accessing health services and maintaining treatment adherence.•Access to mental health services and follow-up compliance dramatically dropped as a consequence of lockdown.•Vulnerable groups are at risk of unmet mental health needs, treatment discontinuation and possible relapse.•Proactive alternative strategies need to be developed to reach these vulnerable populations.</description><subject>Adherence</subject><subject>Adult</subject><subject>Coronavirus</subject><subject>Coronavirus Infections - epidemiology</subject><subject>Coronavirus Infections - prevention & control</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Cross-Sectional Studies</subject><subject>Discontinued</subject><subject>Economic conditions</subject><subject>Economics</subject><subject>Emigrants and Immigrants - psychology</subject><subject>Emigrants and Immigrants - statistics & numerical data</subject><subject>Facilities and Services Utilization - statistics & numerical data</subject><subject>Female</subject><subject>Health needs</subject><subject>Health services</subject><subject>Health Services Accessibility - statistics & numerical data</subject><subject>Homeless</subject><subject>Homeless people</subject><subject>Homeless Persons - psychology</subject><subject>Homeless Persons - statistics & numerical data</subject><subject>Homelessness</subject><subject>Humans</subject><subject>Immigrants</subject><subject>Interviews</subject><subject>Italy - epidemiology</subject><subject>Male</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Mental health services</subject><subject>Mental Health Services - statistics & numerical data</subject><subject>Middle Aged</subject><subject>Migrant workers</subject><subject>Migrants</subject><subject>Noncitizens</subject><subject>Original Research</subject><subject>Pandemics</subject><subject>Pandemics - prevention & control</subject><subject>Patients</subject><subject>Pneumonia, Viral - epidemiology</subject><subject>Pneumonia, Viral - prevention & control</subject><subject>Political asylum</subject><subject>Populations</subject><subject>Poverty</subject><subject>Reduction</subject><subject>Refugees</subject><subject>Refugees - psychology</subject><subject>Refugees - statistics & numerical data</subject><subject>Relapse</subject><subject>Retrospective Studies</subject><subject>Risk reduction</subject><subject>Service utilisation</subject><subject>Shelter in place</subject><subject>Socioeconomic factors</subject><subject>Socioeconomics</subject><subject>Treatment Adherence and Compliance - statistics & numerical data</subject><subject>Treatment compliance</subject><subject>Viral diseases</subject><subject>Vulnerability</subject><subject>Vulnerable Populations</subject><subject>Young Adult</subject><issn>0033-3506</issn><issn>1476-5616</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>BHHNA</sourceid><recordid>eNp9kd-K1DAUh4Mo7uzqC3ghAW-8ac2fNu2ACDKuurC4N-ptyCQn04xtUpO2i8_iy5oy66JeCIEEznd-5JwPoWeUlJRQ8epYjnMHJSOMlESUpK4foA2tGlHUgoqHaEMI5wWviThD5ykdCSGs4fVjdMZZ01Ah6Ab9_AQHNbkFsBtGpaeEg8W7m69X7wq6xX3Q30y49Th4PICfVI87UP3U4QRxcRqw0hpSwsobbEPfh9tiHrEyHUTwuWxDzMGDO0TlpxPmvHGLM7PqU37jFLQLBejgw-A0Ns5ap-d-cpCeoEc2U_D07r5AX95fft59LK5vPlzt3l4Xumr5VFhrCautsQCUVy3RiipiTL3XFdmrraC2bva83XJuedMSaxg11ZYq1orKiAb4BXpzyh3n_QBG50Gj6uUY3aDiDxmUk39XvOvkISyyqci24SIHvLwLiOH7DGmSg0sa-l55CHOSrOL55IWv6It_0GOYo8_jZSpbozVjbabYidIxpBTB3n-GErm6l0e5upere0mEzO5z0_M_x7hv-S07A69PAORlLg6iTNqtmoyLoCdpgvtf_i-QW8OX</recordid><startdate>20200901</startdate><enddate>20200901</enddate><creator>Aragona, M.</creator><creator>Barbato, A.</creator><creator>Cavani, A.</creator><creator>Costanzo, G.</creator><creator>Mirisola, C.</creator><general>Elsevier Ltd</general><general>Elsevier Science Ltd</general><general>The Royal Society for Public Health. Published by Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7QL</scope><scope>7T2</scope><scope>7U3</scope><scope>7U9</scope><scope>ASE</scope><scope>BHHNA</scope><scope>C1K</scope><scope>FPQ</scope><scope>H94</scope><scope>K6X</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200901</creationdate><title>Negative impacts of COVID-19 lockdown on mental health service access and follow-up adherence for immigrants and individuals in socio-economic difficulties</title><author>Aragona, M. ; Barbato, A. ; Cavani, A. ; Costanzo, G. ; Mirisola, C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-fff025fdfee13480ca1a0dd5bc40ba961f57b38933f3780fd21d491a2864d67e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adherence</topic><topic>Adult</topic><topic>Coronavirus</topic><topic>Coronavirus Infections - epidemiology</topic><topic>Coronavirus Infections - prevention & control</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Cross-Sectional Studies</topic><topic>Discontinued</topic><topic>Economic conditions</topic><topic>Economics</topic><topic>Emigrants and Immigrants - psychology</topic><topic>Emigrants and Immigrants - statistics & numerical data</topic><topic>Facilities and Services Utilization - statistics & numerical data</topic><topic>Female</topic><topic>Health needs</topic><topic>Health services</topic><topic>Health Services Accessibility - statistics & numerical data</topic><topic>Homeless</topic><topic>Homeless people</topic><topic>Homeless Persons - psychology</topic><topic>Homeless Persons - statistics & numerical data</topic><topic>Homelessness</topic><topic>Humans</topic><topic>Immigrants</topic><topic>Interviews</topic><topic>Italy - epidemiology</topic><topic>Male</topic><topic>Mental disorders</topic><topic>Mental health</topic><topic>Mental health services</topic><topic>Mental Health Services - statistics & numerical data</topic><topic>Middle Aged</topic><topic>Migrant workers</topic><topic>Migrants</topic><topic>Noncitizens</topic><topic>Original Research</topic><topic>Pandemics</topic><topic>Pandemics - prevention & control</topic><topic>Patients</topic><topic>Pneumonia, Viral - epidemiology</topic><topic>Pneumonia, Viral - prevention & control</topic><topic>Political asylum</topic><topic>Populations</topic><topic>Poverty</topic><topic>Reduction</topic><topic>Refugees</topic><topic>Refugees - psychology</topic><topic>Refugees - statistics & numerical data</topic><topic>Relapse</topic><topic>Retrospective Studies</topic><topic>Risk reduction</topic><topic>Service utilisation</topic><topic>Shelter in place</topic><topic>Socioeconomic factors</topic><topic>Socioeconomics</topic><topic>Treatment Adherence and Compliance - statistics & numerical data</topic><topic>Treatment compliance</topic><topic>Viral diseases</topic><topic>Vulnerability</topic><topic>Vulnerable Populations</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aragona, M.</creatorcontrib><creatorcontrib>Barbato, A.</creatorcontrib><creatorcontrib>Cavani, A.</creatorcontrib><creatorcontrib>Costanzo, G.</creatorcontrib><creatorcontrib>Mirisola, C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Social Services Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>British Nursing Index</collection><collection>Sociological Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>British Nursing Index</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Public health (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aragona, M.</au><au>Barbato, A.</au><au>Cavani, A.</au><au>Costanzo, G.</au><au>Mirisola, C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Negative impacts of COVID-19 lockdown on mental health service access and follow-up adherence for immigrants and individuals in socio-economic difficulties</atitle><jtitle>Public health (London)</jtitle><addtitle>Public Health</addtitle><date>2020-09-01</date><risdate>2020</risdate><volume>186</volume><spage>52</spage><epage>56</epage><pages>52-56</pages><issn>0033-3506</issn><eissn>1476-5616</eissn><abstract>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.
The design of this study is a retrospective cross-sectional study.
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.
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.
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.
•Lockdown can have serious mental health effects on vulnerable groups.•These population subgroups also have greater difficulties in accessing health services and maintaining treatment adherence.•Access to mental health services and follow-up compliance dramatically dropped as a consequence of lockdown.•Vulnerable groups are at risk of unmet mental health needs, treatment discontinuation and possible relapse.•Proactive alternative strategies need to be developed to reach these vulnerable populations.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>32771661</pmid><doi>10.1016/j.puhe.2020.06.055</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Public health (London), 2020-09, Vol.186, p.52-56 |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7409736 |
| source | MEDLINE; Elsevier ScienceDirect Journals; Sociological Abstracts; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Adherence Adult Coronavirus Coronavirus Infections - epidemiology Coronavirus Infections - prevention & control Coronaviruses COVID-19 Cross-Sectional Studies Discontinued Economic conditions Economics Emigrants and Immigrants - psychology Emigrants and Immigrants - statistics & numerical data Facilities and Services Utilization - statistics & numerical data Female Health needs Health services Health Services Accessibility - statistics & numerical data Homeless Homeless people Homeless Persons - psychology Homeless Persons - statistics & numerical data Homelessness Humans Immigrants Interviews Italy - epidemiology Male Mental disorders Mental health Mental health services Mental Health Services - statistics & numerical data Middle Aged Migrant workers Migrants Noncitizens Original Research Pandemics Pandemics - prevention & control Patients Pneumonia, Viral - epidemiology Pneumonia, Viral - prevention & control Political asylum Populations Poverty Reduction Refugees Refugees - psychology Refugees - statistics & numerical data Relapse Retrospective Studies Risk reduction Service utilisation Shelter in place Socioeconomic factors Socioeconomics Treatment Adherence and Compliance - statistics & numerical data Treatment compliance Viral diseases Vulnerability Vulnerable Populations Young Adult |
| title | Negative impacts of COVID-19 lockdown on mental health service access and follow-up adherence for immigrants and individuals in socio-economic difficulties |
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