Impact of the COVID‐19 pandemic on older adults mental health services: A mixed methods study

  1. Rohan Bhome
  2. Jonathan Huntley
  3. Christian Dalton‐Locke
  4. Norha Vera San Juan
  5. Sian Oram
  6. Una Foye
  7. Gill Livingston

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Abstract

Objectives

The COVID‐19 pandemic has had a significant impact on older adults mental health care. Our study aimed to explore staff perspectives on key challenges and innovations in order to help inform the delivery of older adults mental health care in subsequent waves of the pandemic.

Methods

A mixed methods online questionnaire developed by National Institute for Health Research Mental Health Policy Research Unit was used to gather staff perspectives on their challenges at work, problems faced by service users and their carers, and sources of help and support. Descriptive statistics were used for quantitative analysis and descriptive content analysis for qualitative analysis.

Results

158 participants, working in either community or inpatient settings, and from a range of professional disciplines, were included. For inpatient staff, a significant challenge was infection control. In the community, staff identified a lack of access to physical and social care as well as reduced contact with friends and families as being challenges for patients. Remote working was seen as a positive innovation along with COVID‐19 related guidance from various sources and peer support.

Conclusion

Our study, with a focus on staff and patient well‐being, helps to inform service development for future waves of the pandemic. We discuss measures to improve infection control in inpatient settings, the role of voluntary organisations in supporting socially isolated community patients, the need for better integration of physical and mental health services at an organisational level, and the importance of training staff to support patients and their families with end of life planning.

Article activity feed

  1. Version published to 10.1002/gps.5596
  2. ScreenIT

    SciScore for 10.1101/2020.11.14.20231704: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Coding matrices were developed using Microsoft Excel, with the emerging codes in columns and participants’ responses in rows.
    Microsoft Excel
    suggested: (Microsoft Excel, RRID:SCR_016137)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations: Our study has several limitations. There is a risk of sampling bias given that the survey was disseminated through channels which may not have been accessed by all mental health staff. Further, respondents may overly represent those who had strong feelings about the impact of the COVID-19 pandemic and therefore wished to have a platform to voice these. As in the broader survey, non-white mental health staff would appear to be underrepresented [15]. Our study sought to consider the challenges faced by older adult mental health services and the implications for the future, especially in the context of subsequent waves of infection in the pandemic. To truly do this, it would be important to gather perspectives from patients and carers too. While our work did consider patients’ and carers’ difficulties during the pandemic, these were from the perspective of staff. We were unable to evaluate the impact of COVID-19 on the delivery of older adult mental health care in care homes, due to the limited number of these respondents. This forms an important group of patients especially given the significant mortality and challenges faced by care homes during this pandemic [25]. Implications: In inpatient settings, clear protocols for infection control and access to appropriate PPE will be important in subsequent waves of COVID-19. In the community, the impact of the loss of patients’ usual support networks may be mitigated through the help provided by third sector organsiation...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • No funding statement was detected.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.11.14.20231704v1 on medRxiv