Impact on mental health care and on mental health service users of the COVID-19 pandemic: a mixed methods survey of UK mental health care staff
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Abstract
Purpose
The COVID-19 pandemic has potential to disrupt and burden the mental health care system, and to magnify inequalities experienced by mental health service users.
Methods
We investigated staff reports regarding the impact of the COVID-19 pandemic in its early weeks on mental health care and mental health service users in the UK using a mixed methods online survey. Recruitment channels included professional associations and networks, charities, and social media. Quantitative findings were reported with descriptive statistics, and content analysis conducted for qualitative data.
Results
2,180 staff from a range of sectors, professions, and specialties participated. Immediate infection control concerns were highly salient for inpatient staff, new ways of working for community staff. Multiple rapid adaptations and innovations in response to the crisis were described, especially remote working. This was cautiously welcomed but found successful in only some clinical situations. Staff had specific concerns about many groups of service users, including people whose conditions are exacerbated by pandemic anxieties and social disruptions; people experiencing loneliness, domestic abuse and family conflict; those unable to understand and follow social distancing requirements; and those who cannot engage with remote care.
Conclusion
This overview of staff concerns and experiences in the early COVID-19 pandemic suggests directions for further research and service development: we suggest that how to combine infection control and a therapeutic environment in hospital, and how to achieve effective and targeted tele-health implementation in the community, should be priorities. The limitations of our convenience sample must be noted.
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SciScore for 10.1101/2020.06.12.20129494: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The King’s College London research ethics committee approved this study (MRA-19/20-18372), which involved mental health staff in the UK completing an online questionnaire. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources The responses to open-ended questions were left unedited and compiled into coding matrices in Microsoft Excel, with the emerging codes in the columns and cases in rows. Microsoft Excelsuggested: (Microsoft Excel, RRID:SCR_016137)Results from OddPub: We did not detect open data. We also did not detect open code. …
SciScore for 10.1101/2020.06.12.20129494: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The King’s College London research ethics committee approved this study (MRA-19/20-18372), which involved mental health staff in the UK completing an online questionnaire. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources The responses to open-ended questions were left unedited and compiled into coding matrices in Microsoft Excel, with the emerging codes in the columns and cases in rows. Microsoft Excelsuggested: (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: This is only one perspective on the impact of the pandemic on mental health care, albeit one rooted in direct experience: it will be essential to investigate service user and carer perspectives, and to measure impacts on the mental health system more systematically as further data become available. Given the unprecedented pace of change in the world and in mental health services, we prioritised gaining a broad overview of impacts and responses, but much detail will have been missed. Our questionnaire was by necessity an ad hoc and not an established and validated tool. Our sample, gathered by disseminating our questionnaire through a range of channels, is not representative of those who work in mental health care settings, and may either over-represent people who have strong concerns about the situation or those who wish to report successful new practices. We managed to include a range of professions and work settings but did not recruit as successfully as we had hoped outside the NHS – more targeted efforts and time are likely to be needed to reach relevant staff from other sectors. Many people with mental health difficulties also come into contact with GPs, pharmacists, paramedics, and A&E doctors and nurses, especially if they are not under secondary services; we have not included these perspectives. We are especially concerned that, while we do not have any definitive overall figure for the UK mental health care workforce, it is clear that the number of non-W...
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.
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SciScore for 10.1101/2020.06.12.20129494: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Keywords COVID-19, CORONAVIRUS, PANDEMIC, MENTAL HEALTH CARE, MENTAL HEALTH STAFF, MENTAL HEALTH SERVICES Methods The King’s College London research ethics committee approved this study (MRA-19/20-18372), which involved mental health staff in the UK completing an online questionnaire. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable Four-fifths were female ( 1,378 , 80.0 % ) and almost nine-tenths were from white ethnic groups ( 1,433 , 87.0 % ) . Table 2: Resources
Software and Algorithms Sentences Resources The responses to open-ended questions were left unedited and compiled into coding … SciScore for 10.1101/2020.06.12.20129494: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Keywords COVID-19, CORONAVIRUS, PANDEMIC, MENTAL HEALTH CARE, MENTAL HEALTH STAFF, MENTAL HEALTH SERVICES Methods The King’s College London research ethics committee approved this study (MRA-19/20-18372), which involved mental health staff in the UK completing an online questionnaire. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable Four-fifths were female ( 1,378 , 80.0 % ) and almost nine-tenths were from white ethnic groups ( 1,433 , 87.0 % ) . Table 2: Resources
Software and Algorithms Sentences Resources The responses to open-ended questions were left unedited and compiled into coding matrices in Microsoft Excel , with the emerging codes in the columns and cases in rows . Microsoft Excelsuggested: (Microsoft Excel, SCR_016137)Results from OddPub: We did not find a statement about open data. We also did not find a statement about open code. Researchers are encouraged to share open data when possible (see Nature blog).
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 is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.
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