Remote mental health care interventions during the COVID-19 pandemic: an umbrella review

Witteveen, A.b., Young, S., Cuijpers, P., Ayuso-Mateos, J.L., Barbui, C., Bertolini, F., Cabello, M., Cadorin, C., Downes, N., Franzoi, D., Gasior, M., John, Asif, Melchior, M., McDaid, David ORCID: 0000-0003-0744-2664, Palantza, C., Purgato, M., Van Der Waerden, J., Wang, S. and Sijbrandij, M. (2022) Remote mental health care interventions during the COVID-19 pandemic: an umbrella review. Behaviour Research and Therapy, 159. ISSN 0005-7967

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Abstract

Mitigating the COVID-19 related disruptions in mental health care services is crucial in a time of increased mental health disorders. Numerous reviews have been conducted on the process of implementing technology-based mental health care during the pandemic. The research question of this umbrella review was to examine what the impact of COVID-19 was on access and delivery of mental health services and how mental health services have changed during the pandemic. A systematic search for systematic reviews and meta-analyses was conducted up to August 12, 2022, and 38 systematic reviews were identified. Main disruptions during COVID-19 were reduced access to outpatient mental health care and reduced admissions and earlier discharge from inpatient care. In response, synchronous telemental health tools such as videoconferencing were used to provide remote care similar to pre-COVID care, and to a lesser extent asynchronous virtual mental health tools such as apps. Implementation of synchronous tools were facilitated by time-efficiency and flexibility during the pandemic but there was a lack of accessibility for specific vulnerable populations. Main barriers among practitioners and patients to use digital mental health tools were poor technological literacy, particularly when preexisting inequalities existed, and beliefs about reduced therapeutic alliance particularly in case of severe mental disorders. Absence of organizational support for technological implementation of digital mental health interventions due to inadequate IT infrastructure, lack of funding, as well as lack of privacy and safety, challenged implementation during COVID-19. Reviews were of low to moderate quality, covered heterogeneously designed primary studies and lacked findings of implementation in low- and middle-income countries. These gaps in the evidence were particularly prevalent in studies conducted early in the pandemic. This umbrella review shows that during the COVID-19 pandemic, practitioners and mental health care institutions mainly used synchronous telemental health tools, and to a lesser degree asynchronous tools to enable continued access to mental health care for patients. Numerous barriers to these tools were identified, and call for further improvements. In addition, more high quality research into comparative effectiveness and working mechanisms may improve scalability of mental health care in general and in future infectious disease outbreaks.

Item Type:	Article
Official URL:	https://www.sciencedirect.com/journal/behaviour-re...
Additional Information:	© 2022 The Authors
Divisions:	Care Policy and Evaluation Centre
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine B Philosophy. Psychology. Religion > BF Psychology H Social Sciences > HV Social pathology. Social and public welfare. Criminology
Date Deposited:	18 Nov 2022 16:06
Last Modified:	16 Nov 2024 23:39
URI:	http://eprints.lse.ac.uk/id/eprint/117368

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