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. 2021 Dec:4:100061.
doi: 10.1016/j.lana.2021.100061. Epub 2021 Sep 3.

The next pandemic: impact of COVID-19 in mental healthcare assistance in a nationwide epidemiological study

Felipe Ornell  1   2 , Wyllians Vendramini Borelli  3 , Daniela Benzano  1   2 , Jaqueline Bohrer Schuch  1   2 , Helena Ferreira Moura  1   2   4 , Anne Orgler Sordi  1 , Felix Henrique Paim Kessler  1   2 , Juliana Nichterwitz Scherer  1 , Lisia von Diemen  1   2
Affiliations

The next pandemic: impact of COVID-19 in mental healthcare assistance in a nationwide epidemiological study

Felipe Ornell et al. Lancet Reg Health Am. 2021 Dec.

Abstract

Background: Studies have reported the worsening of psychiatric symptoms during the COVID-19 pandemic. However, few studies have evaluated the impact on the access to mental health services during COVID-19. Our aim was to analyze temporal trends and prediction of appointments held in Brazil's public health system, to compare the observed and expected number of mental healthcare appointments during the COVID-19 pandemics.

Methods: An ecological time-series study was performed, analyzing mental health appointments before and during the pandemic (from 2016 and 2020) from the Brazilian governmental database. The structural break in the data series was assessed using the Chow test, with the break considered in March 2020. Bayesian structural time-series models were used to estimate current average appointments and the predicted expectation if there was no pandemic.

Findings: Compared to the expected, between March and August 2020 about 28% less outpatient appointments in mental health were observed, totaling 471,448 individuals with suspended assistance. Group appointments and psychiatric hospitalizations were also severely impacted by the pandemic (decreased of 68% and 33%, respectively). On the other hand, mental health emergency consultations and home care increased during this period (36% and 52%, respectively).

Interpretation: Our findings demonstrate a dramatic change in mental health assistance during the COVID-19 pandemic, which corroborates a recent WHO survey. This phenomenon can aggravate the mental health crisis and generate a parallel pandemic that may last for a longer time than the COVID-19 pandemic.

Funding: This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.

Keywords: Appointments; Covid-19; Mental health; Pandemic; Psychiatric hospitalization; Public health system; SARS-CoV-2.

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Conflict of interest statement

The authors have no conflicts of interest.

Figures

Figure 1
Figure 1
The impact of COVID-19 in temporal trends and prediction analyses of mental health appointments from 2016 to 2020. The blue line represents the expected number of appointments according to the prediction, which is based on data from previous months (January 2016 to March 2020).
See this image and copyright information in PMC

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