scholarly journals Changes in daily mental health service use and mortality at the commencement and lifting of COVID-19 ‘lockdown’ policy in 10 UK sites: a regression discontinuity in time design

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e049721
Author(s):  
Ioannis Bakolis ◽  
Robert Stewart ◽  
David Baldwin ◽  
Jane Beenstock ◽  
Paul Bibby ◽  
...  
Keyword(s):  
Mental Health ◽  
Inpatient Care ◽  
Service Use ◽  
Regression Discontinuity ◽  
Mental Healthcare ◽  
Service Level ◽  
Community Services ◽  
Mental Health Service Use ◽  
Healthcare Data ◽  
Early Intervention In Psychosis

ObjectivesTo investigate changes in daily mental health (MH) service use and mortality in response to the introduction and the lifting of the COVID-19 ‘lockdown’ policy in Spring 2020.DesignA regression discontinuity in time (RDiT) analysis of daily service-level activity.Setting and participantsMental healthcare data were extracted from 10 UK providers.Outcome measuresDaily (weekly for one site) deaths from all causes, referrals and discharges, inpatient care (admissions, discharges, caseloads) and community services (face-to-face (f2f)/non-f2f contacts, caseloads): Adult, older adult and child/adolescent mental health; early intervention in psychosis; home treatment teams and liaison/Accident and Emergency (A&E). Data were extracted from 1 Jan 2019 to 31 May 2020 for all sites, supplemented to 31 July 2020 for four sites. Changes around the commencement and lifting of COVID-19 ‘lockdown’ policy (23 March and 10 May, respectively) were estimated using a RDiT design with a difference-in-difference approach generating incidence rate ratios (IRRs), meta-analysed across sites.ResultsPooled estimates for the lockdown transition showed increased daily deaths (IRR 2.31, 95% CI 1.86 to 2.87), reduced referrals (IRR 0.62, 95% CI 0.55 to 0.70) and reduced inpatient admissions (IRR 0.75, 95% CI 0.67 to 0.83) and caseloads (IRR 0.85, 95% CI 0.79 to 0.91) compared with the pre lockdown period. All community services saw shifts from f2f to non-f2f contacts, but varied in caseload changes. Lift of lockdown was associated with reduced deaths (IRR 0.42, 95% CI 0.27 to 0.66), increased referrals (IRR 1.36, 95% CI 1.15 to 1.60) and increased inpatient admissions (IRR 1.21, 95% CI 1.04 to 1.42) and caseloads (IRR 1.06, 95% CI 1.00 to 1.12) compared with the lockdown period. Site-wide activity, inpatient care and community services did not return to pre lockdown levels after lift of lockdown, while number of deaths did. Between-site heterogeneity most often indicated variation in size rather than direction of effect.ConclusionsMH service delivery underwent sizeable changes during the first national lockdown, with as-yet unknown and unevaluated consequences.

scholarly journals Subclinical psychotic experiences and subsequent contact with mental health services

BJPsych Open ◽  
2017 ◽  
Vol 3 (2) ◽  
pp. 64-70 ◽  
Author(s):  
Vishal Bhavsar ◽  
James H. Maccabe ◽  
Stephani L. Hatch ◽  
Matthew Hotopf ◽  
Jane Boydell ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Service Use ◽  
Mental Health Problems ◽  
Cox Regression ◽  
Mental Healthcare ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Psychotic Experiences

BackgroundAlthough psychotic experiences in people without diagnosed mental health problems are associated with mental health service use, few studies have assessed this prospectively or measured service use by real-world clinical data.AimsTo describe and investigate the association between psychotic experiences and later mental health service use, and to assess the role of symptoms of common mental health disorders in this association.MethodWe linked a representative survey of south-east London (SELCoH-1, n=1698) with health records from the local mental healthcare provider. Cox regression estimated the association of PEs with rate of mental health service use.ResultsAfter adjustments, psychotic experiences were associated with a 1.75-fold increase in the rate of subsequent mental health service use (hazard ratio (HR) 1.75, 95% CI 1.03–2.97) compared with those without PEs. Participants with PEs experienced longer care episodes compared with those without.ConclusionsPsychotic experiences in the general population are important predictors of public mental health need, aside from their relevance for psychoses. We found psychotic experiences to be associated with later mental health service use, after accounting for sociodemographic confounders and concurrent psychopathology.

scholarly journals Psychotic experiences, psychiatric comorbidity and mental health need in the general population: a cross-sectional and cohort study in Southeast London

2019 ◽  
pp. 1-11 ◽  
Author(s):  
Vishal Bhavsar ◽  
Sarah Dorrington ◽  
Craig Morgan ◽  
Stephani L. Hatch ◽  
Philip McGuire ◽  
...  
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Service Use ◽  
Common Mental Disorders ◽  
Psychological Treatment ◽  
Mental Healthcare ◽  
Public Mental Health ◽  
Mental Health Service Use ◽  
Psychotic Experiences ◽  
Cross Sectional

Abstract Background Co-occurrence of common mental disorders (CMD) with psychotic experiences is well-known. There is little research on the public mental health relevance of concurrent psychotic experiences for service use, suicidality, and poor physical health. We aim to: (1) describe the distribution of psychotic experiences co-occurring with a range of non-psychotic psychiatric disorders [CMD, depressive episode, anxiety disorder, probable post-traumatic stress disorder (PTSD), and personality dysfunction], and (2) examine associations of concurrent psychotic experiences with secondary mental healthcare use, psychological treatment use for CMD, lifetime suicide attempts, and poor self-rated health. Methods We linked a prospective cross-sectional community health survey with a mental healthcare provider database. For each non-psychotic psychiatric disorder, patients with concurrent psychotic experiences were compared to those without psychotic experiences on use of secondary mental healthcare, psychological treatment for CMD, suicide attempt, physical functioning, and a composite multimorbidity score, using logistic regression and Cox regressions. Results In all disorders except for anxiety disorder, concurrent psychotic experiences were accompanied by a greater odds of all outcomes (odds ratios) for a unit change in composite multimorbidity score ranged between 2.21 [95% confidence interval (CI) 1.49–3.27] and 3.46 (95% CI 1.52–7.85). Hazard ratios for secondary mental health service use for non-psychotic disorders with concurrent psychotic experiences, ranged from 0.53 (95% CI 0.15–1.86) for anxiety disorders with psychotic experiences to 4.99 (95% CI 1.22–20.44) among those with PTSD with psychotic experiences. Conclusions Co-occurring psychotic experiences indicate greater public mental health burden, suggesting psychotic experiences could be a marker for future preventive strategies improving public mental health.

Barriers to mental health service use in Asian American and European American college students.

2020 ◽  
Vol 11 (2) ◽  
pp. 98-107 ◽  
Author(s):  
Christina B. Gee ◽  
Gagan S. Khera ◽  
Alyssa T. Poblete ◽  
Barunie Kim ◽  
Syeda Y. Buchwach
Keyword(s):  
Mental Health ◽  
College Students ◽  
Mental Health Service ◽  
Health Service ◽  
Asian American ◽  
Service Use ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
European American

Gender, Geography, and Justice: Behavioral Health Needs and Mental Health Service Use Among Women in Rural Jails

2021 ◽  
pp. 009385482110175
Author(s):  
Erin B. Comartin ◽  
Amanda Burgess-Proctor ◽  
Jennifer Harrison ◽  
Sheryl Kubiak
Keyword(s):  
Mental Health ◽  
Behavioral Health ◽  
Rural Women ◽  
Service Use ◽  
Urban Women ◽  
Health Needs ◽  
Mental Health Service Use ◽  
Urban Men ◽  
Health Need ◽  
To Receive

This multi-jail study examines the behavioral health needs and service use in a sample of 3,787 individuals in jail, to compare women in rural jails to their gender and geography counterparts (that is rural men, urban women, and urban men). Compared to urban women (17.9%, n = 677), rural men (18.2%, n = 690), and urban men (56.1%; n = 2,132), rural women (7.6%, n = 288) had significantly higher odds of serious mental illness and co-occurring mental health and substance use disorders. Rural woman were nearly 30 times more likely to receive jail-based mental health services; however, a discrepancy between screened mental health need (43.1%, n = 124) and jail-identified mental health need (8.4%, n = 24) shows rural women are severely under-identified compared to their gender/geography counterparts. These findings have implications for the changing nature of jail populations and suggests the need to improve behavioral health identification methods.

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