Use of mental health services during the pandemic
Mental health services are globally less developed compared to general
medical services and have additional access barriers (Thornicroft &
Tansella, 2013). These include stigma related to having a mental health
condition and associated utilization of mental health services (Chevance
et al., 2020), as well as unavailability of or low priority given to
such services (Öngür et al., 2020). Emerging evidence indicates that
acute COVID-19-related medical concerns and lockdown measures led to
delays in patients’ seeking psychiatric care, as has been reported for
patients with other problems, such as cardiac and neurologic conditions
Öngür et al., 2020). Studies showed decreased rates of
admissions/hospitalizations and emergency room (ER) visits (Szmulewicz
et al., 2021, Busch et al., 2022, Rømer et al., 2021), significant rates
of missed appointments (Muruganandam et al., 2020, Kertzscher et al.,
2022, Seo et al., 2021) and discontinuation of medications (Muruganandam
et al., 2020, Gupta et al., 2022) for psychiatric patients. Several
studies have examined if mental health services use differ in relation
to specific groups of mental disorders. Some found increased rates of
services use for patients with psychosis (Deren et al., 2023) and eating
disorder (Akgül et al., 2023) or general mental health outpatient visits
(Yang et al., 2020). In a retrospective chart review of psychiatric
outpatients, there was a decrease in use of mental health services for
patients with schizophrenia, depression, and anxiety disorders during a
three-month period within the pandemic, with the greatest reduction for
those with anxiety disorders (Seo et al., 2021). Mental health-related
hospitalizations and emergency department visits declined immediately
after the onset of the pandemic, again with the largest decline for
hospitalization for those with anxiety disorders (Saunders et al.,
2021). In another study, psychiatric emergency department visits were
reduced for most psychiatric diagnosis subgroups except for patients
with schizophrenia (Hamlin et al., 2022). Conflicting results could be
due to different samples or to differential availability of
telemedicine.