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.