Challenges facing mental health systems arising from the COVID-19 pandemic: Evidence from 14 European and North American countries

Janet R Cummings; Xinyue Zhang; Coralie Gandré; Alisha Morsella; Laura Shields-Zeeman; Juliane Winkelmann; Sara Allin; Gonçalo Figueiredo Augusto; Fidelia Cascini; Zoltán Cserháti; Antonio Giulio de Belvis; Astrid Eriksen; Inês Fronteira; Margaret Jamieson; Liubovė Murauskienė; William L Palmer; Walter Ricciardi; Hadar Samuel; Silvia Gabriela Scintee; Māris Taube; Karsten Vrangbæk; Ewout van Ginneken

doi:10.1016/j.healthpol.2023.104878

Challenges facing mental health systems arising from the COVID-19 pandemic: Evidence from 14 European and North American countries

Janet R Cummings, Xinyue Zhang, Coralie Gandré, Alisha Morsella, Laura Shields-Zeeman, Juliane Winkelmann, Sara Allin, Gonçalo Figueiredo Augusto, Fidelia Cascini, Zoltán Cserháti, Antonio Giulio de Belvis, Astrid Eriksen, Inês Fronteira, Margaret Jamieson, Liubovė Murauskienė, William L Palmer, Walter Ricciardi, Hadar Samuel, Silvia Gabriela Scintee, Māris TaubeKarsten Vrangbæk, Ewout van Ginneken

Research output: Contribution to journal › Review article › peer-review

Abstract

We assessed challenges that the COVID-19 pandemic presented for mental health systems and the responses to these challenges in 14 countries in Europe and North America. Experts from each country filled out a structured questionnaire with closed- and open-ended questions between January and June 2021. We conducted thematic analysis to investigate the qualitative responses to open-ended questions, and we summarized the responses to closed-ended survey items on changes in telemental health policies and regulations. Findings revealed that many countries grappled with the rising demand for mental health services against a backdrop of mental health provider shortages and challenges responding to workforce stress and burnout. All countries in our sample implemented new policies or initiatives to strengthen mental health service delivery - with more than two-thirds investing to bolster their specialized mental health care sector. There was a universal shift to telehealth to deliver a larger portion of mental health services in all 14 countries, which was facilitated by changes in national regulations and policies; 11 of the 14 participating countries relaxed regulations and 10 of 14 countries made changes to reimbursement policies to facilitate telemental health care. These findings provide a first step to assess the long-term challenges and re-organizational effect of the COVID-19 pandemic on mental health systems in Europe and North America.

Original language	English
Article number	104878
Pages (from-to)	1-12
Number of pages	12
Journal	Health Policy
Volume	136
DOIs	https://doi.org/10.1016/j.healthpol.2023.104878
Publication status	Published - Oct 2023

Bibliographical note

Publisher Copyright:
© 2023

Funding

☆ This article has been made Open Access through funding by the European Observatory on Health Systems and Policies as part of its Health Systems and Policy Monitor ( www.hspm.org), an innovative platform that provides a detailed description of health systems and provides up to date information on reforms and changes that are particularly policy relevant.

Keywords

Health policy
Healthcare reform
Healthcare systems
Mental health
Telehealth

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.healthpol.2023.104878Licence: CC BY-NC-ND

1-s2.0-S016885102300163X-mainFinal published version, 783 KBLicence: CC BY-NC-ND

Cite this

Cummings, J. R., Zhang, X., Gandré, C., Morsella, A., Shields-Zeeman, L., Winkelmann, J., Allin, S., Augusto, G. F., Cascini, F., Cserháti, Z., de Belvis, A. G., Eriksen, A., Fronteira, I., Jamieson, M., Murauskienė, L., Palmer, W. L., Ricciardi, W., Samuel, H., Scintee, S. G., ... van Ginneken, E. (2023). Challenges facing mental health systems arising from the COVID-19 pandemic: Evidence from 14 European and North American countries. Health Policy, 136, 1-12. Article 104878. https://doi.org/10.1016/j.healthpol.2023.104878

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abstract = "We assessed challenges that the COVID-19 pandemic presented for mental health systems and the responses to these challenges in 14 countries in Europe and North America. Experts from each country filled out a structured questionnaire with closed- and open-ended questions between January and June 2021. We conducted thematic analysis to investigate the qualitative responses to open-ended questions, and we summarized the responses to closed-ended survey items on changes in telemental health policies and regulations. Findings revealed that many countries grappled with the rising demand for mental health services against a backdrop of mental health provider shortages and challenges responding to workforce stress and burnout. All countries in our sample implemented new policies or initiatives to strengthen mental health service delivery - with more than two-thirds investing to bolster their specialized mental health care sector. There was a universal shift to telehealth to deliver a larger portion of mental health services in all 14 countries, which was facilitated by changes in national regulations and policies; 11 of the 14 participating countries relaxed regulations and 10 of 14 countries made changes to reimbursement policies to facilitate telemental health care. These findings provide a first step to assess the long-term challenges and re-organizational effect of the COVID-19 pandemic on mental health systems in Europe and North America.",

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year = "2023",

month = oct,

doi = "10.1016/j.healthpol.2023.104878",

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Cummings, JR, Zhang, X, Gandré, C, Morsella, A, Shields-Zeeman, L, Winkelmann, J, Allin, S, Augusto, GF, Cascini, F, Cserháti, Z, de Belvis, AG, Eriksen, A, Fronteira, I, Jamieson, M, Murauskienė, L, Palmer, WL, Ricciardi, W, Samuel, H, Scintee, SG, Taube, M, Vrangbæk, K & van Ginneken, E 2023, 'Challenges facing mental health systems arising from the COVID-19 pandemic: Evidence from 14 European and North American countries', Health Policy, vol. 136, 104878, pp. 1-12. https://doi.org/10.1016/j.healthpol.2023.104878

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T1 - Challenges facing mental health systems arising from the COVID-19 pandemic

T2 - Evidence from 14 European and North American countries

AU - Cummings, Janet R

AU - Zhang, Xinyue

AU - Gandré, Coralie

AU - Morsella, Alisha

AU - Shields-Zeeman, Laura

AU - Winkelmann, Juliane

AU - Allin, Sara

AU - Augusto, Gonçalo Figueiredo

AU - Cascini, Fidelia

AU - Cserháti, Zoltán

AU - de Belvis, Antonio Giulio

AU - Eriksen, Astrid

AU - Fronteira, Inês

AU - Jamieson, Margaret

AU - Murauskienė, Liubovė

AU - Palmer, William L

AU - Ricciardi, Walter

AU - Samuel, Hadar

AU - Scintee, Silvia Gabriela

AU - Taube, Māris

AU - Vrangbæk, Karsten

AU - van Ginneken, Ewout

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N2 - We assessed challenges that the COVID-19 pandemic presented for mental health systems and the responses to these challenges in 14 countries in Europe and North America. Experts from each country filled out a structured questionnaire with closed- and open-ended questions between January and June 2021. We conducted thematic analysis to investigate the qualitative responses to open-ended questions, and we summarized the responses to closed-ended survey items on changes in telemental health policies and regulations. Findings revealed that many countries grappled with the rising demand for mental health services against a backdrop of mental health provider shortages and challenges responding to workforce stress and burnout. All countries in our sample implemented new policies or initiatives to strengthen mental health service delivery - with more than two-thirds investing to bolster their specialized mental health care sector. There was a universal shift to telehealth to deliver a larger portion of mental health services in all 14 countries, which was facilitated by changes in national regulations and policies; 11 of the 14 participating countries relaxed regulations and 10 of 14 countries made changes to reimbursement policies to facilitate telemental health care. These findings provide a first step to assess the long-term challenges and re-organizational effect of the COVID-19 pandemic on mental health systems in Europe and North America.

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KW - Health policy

KW - Healthcare reform

KW - Healthcare systems

KW - Mental health

KW - Telehealth

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DO - 10.1016/j.healthpol.2023.104878

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ER -

Challenges facing mental health systems arising from the COVID-19 pandemic: Evidence from 14 European and North American countries

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

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