The revised version is currently only available in English. Nevertheless, the findings provide several interesting observations that could have implications for the response to the current and future pandemics and for future research. The content is primarily evidence-based but ideas… Read more » Improving the mental health and wellbeing of the population is a national priority because this is recognised as having a positive effect on many different aspects of society. b. Denotes range of number of admissions per week during period. "clr": false, It is also conceivable that some gatekeepers may have believed certain in-patient mental health services were closed during lockdown. Furthermore, when patients do present at emergency departments, delays in mental health assessments and psychiatric admissions may occur as a consequence of requiring confirmation of negative COVID-19 test results.Reference Xiang, Ning and Kayser13 Equally, admission-related decisions made by mental health professionals may have been altered by COVID-19-related concerns, resulting in a heightened clinical threshold for deciding to admit a patient. Supplementary material is available online at https://doi.org/10.1192/bjo.2020.104. Mental Health Act: your rights (easy read) The reduced admissions to acute mental health services for adults should be interpreted with some caution, however, as shortly after commencement of lockdown, one of the seven acute mental health adult wards (a 20-bedded ward) was temporarily converted to a CAMHS ward, as the previous CAMHS ward being used pre-lockdown, based at a separate hospital site, was closed. Retrospective Trust data was collected from electronic case records pertaining to weekly admissions during a 16-week-period from 27 January 2020 to 17 May 2020, corresponding to the 8 weeks immediately prior to (27 January–22 March 2020) and immediately subsequent to (23 March–17 May 2020) COVID-19 government-regulated lockdown in the UK on 23 March 2020 (referred to as the pre-lockdown and lockdown periods, respectively). As a result of the small numbers of serious incidents, no statistical analysis was performed for this variable, but descriptive data is presented. Please tell us the format you need. 82 KB. Alongside physical morbidity and mortality, pandemics such as COVID-19 can have a significant impact on the mental health of the affected population.Reference Chakraborty5 This may have a consequent effect on the number of referrals to specialist mental health services, as well as the number of admissions to mental health in-patient units. This item of legislation is currently only available in its original format. Few changes were observed in the numbers of serious incidents during this time (pre-lockdown n = 23; lockdown n = 20). Regarding healthcare factors, it is possible the referral reduction could reflect a reduced healthcare workforce, because of staff self-isolating or being on sickness absence leave with COVID-19 symptoms.Reference Adams and Walls11 Public health messaging has encouraged patients to avoid immediately attending emergency departments if possible,12 which usually provide a major entry point for the mental healthcare system,Reference Xiang, Ning and Kayser13 and data from both England and China demonstrate substantial reductions in emergency department attendance. 2016. A service provided in England, Scotland or Northern Ireland which is the equivalent of a secondary mental health service provided in Wales is to be regarded as a secondary mental health service for the purposes of section 22 (entitlement to assessment) and section 23 (assessments: the relevant discharge period) of the Measure. 3. Student mental health is not just a post-secondary concern; it is a societal issue with ripple effects on everything from health care, to the workplace and the economy. "languageSwitch": true Method. 3. A draft of this instrument, has been laid before the National Assembly for Wales in accordance with section 52(5)(a) of the Measure, and approved by resolution of the National Assembly for Wales. See section 5 (meaning of “local primary mental health support services”) of the Measure for the meaning of local primary mental health support services. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, Copyright © The Author(s), 2020. This paper reports the numbers of referrals and admissions to mental health services in a large geographical area within England in the weeks immediately preceding and during COVID-19 lockdown. b. Denotes range of number of referrals per week during period. Render date: 2020-12-02T15:41:21.724Z If you need a more accessible version of this document please email digital@gov.wales. "lang": "en" This site additionally contains content derived from EUR-Lex, reused under the terms of the Commission Decision 2011/833/EU on the reuse of documents from the EU institutions. Professor Ford stresses that mental health should not be seen as a bigger problem for secondary schools. Referrals to all service types within Core AMH reduced significantly (P < 0.05), except the forensic service, where there was a slight increase (pre-lockdown n = 51; lockdown n = 64). The Welsh Ministers' Code of Practice on the carrying out of Regulatory Impact Assessments was considered in relation to this Order. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists, Hostname: page-component-79f79cbf67-xsjvs In this Order “the Measure” (“y Mesur”) means the Mental Health (Wales) Measure 2010. Please note that individual numbers of serious incidents within psychiatric subspecialties have not been reported in order to comply with statistical disclosure standards. The Welsh Ministers make this Order in exercise of the powers conferred by sections 49(4) and 52(2) of the Mental Health (Wales) Measure 2010(1). S.T., V.C., H.H., P.P., H.B. No eLetters have been published for this article. Leicestershire Partnership NHS Trust (LPT) serves around one million people living in both urban and rural areas within Leicester City (approximately 350 000), Leicestershire (approximately 690 000) and Rutland (approximately 40 000).8 Compared with England, the population served by LPT has a higher proportion of individuals in their late teens and early twenties, with lower proportions of young children, as well as people in the 30–50 and >70 year age groups. "metricsAbstractViews": false, Excepting the place of safety service (pre-lockdown n = 42; lockdown n = 27), all services within AMH saw significant decreases in referrals. Original (As Enacted or Made) - English: The original English language version of the legislation as it stood when it was enacted or made. Psychology referral info. This primary care evidence suggests that social prescribing could be extended to secondary mental health services (Friedli and Watson, 2004) as a treatment option available to Community Mental Health Teams(CMHTs) supporting people with more serious mental health conditions that cannot be treated in primary care settings. Does the individual have a psychological difficulty which is of at least moderate severity... Memory Services referral: SPA. What is Secondary Health Care? In this paper we report the patterns of both mental health referrals and admissions in one geographical region of the UK in two 8-week periods, immediately prior to lockdown, and immediately following the commencement of lockdown. general hospital services (short stay wards, and consultation-liaison services to other medical departments), can manage acute episodes of mental … I have extracted fatal incident data September 2017 to September 2020 for NHS trusts with specialist mental health services from the following annual NRLS reports: NRLS monthly report 2017-2018. Close this message to accept cookies or find out how to manage your cookie settings. Future research is required to elucidate the medium–long-term impact of COVID-19 and lockdown on mental health patients and their patterns of service utilisation. http://creativecommons.org/licenses/by/4.0/, https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200813-covid-19-sitrep-206.pdf?sfvrsn=bf38f66b_6, https://www.gov.uk/government/speeches/pm-address-to-the-nation-on-coronavirus-23-march-2020, https://www.leicspart.nhs.uk/wp-content/uploads/2019/11/2017-MYEs-and-2011-Census-demographic-profiles-LLR-LAs-UAs-DCs-v7.pdf, https://www.england.nhs.uk/wp-content/uploads/2015/04/serious-incidnt-framwrk-upd.pdf, https://www.hra.nhs.uk/planning-and-improving-research/policies-standards-legislation/governance-arrangement-research-ethics-committees, https://www.nhs.uk/conditions/coronavirus-covid-19/social-distancing/using-the-nhs-and-other-health-services/, https://doi.org/10.1080/01634372.2020.1779160, https://www.gov.uk/government/publications/full-guidance-on-staying-at-home-and-away-from-others, https://www.gov.uk/coronavirus/worker-support, https://www.gov.uk/government/news/first-food-parcels-delivered-to-clinically-vulnerable-people. the term 'community mental health services' covers much more than primary health care as it also encompasses a range of secondary and tertiary mental health care delivered by services based in community settings outside hospital campuses. for this article. In the UK, the COVID-19 government-regulated lockdown came into immediate effect on the 23 March 2020, following a statement by Prime Minister Boris Johnson.7 During the lockdown, UK residents were only permitted to leave their homes for very limited purposes, including shopping for basic necessities, one form of exercise per day, any medical need or to provide care or help a vulnerable person, and travelling to and from work, but only when absolutely necessary. The COVID-19 lockdown remained consistently in effect throughout the entire lockdown period described in this study. the original print PDF of the as enacted version that was used for the print copy, lists of changes made by and/or affecting this legislation item, confers power and blanket amendment details, links to related legislation and further information resources, the original print PDF of the as made version that was used for the print copy. The project is intended to report findings from the first phase (qualitative interviews) in Autumn 2020. Feature Flags: { Serious incidents during this time frame were also analysed. The secondary care mental health services for adults and young people with coexisting severe mental illness and substance misuse path for the coexisting severe mental illness and substance misuse: assessment and management in healthcare settings pathway. Treatment is provided by, for instance, a psychiatrist or clinical psychologist working in … Mental health services are free on the NHS, but in some cases you'll need a referral from your GP to access them. Encouraging an integrated model of care that incorporates mental health, substance abuse, and physical health care services into coordinated care systems. Data pertaining to mental health referral and hospital admissions to adult mental health, child and adolescent mental health, intellectual disability and mental health services for older people were collated retrospectively from electronic records for both 8 weeks pre-lockdown and the first 8 weeks of lockdown in England. Numbers of serious incidents in the pre-lockdown and lockdown periods were similar, with 23 incidents pre-lockdown, compared with 20 incidents in lockdown. Although one may have suspected that reduced numbers of referrals and admissions would have reflected in increased crisis situations and related serious untoward incidents, this was not observed in our study. Article 4 of this Order provides that services in England, Scotland or Northern Ireland which are the equivalent of secondary mental health services provided in Wales are to be regarded as secondary mental health services for certain purposes in Part 3 of the Measure. Behavioral Health Integration (BHI) is one approach that can improve access to mental health services for children and their families. This research should incorporate the sociodemographic and clinical characteristics of patients, such as age, gender, ethnicity and whether the patient has a history of engagement with psychiatric services. While mental health challenges get more common as children get older, many of … It has been written by a group of primary mental health care experts, in consultation with patients and carers. Tertiary care … This guide describes what good quality, modern, primary mental health care services look like. were involved in the acquisition of the data. Secondary mental health care is intended for patients with serious and complex psychiatric disorders, like ADHD, anxiety disorder or post-traumatic stress disorder (PTSD). Secondary care is services which generally will need a referral from a GP. The Emotional Wellbeing Service provides a bridge between primary and secondary mental health services in Sheffield. In order to comply with statistical disclosure standards, where data values within individual cells were less than five, specific values were not reported. A care and treatment plan is for individuals receiving secondary mental health services under The Mental Health (Wales) Measure (2010). This compares with 20 serious incidents in the lockdown period, including 12 in the community setting and 8 in the in-patient hospital setting. The data reported here is from a single healthcare trust in England, and thus may not be generalisable to all regions. Admissions data was also collected for child and adolescent mental health services (CAMHS) and mental health services for older people (MHSOP) beds. This includes both clinical treatment, and support and recovery care. Table 2 Referrals pre-lockdown and during lockdown. The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on both the physical and mental well-being of the global population. Partnering with state officials and other stakeholders to design and implement primary, secondary, and tertiary mental health-focused awareness campaigns. "isLogged": "0", As many people with psychiatric needs rely on members of their support network providing a caring role in order to function, it is possible that the public health messaging of ‘stay at home’20 and the government scheme of furloughing employees21 may have facilitated the availability of increased social/familial support within the household. Services and treatment which are made available as local primary mental health support services … "openAccess": "1", This would help to inform public health strategies and healthcare resource planning and help to ensure mental health services are available for individuals and populations that require them. If you're worried about a child or need advice and support for coping with anything affecting your child's emotional or mental health. Additionally, the population served by LPT has greater ethnic diversity (with 21.6% of people coming from a Black and minority ethnic background, compared with 14.6% for England), lower rates of disability (with 16.5% of people reporting limitations on their day-to-day activities compared with 17.6% for England), and a slightly higher proportion of married people (48.8%, compared with 46.6% for England).8. 1). For raw data pertaining to numbers of admissions on a week-by-week basis, please refer to Supplementary Table 1 available at https://doi.org/10.1192/bjo.2020.104. Minister for Health and Social Services, one of the Welsh Ministers. Research on the mental health of trafficked children is limited, and little is known about the use of mental health services by this group. Secondary mental health services include the community mental health team (CMHT), assertive outreach team and early intervention team. Statistically significant (P < 0.05) decreases in admissions were observed for acute mental health services for adults (pre-lockdown n = 152; lockdown n = 121), as well as MHSOP (pre-lockdown n = 64; lockdown n = 47) (Table 1 and Fig. There are several potential explanations for reduced referrals and admissions to secondary mental health services. See section 2 (joint schemes for the provision of local primary mental health support services) and section 4 (failures to agree schemes) of the Measure regarding schemes for the provision of local primary mental health support services in local authority areas. } To describe secondary mental health service utilisation pre-lockdown and during lockdown within Leicestershire, UK, and the numbers of serious incidents during this time frame. Secondary care services are usually provided by specialist teams made up of a variety of health professionals lead by consultants. Indeed, a recent French studyReference Pignon, Gourevitch, Tebeka, Dubertret, Cardot and Dauriac-Le Masson6 reports a 54% reduction in psychiatric emergency consultations in the 4 weeks immediately subsequent to COVID-19 lockdown, compared with the equivalent 4-week period in 2019. "metrics": true, Identification of comorbid post-traumatic stress disorder (PTSD) in patients with other serious mental illness is of substantial importance given that this is associated with poorer clinical outcomes of these disorders,1 – 4 and that PTSD is a treatable disorder.5 Some studies suggest that a large proportion of patients in secondary-care mental health services with other (non-PTSD) primary diagnoses meet criteria for PTSD on screening… See section 49 (meaning of secondary mental health services) of the Measure for the meaning of secondary mental health services. It might be considered that patients being admitted to mental health services are those with higher or immediate needs; however, inferences regarding such characteristics cannot be drawn from this data. Children and young people's mental health services (CYPMHS) information for parents and carers. Latest Available (revised):The latest available updated version of the legislation incorporating changes made by subsequent legislation and applied by our editorial team. Significantly (P < 0.05) reduced referrals to a diverse range of mental health services were observed during lockdown, including child and adolescent, adult, older people and intellectual disability services. 4. No changes have been applied to the text. Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views. The authors cited possible increased strengths and improved coping strategies during disasters as a possible explanation for this phenomenon,Reference Pfefferbaum and North16 as such a trend in mental health presentations was also observed following the September 11 World Trade Centre terrorist attacks.Reference Bonanno, Galea, Bucciarelli and Vlahov19.