open access publication

Article, 2023

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

HEALTH POLICY, ISSN 0168-8510, 0168-8510, Volume 136, 10.1016/j.healthpol.2023.104878

Contributors

Cummings, J. R. Fraser (Corresponding author) [1] [2] Zhang, Xinyue 0000-0002-6526-6833 [1] [2] Gandre, Coralie 0000-0002-0178-5626 [3] [4] [5] [6] [7] [8] Morsella, Alisha [9] [10] Shields-Zeeman, Laura [11] [12] Winkelmann, Juliane [13] Allin, Sara 0000-0002-0579-8985 [14] Augusto, Gonçalo Figueiredo 0000-0002-1383-1319 [15] Cascini, Fidelia 0000-0001-6499-0734 [9] [10] Cserhati, Zoltan [16] de Belvis, Antonio Giulio [9] [10] Eriksen, Astrid [17] Fronteira, I. 0000-0003-1406-4585 [15] [18] Jamieson, Margaret 0000-0002-9609-1108 [14] Murauskien, Liubove [19] Palmer, William L. [20] Ricciardi, Walter 0000-0002-5655-688X [9] [10] Samuel, Hadar [21] Scintee, Silvia Gabriela [22] Taube, Maris 0000-0002-1144-8586 [23] Vrangbaek, K. 0000-0002-5850-2367 [24] van Ginneken, Ewout 0000-0003-1923-3501 [17] [25]

Affiliations

  1. [1] Emory Univ, Dept Hlth Policy & Management, 1518 Clifton Rd NE,Room 650, Atlanta, GA 30322 USA
    2. [NORA names: United States; America, North; OECD];
  2. [2] Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA USA
    3. [NORA names: United States; America, North; OECD];
  3. [3] Hop Robert Debre, AP HP, Paris, France
    4. [NORA names: France; Europe, EU; OECD];
  4. [4] Hop Robert Debre, AP HP, Paris, France
    5. [NORA names: France; Europe, EU; OECD];
  5. [5] Hop Robert Debre, AP HP, Paris, France
    6. [NORA names: France; Europe, EU; OECD];

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.

Keywords

Health policy, Healthcare reform, Healthcare systems, Mental health, Telehealth

Data Provider: Clarivate

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