National Covid Memorial

The pandemic has posed unique challenges for mental health services in England due to reduced service capacity at a time of fluctuating demand according to a new paper. Writing in the Journal of Health Services Research and Policy, Professor Russell Mannion, Dr Fred Konteh and Professor Rowena Jacobs say that mental health trusts have shown great resilience in rapidly implementing new models of care and developing creative digital solutions at speed. In particular, the rapid deployment of digital technology and the shift to remote provision has played a vital role in connecting providers with service users, and allowed healthcare professionals and teams to maintain links across health and care systems. New collaborative arrangements have been stimulated by a sudden shared sense of urgency and enabled by additional funding, a more permissive policy environment and lighter-touch regulation. 

Yet the researchers from the Universities of Birmingham and York say that the mental health workforce has been severely overstretched with a consequent significant negative impact on the wellbeing of staff, particularly for those from minority ethnic backgrounds, who have been disproportionately affected. And there are concerns that digital technology could effectively disenfranchise some vulnerable groups and exacerbate existing health inequalities. 

They argue that although the pandemic has acted as a significant catalyst for major service innovations and opened up new pathways of care in areas that over many years had made only incremental progress, those changes need to be urgently and rigorously appraised to assure their cost-effectiveness, sustainability and impact on social exclusion and health inequalities. Such changes are not only structural, but also cultural and behavioural and they argue that future evaluations should seek to identify those positive values and behaviours, which have been suppressed during the pandemic and which might need to be reinforced; those that have newly emerged and are facilitative of high performance; and those that are damaging to patient care. 

They conclude that the mental health toll of the pandemic will play out in the years, if not decades, to come and a full assessment of its repercussions on population mental health and the demand for services remains an ongoing task. 

"Careful appraisal is required to produce rigorous and relevant evidence on what has worked (how, why and for whom) and what needs retaining, modifying or abandoning before changes in mental health services are embedded and become the new normal". 

Mannion, R., Konteh, F. H. and Jacobs, R. (2022) ‘Impact of COVID-19 in mental health trusts’, Journal of Health Services Research & Policy. doi: 10.1177/13558196221116298.

Professor Russell Mannion