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Edited by
Rob Waller, NHS Lothian,Omer S. Moghraby, South London & Maudsley NHS Foundation Trust,Mark Lovell, Esk and Wear Valleys NHS Foundation Trust
Edited by
Rob Waller, NHS Lothian,Omer S. Moghraby, South London & Maudsley NHS Foundation Trust,Mark Lovell, Esk and Wear Valleys NHS Foundation Trust
Edited by
Rob Waller, NHS Lothian,Omer S. Moghraby, South London & Maudsley NHS Foundation Trust,Mark Lovell, Esk and Wear Valleys NHS Foundation Trust
Edited by
Rob Waller, NHS Lothian,Omer S. Moghraby, South London & Maudsley NHS Foundation Trust,Mark Lovell, Esk and Wear Valleys NHS Foundation Trust
Edited by
Rob Waller, NHS Lothian,Omer S. Moghraby, South London & Maudsley NHS Foundation Trust,Mark Lovell, Esk and Wear Valleys NHS Foundation Trust
Mental Health is now a digital field. The last few decades have brought digital approaches to both clinical systems and service user supports. The COVID-19 pandemic has further accelerated this, highlighting both new ways of working but also major issues with our hardware and clinical systems. This book will empower those working in mental health to to gain the most from digital changes, to build better services, and to enhance the quality of care that is delivered to patients. It will update readers on the digital mental health landscape and cover technology-enabled care, big data, the challenges of technology in the NHS, and the role of professional bodies in developing future digital clinicians. In an increasingly digital world this is a critical guide for mental health professionals to realise the benefits of technology for patients.
Lockdown during the pandemic has had significant impacts on public mental health. Previous studies suggest an increase in self-harm and suicide in children and adolescents. There has been little research on the roles of stringent lockdown.
Aims
To investigate the mediating and predictive roles of lockdown policy stringency measures in self-harm and emergency psychiatric presentations.
Method
This was a retrospective cohort study. We analysed data of 2073 psychiatric emergency presentations of children and adolescents from 23 hospital catchment areas in ten countries, in March to April 2019 and 2020.
Results
Lockdown measure stringency mediated the reduction in psychiatric emergency presentations (incidence rate ratio of the natural indirect effect [IRRNIE] = 0.41, 95% CI [0.35, 0.48]) and self-harm presentations (IRRNIE = 0.49, 95% CI [0.39, 0.60]) in 2020 compared with 2019. Self-harm presentations among male and looked after children were likely to increase in parallel with lockdown stringency. Self-harm presentations precipitated by social isolation increased with stringency, whereas school pressure and rows with a friend became less likely precipitants. Children from more deprived neighbourhoods were less likely to present to emergency departments when lockdown became more stringent,
Conclusions
Lockdown may produce differential effects among children and adolescents who self-harm. Development in community or remote mental health services is crucial to offset potential barriers to access to emergency psychiatric care, especially for the most deprived youths. Governments should aim to reduce unnecessary fear of help-seeking and keep lockdown as short as possible. Underlying mediation mechanisms of stringent measures and potential psychosocial inequalities warrant further research.
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