A collective case study of mental health systems’ response to COVID-19: Impact on patterns of care provision for depression and anxiety in two comparable regions of Southern Europe

• G Castelpietra ^[3] ; T Niyonsenga ^[1] ; A Iruin ^[4] ; U Albert ^[2] ; A Gabilondo ^[5] ; L Salvador-Carulla ^[1]
  1. [1] University of Canberra

     University of Canberra

     Australia

     
  2. [2] University of Trieste

     University of Trieste

     Trieste, Italia

     
  3. [3] Department Adulte 2, Centre Neuchâtelois de Psychiatrie, Marin-Epagnier, Switzerland; Mental Health Flagship, Division of Country Health Policies and Systems (CPS), WHO Regional Office for Europe, Copenhagen, Denmark; Health Research Institute, Faculty of Health, University of Canberra, Bruce ACT Australia
  4. [4] Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain
  5. [5] Basque Health Service (Osakidetza), Gipuzkoa Mental Health Network, Donostia-San Sebastián, Gipuzkoa, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Gipuzkoa, Spain

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• Localización: European journal of psychiatry, ISSN 0213-6163, Vol. 39, Nº 1, 2025
• Idioma: inglés
• DOI: 10.1016/j.ejpsy.2024.100278
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  • Background and Objectives COVID-19 pandemic has affected the mental health system (MHS) globally, although significant geographical variation was found, particularly for depression and anxiety. The understanding of its impact at the regional level of the context of care is limited when compared to national evaluations.

    Methods Collective case study comparing the prior pattern of care with the first 11 months of COVID-19 in two sites: Gipuzkoa (Spain) and Friuli Venezia Giulia - FVG (Italy). Information from both sites derive from administrative data of MHS in the two regions harmonized for comparison. Data included prevalence of psychiatric diagnoses (ICD-10 F30-F39 and F40-F49 codes), number of hospitalisations, mean and range of psychiatric and psychological interventions. Significance of time-period and location difference was assessed using the Chi-square and the T-statistics for prevalence and count data, respectively.

    Results MHS is community-based in both sites. The prevalence of anxiety decreased in FVG, while a decrease in hospitalisations was found in Gipuzkoa. Both sites registered an increase in psychiatric visits for anxiety and depression. In both periods, FVG showed significant lower prevalence of diagnoses, but higher mean number of psychiatric interventions.

    Conclusions : The COVID-19 outbreak is a paradigmatic example of complex dynamic systems in public health and illustrates the importance of considering its local context and time dependency. The Standard mapping and coding of local MHS provision is essential to allow comparison and reduce ambiguity. This study highlights the importance of ecosystem research to better interpret epidemiological data and support the development of evidence-informed policymaking.