COVID-19 and mental health treatment in primary care: Impact of a global pandemic on a psychopharmacological collaborative care management program.

Abstract

Objective: The COVID-19 pandemic has had a profound impact on individuals with mental health (MH) disorders and on the delivery of MH services. Few studies have examined treatment models not requiring substantial changes to the delivery of services during pandemic restrictions, such as collaborative care management (CoCM) programs. Therefore, a longitudinal retrospective cohort analysis was conducted to examine the impact of the COVID-19 pandemic on a psychopharmacological CoCM program.

Method: Data were collected on all U.S. Veterans enrolled in a CoCM program at a large VA during the first 10 months of the COVID-19 pandemic and compared to a matched control group one-year prior to that date. Treatment in the program pre-COVID vs. treatment during the pandemic was compared in relation to baseline symptomatology, improvements in MH symptoms, and program adherence.

Results: A total of 462 Veterans were referred during the control period, compared to 351 during the same time period during the pandemic. Veterans enrolled during the first four months of each study arm, to allow for a minimum of 6 months of follow up data, had no differences in baseline symptoms of depression or anxiety between groups. Veterans receiving care during the pandemic had higher rates of program completion than pre-pandemic controls. COVID-era Veterans also had higher rates of depression response compared to controls, but no differences were observed between groups on depression remission, anxiety response, or anxiety remission.

Conclusions: Psychopharmacological CoCM treatment models can successfully manage depression and anxiety with no observed decrease in the effectiveness of this intervention even during periods of unprecedented disruptions to MH services.