[Utilization of mental health services in Germany during the first year of the COVID-19 pandemic-Systematic review and meta-analysis].

Abstract

Background: During the coronavirus disease 2019 (COVID-19) pandemic studies showed indications of changes in the utilization of inpatient, outpatient and emergency mental healthcare services; however, the level of observation and representativeness of these studies were heterogeneous.

Objectives: Changes in the utilization of psychiatric and psychotherapeutic care in the first year of the COVID-19 pandemic were classified through a systematic literature search, evaluation of the quality and observational levels as well as a meta-analysis of the effects.

Material and methods: A systematic search was carried out in PubMed, PsycInfo and Embase until June 2023 and a follow-up search in PubMed up to and including October 2024. Data were assigned to the periods first lockdown phase, between lockdown phases, second lockdown phase and entire pandemic year 2020.

Results: A total of 17 studies were included. There were reductions in the number of inpatient admissions for the first lockdown phase of relative risk, RR 0.74, 95% confidence interval CI 0.70-0.79, I² 95.5%, t² 0.0053 and for the second lockdown phase of RR 0.78, 95% CI 0.75-0.81, I² 97.1%, t² 0.0058. Only studies with a low observational level were found for psychiatric emergency care and only two studies with different indicators for outpatient utilization. There were no clear changes in the prescription of psychotropic drugs.

Conclusion: In the first year of the COVID-19 pandemic utilization of mental healthcare services was reduced, especially for the inpatient sector. The effects of these significant restrictions are unclear. We therefore propose a mental healthcare surveillance that could promptly record such changes and possible consequences.