Adapting mental health services to the COVID-19 pandemic: reflections from professionals in four countries

ABSTRACT

The COVID-19 pandemic significantly changed the lives of a majority of the world’s population. People have been encouraged to implement social distancing behaviors enforced by governments, and have experienced loss of employment or changes to their usual working environment. In the mental health sector, psychologists and psychiatrists have been forced to alter the standard care of patients without compromising safety. This article documents the experiences of the authors – mental health professionals in four countries, Canada, Russia, Australia and Japan – at the time of the COVID-19 pandemic, and offers recommendations on how clinical, training, and research practices may need to be adjusted to deal with lockdown situations. Clinicians adapted their usual best practices by learning new skills and updating their knowledge base. Mental health clinicians noticed that the pandemic led to symptomatic changes in some of their patients. Most clinicians moved towards providing telemental health services, such as conducting assessments and treatments remotely. Those who continued seeing patients in person employed personal protective equipment with various impacts on the clinician–patient relationship. The dilemmas of mass quarantines need to be carefully examined, as their effects on numerous health and psychosocial variables appear to be far-reaching.

KEYWORDS:

• Mental health services
• telemental health
• COVID-19 pandemic
• quarantine
• recommendations

Acknowledgments

Daniel Cavanagh, Maria Russkova, Harriët Abrahams, Pablee Wong, Momoka Sunohara, Svetlana Zaremba-Pike, Sandra Swartling and Ulf Lager provided helpful comments or assistance during this project. We would also like to thank the anonymous reviewers who provided constructive feedback.

Disclosure statement

We have no conflicts of interest to disclose.

Notes

1. e.g., relatively lax responses in Sweden (Baker, 2020 to more assertive approaches in Russia (The Moscow Times, 2020) and China (The Guardian, 2020)

Additional information

Notes on contributors

Tomas Jurcik

Tomas Jurcik, Ph.D., RPsych is an Assistant Professor at the School of Psychology, National Research University - Higher School of Economics in Moscow. His publications are in the area of cultural-clinical psychology and psychiatry, acculturation and immigrant mental health, and community psychology. The current research interest is in evaluating and adapting cognitive therapy to the Russian context. He is also a registered psychologist in British Columbia, Canada, where he directs Health and Balance Counselling, a small group practice. He completed his doctorate in clinical psychology at Concordia University in Montreal, Canada.

G. Eric Jarvis

G. Eric Jarvis, M.D, M.Sc. is an Associate Professor of Psychiatry at McGill University & Director of the Cultural Consultation Service and First Episode Psychosis Program at the Jewish General Hospital. His clinical work involves the cross-cultural assessment of immigrants and refugees. His current research includes developing culturally adapted interventions for patients with early psychosis, linguistic barriers to psychiatric services, and religious interventions in mental health care. Dr. Jarvis also writes about the history of psychiatry.

Jelena Zeleskov Doric

Jelena Zeleskov Doric, Ph.D., is a psychologist and Gestalt psychotherapist who works in her private practice in Sydney. She provides consultancy services and clinical supervision. She worked at Charles Darwin University and Australian College of Applied Psychology. She is an active researcher interested in the relationship between neuroscience, attachment, and gestalt therapy. She is a registered psychologist in Australia and a registered clinical psychologist in Europe.

Yulia Krasavtseva

Yulia Krasavtseva, MA, is a clinical psychologist at the Center for Cognitive therapy and a teaching assistant at Sechenov University. She is a Ph.D. candidate from Lomonosov Moscow State University. Her research includes decision-making, the Dark Triad traits, intelligence, risk-taking, and other topics. Among her clinical patients are people suffering from a variety of anxiety disorders, OCD, and eating disorders.

Alexandra Yaltonskaya

Alexandra Yaltonskaya, MD, Ph.D., Senior Researcher at V.Serbsky National Medical Research Center for Psychiatry and Narcology and Co-founder and training director of Moscow Institute of Schema Therapy, Moscow, Russia. Her clinical and research work involves psychotherapy for people with chronic affective and personality disorders, PTSD, and complex PTSD. One of her goals is spreading evidence-based psychotherapy among Russian mental health providers.

Kaori Ogiwara

Kaori Ogiwara, MA, is a Certified Clinical Psychologist and Certified Public Psychologist in Japan. She graduated from the University of Queensland (Australia) with BA Honours in Psychology, and Ochanomizu Women’s University (Japan) with a Masters in Human Developmental Sciences. She has been working as a psychotherapist for over 15 years and is currently in private practice in Tokyo, offering mental health services to the local and English-speaking community residing in Japan. Her main area of clinical focus is eating disorders and related body-image issues in adolescents and adults.

Jun Sasaki

Jun Sasaki, Ph.D., is an Associate Professor of Clinical Psychology at Osaka University and Deputy Director of Osaka University Counseling Center, Japan. He is also working for a private enterprise to provide psychological education and treatment. He is a Certified Public Psychologist specializing in Cognitive-Behavioral Therapy. His research includes social anxiety disorder, psychoeducation, and the training of cognitive-behavioral therapists. He is also a member of the board of directors of the Japanese Society of Certified Public Psychologists.

Stephanie Dubois

Stephanie Dubois, Ph.D., is a licensed clinical and counseling psychologist at Parkwood Institute Mental Health working with adult inpatients in the Assessment and Treatment and Rehabilitation Programs. She is an associate scientist at Lawson Health Research Institute (LHRI) and holds adjunct appointments at both Western University and The University of Waterloo. She is active in the London Clinical Psychology Residency Consortium and in supervision she emphasizes professional identity, mentoring, and advocacy.

Karina Grigoryan

Karina Grigoryan, MA, is a Research Assistant and Ph.D. student at the Doctoral School of Psychology, National Research University Higher School of Economics, Moscow, Russia. Her research interests are in the intersection between social, clinical, and health psychology. She is mainly involved in projects in mental health. One current project is in the area of international differences in psychiatric diagnostic practices. She is currently a research fellow at the Center for Epidemiology and Community Medicine (Centrum för epidemiologi och samhällsmedicin) in Stockholm, Sweden.