Social Experiences and Health Needs of Patients with Severe Mental Illness and their Caregivers during the first year of the COVID-19 pandemic in Spain

Figures & data

Figure 1. Qualitative research Process Flow Chart.

Table 1. Severe mental health illness diagnostic categories (ICD-10) included in the qualitative study.

- Schizophrenia (F20.0)

- Schizotypal disorder (F21)

- Persistent delusional disorders (F22)

- Induced delusional disorder (F24)

- Schizoaffective disorders (F25)

- Other nonorganic psychotic disorders (F28)

- Unspecified nonorganic psychosis (F29)

- Bipolar affective disorder (F31.0)

- Severe depressive episode with psychotic symptoms (F32.3)

- Recurrent depressive disorder (F33)

- Obsessive-compulsive disorder (F42)

Table 2. Main interviews characteristics (interviewer profiles and average duration) according to the heterogeneity criteria and depending on urban or rural environments.

	Place of residence	SMI patients	Caregivers
Interviewees number	Rural	11	11
	Urban	10	10
Average age (years old)	Rural	62.7 ± 9.6	52.5 ± 15.4
	Urban	55.8 ± 15.1	53.2 ± 18.9
Gender (female)	Rural	7 (of 11)	7 (of 11)
	Urban	6 (of 10)	3 (of 10)
Interview average duration (minutes ± SD)	Rural	21.8 ± 2.5
	Urban	16.8 ± 9.7
Patient disability (^a)	Rural	3 (of 11)	--
	Urban	4 (of 10)
Caregiver overload (^b)	Rural	--	9 (of 11)
	Urban		4 (of 10)
Family dysfunction (^c)	Rural	4 (of 11)	4 (of 11)
	Urban	1 (of 10)	3 (of 10)

Questionnaires used for recruitment:

^aWHODAS 2.0 questionnaire (significative disability, cut-off score ≥ 10);

^bThe Zarit Burden Interview (short version) (caregiving burden, cut-off score ≥ 17);

^cThe Apgar family questionnaire (family dysfunction, cut-off score ≤ 3).

Table 3. Themes, subthemes and codes obtained through content analysis.

Themes	Subthemes	Codes
Social isolation	Sense of vulnerability Caregiving burden Lack of formal social support	Isolation / helplessnes / confinement / stigma / disability / self-care / social support / information
Health Services Accessibility	Changes in Healthcare Telemedicine use Urgent situations	Accessibility / delays / risk of contagion / face-to-face appointment / telemedicine / urgent demand
Continuity of Healthcare	Turnover of professionals Primary-Specialised care communication Trust in health professionals	Continuity / turnover / professional rol / communication / comfidentiality / psychiatrist / family doctor / other professionals