abstract: 'Mitigating the COVID-19 related disruptions in mental health care

  services is crucial in a time of increased mental health disorders.

  Numerous reviews have been conducted on the process of implementing

  technology-based mental health care during the pandemic. The research

  question of this umbrella review was to examine what the impact of

  COVID-19 was on access and delivery of mental health services and how

  mental health services have changed during the pandemic. A systematic

  search for systematic reviews and meta-analyses was conducted up to

  August 12, 2022, and 38 systematic reviews were identified. Main

  disruptions during COVID-19 were reduced access to outpatient mental

  health care and reduced admissions and earlier discharge from inpatient

  care. In response, synchronous telemental health tools such as

  videoconferencing were used to provide remote care similar to pre-COVID

  care, and to a lesser extent asynchronous virtual mental health tools

  such as apps. Implementation of synchronous tools were facilitated by

  time-efficiency and flexibility during the pandemic but there was a lack

  of accessibility for specific vulnerable populations. Main barriers

  among practitioners and patients to use digital mental health tools were

  poor technological literacy, particularly when preexisting inequalities

  existed, and beliefs about reduced therapeutic alliance particularly in

  case of severe mental disorders. Absence of organizational support for

  technological implementation of digital mental health interventions due

  to inadequate IT infrastructure, lack of funding, as well as lack of

  privacy and safety, challenged implementation during COVID-19. Reviews

  were of low to moderate quality, covered heterogeneously designed

  primary studies and lacked findings of implementation in low- and

  middle-income countries. These gaps in the evidence were particularly

  prevalent in studies conducted early in the pandemic. This umbrella

  review shows that during the COVID-19 pandemic, practitioners and mental

  health care institutions mainly used synchronous telemental health

  tools, and to a lesser degree asynchronous tools to enable continued

  access to mental health care for patients. Numerous barriers to these

  tools were identified, and call for further improvements. In addition,

  more high quality research into comparative effectiveness and working

  mechanisms may improve scalability of mental health care in general and

  in future infectious disease outbreaks.'
affiliation: 'Witteveen, AB (Corresponding Author), Vrije Univ Amsterdam, Amsterdam
  Publ Hlth Inst, Clin Neuro \& Dev Psychol, Amsterdam, Netherlands.

  Witteveen, AB (Corresponding Author), Vrije Univ Amsterdam, Amsterdam Publ Hlth
  Inst, WHO Collaborating Ctr Res \& Disseminat Psychol In, Amsterdam, Netherlands.

  Witteveen, A. B.; Young, S.; Cuijpers, P.; Franzoi, D.; Gasior, M.; Palantza, C.;
  Wang, S.; Sijbrandij, M., Vrije Univ Amsterdam, Amsterdam Publ Hlth Inst, Clin Neuro
  \& Dev Psychol, Amsterdam, Netherlands.

  Witteveen, A. B.; Young, S.; Cuijpers, P.; Franzoi, D.; Gasior, M.; Palantza, C.;
  Wang, S.; Sijbrandij, M., Vrije Univ Amsterdam, Amsterdam Publ Hlth Inst, WHO Collaborating
  Ctr Res \& Disseminat Psychol In, Amsterdam, Netherlands.

  Ayuso-Mateos, J. L., Hosp Univ La Princesa, Inst Invest Sanitaria Princesa IIS Princesa,
  Dept Psychiat, Madrid, Spain.

  Ayuso-Mateos, J. L.; Cabello, M., Univ Autonoma Madrid, Dept Psychiat, Madrid, Spain.

  Ayuso-Mateos, J. L.; Cabello, M., CIBERSAM, Inst Salud Carlos III, Ctr Invest Biomed
  Red Salud Mental, Madrid, Spain.

  Barbui, C.; Bertolini, F.; Cadorin, C.; Purgato, M., Univ Verona, Sect Psychiat,
  Dept Neurosci Biomed \& Movement Sci, WHO Collaborating Ctr Res \& Training Mental
  Hlth, Verona, Italy.

  John, A., Swansea Univ, Hlth Data Sci, Med Sch, Swansea, W Glam, Wales.

  Downes, N.; Melchior, M.; Van der Waerden, J., Sorbonne Univ, Inst Pierre Louis
  dEpidemiol \& Sante Publ IPLESP, Fac Med St Antoine, INSERM,Equipe Rech Epidemiol
  Sociale ERES, Paris, France.

  McDaid, D., London Sch Econ \& Polit Sci, Dept Hlth Policy, Care Policy \& Evaluat
  Ctr, London, England.'
article-number: '104226'
author: Witteveen, A. B. and Young, S. and Cuijpers, P. and Ayuso-Mateos, J. L. and
  Barbui, C. and Bertolini, F. and Cabello, M. and Cadorin, C. and Downes, N. and
  Franzoi, D. and Gasior, M. and John, A. and Melchior, M. and McDaid, D. and Palantza,
  C. and Purgato, M. and Van der Waerden, J. and Wang, S. and Sijbrandij, M.
author-email: a.b.witteveen@vu.nl
author_list:
- family: Witteveen
  given: A. B.
- family: Young
  given: S.
- family: Cuijpers
  given: P.
- family: Ayuso-Mateos
  given: J. L.
- family: Barbui
  given: C.
- family: Bertolini
  given: F.
- family: Cabello
  given: M.
- family: Cadorin
  given: C.
- family: Downes
  given: N.
- family: Franzoi
  given: D.
- family: Gasior
  given: M.
- family: John
  given: A.
- family: Melchior
  given: M.
- family: McDaid
  given: D.
- family: Palantza
  given: C.
- family: Purgato
  given: M.
- family: Van der Waerden
  given: J.
- family: Wang
  given: S.
- family: Sijbrandij
  given: M.
da: '2023-09-28'
doi: 10.1016/j.brat.2022.104226
eissn: 1873-622X
files: []
issn: 0005-7967
journal: BEHAVIOUR RESEARCH AND THERAPY
keywords: 'COVID-19; Mental health service delivery; e-mental health psychological

  interventions; Implementation; Scalability; Continuity of care'
keywords-plus: SYSTEMATIC REVIEWS; CORONAVIRUS; DISORDERS; SERVICES; PEOPLE; INCOME;
  UK
language: English
month: DEC
number-of-cited-references: '94'
orcid-numbers: 'McDaid, David/0000-0003-0744-2664

  Sijbrandij, Marit/0000-0001-5430-9810

  Bertolini, Federico/0000-0003-0936-2908

  Cabello, Maria/0000-0003-2362-6092

  Cadorin, Camilla/0000-0002-7642-2096

  Young, Susanne/0000-0001-5803-907X

  van der Waerden, Judith/0000-0002-5324-1372

  Witteveen, Anke/0000-0002-9636-7522

  Cuijpers, Pim/0000-0001-5497-2743'
papis_id: be60bad31c76db257015cc069b8feb59
ref: Witteveen2022remotemental
researcherid-numbers: 'McDaid, David/E-5959-2014

  Sijbrandij, Marit/N-6131-2018

  '
tags:
- review
times-cited: '5'
title: 'Remote mental health care interventions during the COVID-19 pandemic: An umbrella
  review'
type: Review
unique-id: WOS:001043962500005
usage-count-last-180-days: '0'
usage-count-since-2013: '4'
volume: '159'
web-of-science-categories: Psychology, Clinical
year: '2022'