The impact of first wave of COVID-19 on referrals to Mtarfa Mental Health Clinic and evaluation of service response

Abstract

BACKGROUND: The COVID-19 pandemic necessitated social distancing measures to curb the spread of disease. This disrupted daily activities and social interaction with attendant impact on mental well-being, as well as mental health service provision.

METHOD: The study aims to investigate first contact community psychiatry referrals to the Mtarfa mental health clinic before and after the onset of COVID -19 and the adequacy of the service response. Following necessary approvals an index of new case appointments was constructed from the register at Mtarfa MHC from 11 March 2019 to 31 December 2020. This was cross referenced with eMR. The imposition of social distancing on 12 March 2020 was used to separate the date into before and after the onset of COVID-19.

RESULTS: A total of 236 new case appointments were identified, 92 of these records preceded the onset of COVID-19 and 144 records followed. The date of referral was available in 105 of the 136 appointments attended. The waiting time could be calculated in 77.2% of these appointments, 76.4% before the onset of COVID-19 and 77.8.% after. The mean number of new case referrals received per month increased from 7.4 before the first wave to 21.2 after, a three-fold increase. Mean waiting time was 21.6 weeks prior to the onset of COVID-19 which decreased to 7.4 weeks when a steady state was observed after the first wave.

CONCLUSION: The COVID-19 pandemic posed significant challenges to community mental health services resulting in major service restructuring. These challenges were met through staff redeployment and increased clinic frequency. The service increase successfully met a threefold increase in new case appointments at the clinic and decreased waiting time by two thirds.