{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T14:12:47Z","timestamp":1765807967558,"version":"3.44.0"},"reference-count":32,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T00:00:00Z","timestamp":1632787200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIHR Oxford Health Biomedical Research Centre","award":["BRC-1215-20005"],"award-info":[{"award-number":["BRC-1215-20005"]}]},{"DOI":"10.13039\/501100006546","name":"Angelini Pharma","doi-asserted-by":"publisher","award":["HQR02150"],"award-info":[{"award-number":["HQR02150"]}],"id":[{"id":"10.13039\/501100006546","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Evid Based Mental Health"],"accepted":{"date-parts":[[2021,9,4]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The effects of COVID-19 on the shift to remote consultations remain to be properly investigated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To quantify the extent, nature and clinical impact of the use of telepsychiatry during the COVID-19 pandemic and compare it with the data in the same period of the 2 years before the outbreak.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used deidentified electronic health records routinely collected from two UK mental health Foundation Trusts (Oxford Health (OHFT) and Southern Health (SHFT)) between January and September in 2018, 2019 and 2020. We considered three outcomes: (1) service activity, (2) in-person versus remote modalities of consultation and (3) clinical outcomes using Health of the Nation Outcome Scales (HoNOS) data. HoNOS data were collected from two cohorts of patients (cohort 1: patients with \u22651 HoNOS assessment each year in 2018, 2019 and 2020; cohort 2: patients with \u22651 HoNOS assessment each year in 2019 and 2020), and analysed in clusters using superclasses (namely, psychotic, non-psychotic and organic), which are used to assess overall healthcare complexity in the National Health Service. All statistical analyses were done in Python.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>Mental health service activity in 2020 increased in all scheduled community appointments (by 15.4% and 5.6% in OHFT and SHFT, respectively). Remote consultations registered a 3.5-fold to 6-fold increase from February to June 2020 (from 4685 to a peak of 26\u2009245 appointments in OHFT and from 7117 to 24\u2009987 appointments in SHFT), with post-lockdown monthly averages of 23\u2009030 and 22\u2009977 remote appointments\/month in OHFT and SHFT, respectively. Video consultations comprised up to one-third of total telepsychiatric services per month from April to September 2020. For patients with dementia, non-attendance rates at in-person appointments were higher than remote appointments (17.2% vs 3.9%). The overall HoNOS cluster value increased only in the organic superclass (clusters 18\u201321, n=174; p&lt;0.001) from 2019 to 2020, suggesting a specific impact of the COVID-19 pandemic on this population of patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions and clinical implications<\/jats:title>\n                  <jats:p>The rapid shift to remote service delivery has not reached some groups of patients who may require more tailored management with telepsychiatry.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/ebmental-2021-300287","type":"journal-article","created":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T15:13:28Z","timestamp":1632842008000},"page":"161-166","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Impact of COVID-19 on telepsychiatry at the service and individual patient level across two UK NHS mental health Trusts"],"prefix":"10.1136","volume":"24","author":[{"given":"James SW","family":"Hong","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Oxford, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Sheriff","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Oxford, Oxford, UK"},{"name":"Oxford Health NHS Foundation Trust, Oxford, Oxfordshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharine","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Oxford, Oxford, UK"},{"name":"Oxford Health NHS Foundation Trust, Oxford, Oxfordshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anneka","family":"Tomlinson","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Oxford, Oxford, UK"},{"name":"Oxford Health NHS Foundation Trust, Oxford, Oxfordshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fathi","family":"Saad","sequence":"additional","affiliation":[{"name":"Oxford Health NHS Foundation Trust, Oxford, Oxfordshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanya","family":"Smith","sequence":"additional","affiliation":[{"name":"Oxford Health NHS Foundation Trust, Oxford, Oxfordshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomas","family":"Engelthaler","sequence":"additional","affiliation":[{"name":"Akrivia Health, Oxford Centre for Innovation, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Phiri","sequence":"additional","affiliation":[{"name":"Southern Health NHS Foundation Trust, Southampton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5659-3296","authenticated-orcid":false,"given":"Catherine","family":"Henshall","sequence":"additional","affiliation":[{"name":"Oxford Health NHS Foundation Trust, Oxford, Oxfordshire, UK"},{"name":"Faculty of Health and Life Sciences, Oxford Brookes University Faculty of Health and Life Sciences, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Ede","sequence":"additional","affiliation":[{"name":"Oxford Health NHS Foundation Trust, Oxford, Oxfordshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike","family":"Denis","sequence":"additional","affiliation":[{"name":"Akrivia Health, Oxford Centre for Innovation, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamina","family":"Mitter","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Oxford, Oxford, UK"},{"name":"Oxford Health NHS Foundation Trust, Oxford, Oxfordshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2126-799X","authenticated-orcid":false,"given":"Armando","family":"D'Agostino","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Milan, Milano, Lombardia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giancarlo","family":"Cerveri","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Addiction, ASST Lodi, Lodi, Lombardia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Tomassi","sequence":"additional","affiliation":[{"name":"Psychiatric Unit 1, Azienda ULSS 9 Scaligera, Verona, Veneto, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanaya","family":"Rathod","sequence":"additional","affiliation":[{"name":"Southern Health NHS Foundation Trust, Southampton, 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