Skilbeck Lilian, Spanton Christopher, Roylance Ian
East London NHS Foundation Trust, Newham Talking Therapies, Vicarage Lane Health Centre, 10 Vicarage Lane, Stratford, London E15 4ES, UK.
Cogn Behav Therap. 2020 Aug 18;13:e34. doi: 10.1017/S1754470X20000379.
Infectious disease outbreaks have occurred sporadically over the centuries. The most significant ones of this century, as reported by the World Health Organization, include the EVD epidemic, SARS pandemic, Swine Flu pandemic and MERS pandemic. The long-term mental health consequences of outbreaks are as profound as physical ones and can last for years post-outbreak. This highlights the need for enhancing the preparedness of pragmatic mental health service provision. Due to its magnitude, the novel COVID-19 pandemic has proven to be the most impactful. Compared with previous outbreaks, COVID-19 has also occurred at higher rates in frontline staff in addition to patients. As COVID-19 is more contagious than earlier outbreaks, there is a need to identify infected people quickly and isolate them and their contacts. This is the current context in which mental health services including IAPT have had to operate. Evidently, Improving Access to Psychological Therapies (IAPT) services are a major mental health service provider in the UK that have demonstrated variability in their response to COVID-19. While some IAPT services quickly adapted their existing strengths and resources (e.g. remote working), other services were less prepared. To date, there are no clear unitary guidelines on how IAPT services can use their pre-existing resources to respond to the long-term effects of outbreaks. In light of this, the current paper aims to reflect on the lessons learned from past outbreaks in order to consider how an enhanced remit of IAPT might integrate with other services to meet the long-term needs of patients and staff affected by COVID-19.
(1)To understand the development of IAPT within the NHS mental health services.(2)To understand the nature of past outbreaks and COVID-19.(3)To reflect on lessons from past outbreaks in order to understand how IAPT can respond to the long-term effects of COVID-19.
几个世纪以来,传染病疫情时有爆发。据世界卫生组织报告,本世纪最重大的疫情包括埃博拉病毒病疫情、非典大流行、猪流感大流行和中东呼吸综合征大流行。疫情对心理健康造成的长期影响与身体影响一样严重,且在疫情结束后可能持续数年。这凸显了加强务实的心理健康服务准备工作的必要性。新型冠状病毒病大流行规模巨大,已被证明是影响最为深远的。与以往疫情相比,除患者外,新冠病毒病在一线工作人员中的感染率也更高。由于新冠病毒病比早期疫情更具传染性,因此需要迅速识别感染者并对其及其接触者进行隔离。这就是包括改善心理治疗服务(IAPT)在内的心理健康服务目前必须运行的背景。显然,改善心理治疗服务(IAPT)是英国主要的心理健康服务提供商,它们对新冠病毒病的应对表现出了差异。一些IAPT服务迅速利用其现有优势和资源(如远程工作)进行调整,而其他服务则准备不足。迄今为止,对于IAPT服务如何利用其现有资源应对疫情的长期影响,尚无明确统一的指导方针。有鉴于此,本文旨在反思从过去疫情中吸取的教训,以探讨IAPT扩大后的职责如何与其他服务相结合,以满足受新冠病毒病影响的患者和工作人员的长期需求。
(1)了解IAPT在国民保健服务心理健康服务体系中的发展情况。(2)了解过去疫情及新冠病毒病的性质。(3)反思过去疫情的教训,以了解IAPT如何应对新冠病毒病的长期影响。