The impact of viral epidemics and pandemics on acute mental health service use: an integrative review

Health Psychol Rev. 2021 Mar;15(1):1-33. doi: 10.1080/17437199.2021.1886864. Epub 2021 Feb 23.


The aim of this integrative review was to examine the impact of past viral epidemics on mental health, with a specific focus on changes in numbers of acute mental health presentations and mental health service recommendations in response to this, in the context of the COVID-19 pandemic. Following PRISMA methodology, databases were searched for relevant publications. A total of 83 articles with a range of methodologies were included to ensure broad coverage of this rapidly emerging research area. The literature supports an initial increase in mental health concerns which generally do not reach the threshold for diagnosis with a mental illness, but present to frontline telephone services. There is a potential delay before community and hospital-based mental health services see an increase in new or relapsing mental illness presentations. However vulnerable populations, such as people with pre-existing mental illness, are at increased risk of mental health issues during such public health crises. Many of the general recommendations distilled from the literature are closely aligned with existing strategic frameworks for mental health service provision. However, in review of these frameworks, gaps in the literature become more apparent, such as a failure to include people with lived experience, peer workers, and First Nations People in the COVID-19 mental health response.

Keywords: COVID-19; SARS; Viral pandemic; mental health; service use; strategic frameworks.

Publication types

  • Review

MeSH terms

  • COVID-19*
  • Humans
  • Mental Disorders / epidemiology*
  • Mental Health Services*
  • Patient Acceptance of Health Care*