Investigating the impact of Covid-19 on mental health services using informatics

In this project applied informatics researchers will analyse clinical records and service data to investigate and monitor the response of mental health services in south London during the pandemic.

The researchers will analyse the most up-to-date information, using data collected in real-time from the South London and Maudsley NHS Foundation Trust's (SLaM) Clinical Record Interactive Search (CRIS) data platform and Lambeth DataNet primary care data (which covers all GP practices in Lambeth) .

How is the project being carried out?

Given the fast-moving nature of the pandemic, we are working with SLaM's leadership to establish weekly research priorities. These priorities include service metrics, symptom profiles and effective crisis management. 

We are working with four acute NHS Trusts within SLaM’s catchment to gather data on A&E attendance and hospital admissions for SLaM patients. This means we can profile wider service use on a monthly basis, as well as understand levels of intensive care use. 

We are also tracking mortality rates as we link our data to the NHS spine, as well as pooling data from all practices in Lambeth via Lambeth DataNet to further quantify service activity. More detailed linked extracts will be obtained from the CogStack data platform at King’s College Hospital.

Throughout the project, we will use novel text-mining techniques to pick up relevant entries from electronic health records, including Covid-19 status, social isolation, and levels of support and family contact.

Potential impact of the study

The aim of the project is to produce informative and rapidly shared analysis to inform mental healthcare in south London and at other mental health trusts during the Covid-19 crisis. The project will also demonstrate the value and potential of integrated clinical informatics platforms.

Achievements so far

• The project has produced seven pre-print publications available online (see below), which share important data on topics including groups at risk, causes of death and service use.
• SLaM have set up a Quality Centre team that meets frequently to consider new findings and data needs, and to ensure that these are coordinated across the Trust. 
• We have detected potential relapses of SLaM patients with bipolar disorder presenting to emergency services. 
• We have described for the first time the different causes of SLaM’s excess deaths during the pandemic’s first wave. 
• We have met with colleagues from Public Health England and NHS England to discuss the national implications of our analysis, given the scarcity of data in this field.
• We are working with 10 other mental healthcare providers across the UK to confirm trends in patient and service use data that we have detected in SLaM. 

Our collaborators

This project is led by Robert Stewart and Matthew Broadbent, supported by Fiona Gaughran, Richard Dobson, Mark Ashworth and Matthew Hotopf. It has strong links with data science networks including HDR-UK, the NIHR Mental Health Translational Research Centre, and NIHR Health Informatics Collaborative.

The study is funded by a King’s Together Award and South London and Maudsley NIHR Biomedical Research Centre and King’s College London’s MRC Mental Health Data Pathfinder award. It was adopted by the ARC in September 2020 and is expected to finish in March 2021.

Our publications

• Mental health service activity during Covid-19 lockdown: South London and Maudsley data on working age community and home treatment team services and mortality from February to mid-May 2020 
• Using past and current data to estimate potential crisis service use in mental healthcare after the Covid-19 lockdown: South London and Maudsley data. 2020. 
• Excess mortality in mental health service users during the Covid-19 pandemic described by ethnic group: South London and Maudsley data. 2020. 
• Mental health service activity during Covid-19 lockdown among individuals with personality disorders: South London and Maudsley data on services and mortality from January to May 2020.  
• Comparison of mental health service activity before and shortly after UK social distancing responses to the Covid-19 pandemic: February-March 2020.  
• Mental health service activity during Covid-19 lockdown among individuals with potential neurodevelopmental disorders: South London and Maudsley data on services and mortality from January to July 2020. 
• Causes of death in mental health service users during the first wave of the Covid-19 pandemic: South London and Maudsley data from March to June 2020, compared with 2015-2019.