The expanding backlog of mental health patients and the continued toll of zero-COVID policy on healthcare settings

Samantha J. Cardno, Arash Sahraie* (Corresponding Author)

*Corresponding author for this work

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Aim and Scope: Prior research has shown that isolation measures implemented to contain previous pandemics had led to negative impacts on mental health. There has been increased awareness of mental health issues over the past few years with more patients encouraged to seek help. Nevertheless, operational restrictions imposed on the health services to contain COVID-19 have resulted in reduced capacity in the health service. We have aimed to measure the combined
effects of increased demand and reduction in capacity on the backlog of patients awaiting access to specialist care in Scotland.
Design: To quantify the effect that the present pandemic has had on access to specialist care, comprehensive data on referrals by general practitioners (GPs) for specialist mental health support was obtained for 2016-2020 period following Freedom of Information (FOI) requests to all 14 health boards of National Health Service (NHS) Scotland.
Results: Monthly GP referral counts accumulated across all health boards revealed the extent of demand for specialist mental health support. Prior to the pandemic there was a 4-5% annual rise in the number of mental health related GP referrals in Scotland. Pandemic related restrictions imposed to curb infections has led to a higher incidence of mental health problems. However,
there was a 27% drop in referrals in 2020 alone, affecting an estimated 43,522 patients. The reduction on mental health provisions is similar in profile to the drop in number of planned hospital admissions.
Conclusions: Policies to combat COVID-19 resulted in significant negative impacts on the mental health of the population. The continued restrictions on healthcare settings limit their operations, resulting in long waiting lists for accessing specialist care. Despite some easing for restrictions on public, restrictions on healthcare settings place strict limits on their operations and
therefore are detrimental to public health.
Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalMedical Research Archives
Issue number4
Early online date29 Apr 2022
Publication statusPublished - 30 Apr 2022

Bibliographical note

Acknowledgements: We would like to thank all 14 Scottish National Health Boards that provided the data after an FOI request and waived all administrative charges. We would like to thank all general practitioners who commented on earlier drafts of this article.
Funding: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors

Data Availability Statement

Data Sharing: All raw data and data summaries are available on Open Science Forum: Sahraie A, Cardno SJ. Scottish GP Mental Health Referrals 2020. 2021.


  • Mental Health
  • General Practitioner
  • Referrals
  • COVID-19


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