Have the COVID-19 outbreak and related restrictions affected the right to mental health of people with severe mental health conditions?

The Coronavirus disease (COVID-19) outbreak, and the restrictions implemented by governments to limit its public health impact, may have determined a reduction of the right to mental health of people with severe mental health conditions, that is a limitation to adequate, human, and value-based mental healthcare, with rising inequalities in comparison with the general population. This systematic review was, therefore, conducted to collate evidence on the impact of the pandemic period on the mental health of individuals with pre-existing severe mental health conditions. Of 3,774 retrieved citations, we selected 21 studies meeting the inclusion criteria. The majority of the included studies assessed trends in psychological symptoms over the pandemic period, then arguing that symptoms worsened for a number of reasons, including the risk of contracting the virus, the disruption of mental health services, and the feelings of loneliness and isolation associated with the restriction measures. Even though studies provided somewhat contradictory results, the majority of evidence indicates that people with pre-existing mental health conditions were more likely to report greater self-isolation distress, anxiety, depression, COVID-19-related perceived stress, and were more likely to voluntarily self-isolate than those without a mental health condition. These findings appeared to suggest that a combination of factors related to the pandemic itself and to the prevention and mitigation strategies were responsible for a reduction of the right to mental health of people with mental health conditions, with increased inequalities in comparison with the general population.