Early impacts of the COVID-19 pandemic on mental health care and on people with mental health conditions: framework synthesis of international experiences and responses

PURPOSE: The COVID-19 pandemic has many potential impacts on people with mental health conditions and on mental health care, including direct consequences of infection, effects of infection control measures and subsequent societal changes. We aimed to map early impacts of the pandemic on people with pre-existing mental health conditions and services they use, and to identify individual and service-level strategies adopted to manage these. METHODS: We searched for relevant material in the public domain published before 30 April 2020, including papers in scientific and professional journals, published first person accounts, media articles, and publications by governments, charities and professional associations. Search languages were English, French, German, Italian, Spanish, and Mandarin Chinese. Relevant content was retrieved and summarised via a rapid qualitative framework synthesis approach. RESULTS: We found 872 eligible sources from 28 countries. Most documented observations and experiences rather than reporting research data. We found many reports of deteriorations in symptoms, and of impacts of loneliness and social isolation and of lack of access to services and resources, but sometimes also of resilience, effective self-management and peer support. Immediate service challenges related to controlling infection, especially in inpatient and residential settings, and establishing remote working, especially in the community. We summarise reports of swiftly implemented adaptations and innovations, but also of pressing ethical challenges and concerns for the future. CONCLUSION: Our analysis captures the range of stakeholder perspectives and experiences publicly reported in the early stages of the COVID-19 pandemic in several countries. We identify potential foci for service planning and research

The developmental trajectory of English conditional grammar in 4- to 11-year-old children

Grammar is an essential aspect of language and communication, yet little is known about the developmental trajectory of the conditional – a complex grammar structure. We extended existing research to get a clearer idea of the developmental trajectory of Type I, Type II and Type III conditionals in typically developing children aged 4- to 11-years old. Data from 316 children were collected on measures of production and comprehension of the conditional, alongside measures of general ability, memory and word reading. Our data shows that as the complexity of the conditional sentence increases, so does the difficultly in correctly reproducing it. However, a more stable development was observed when measuring children’s comprehension which, along with the observed links between acquisition and reasoning, suggests that comprehension may be reliant on a qualitative change in children’s thinking. We also found links between acquisition and word reading which points to an important relationship between success in the early stages of reading and the internalisation of this grammar. Conditional grammar is important within keyschool subjects such as English, maths and science; we were able to combine our data with published data to map out the ages at which typically developing children should be able to reproduce and comprehend conditionals. Identifying those children who are lagging behind in this language development should in turn allow targeted intervention and enable a reduction in the number of those entering secondary school without complete production or comprehension of conditionals