{'fraction_non_alphanumeric': 0.025500322788896062, 'fraction_numerical': 0.007424144609425436, 'mean_word_length': 5.389690721649485, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 1, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
The Impact of the COVID-19 Pandemic on Mental Health Service Delivery in Barbados

The World Health Organisation (WHO) assessed that “COVID-19 could be characterised as a pandemic” (Ref. 1, p 1) on March 11, 2020. The consequences of this pandemic have reverberated throughout almost every aspect of daily life worldwide with social/physical distancing, frequent hand washing, wearing of face masks, curfew, quarantine, and isolation. Health care services were forced to adapt by finding innovative ways to continue the assessment and management of patients in a manner that was acceptable, safe, and appropriate to the patient and heath care service provider. Several countries have described their mitigation efforts, given the reduced access to outpatient services, reduced inpatient beds, restrictions on visiting and interactions with families, and cancelation of elective procedures. In addition, the impact on the health care system as it relates to financial loss, racial and ethnic disparities, lack of insurance coverage, and the need for legislative reform to adequately address these deficiencies, has been documented. These authors described significant financial losses by hospitals and private clinics in the United States, in part due to less demand for routine services, while demand for specialized care was very high. In Europe, job loss and subsequent reduction in income and workload were associated with increased feelings of depression and anxiety among workers. Fears of contracting the virus, concerns about spreading it to others, the imposition of public health measures, and the general disruption of life have all lead to an increase in demand for mental health services. Those affected include not only people with preexisting mental health conditions and health care workers, but the general population as well. Further, indications are that the psychological impact will likely continue beyond the physical health effects of the pandemic. Gavin et al. have opined that there will be an increase in mental illness and suicidality as the pandemic progresses and the new realities of life become more evident. Of particular interest was the response within secure psychiatric facilities, where there were unique challenges: inability of patients to utilize escorted community leave privileges; difficulty isolating patients with behavioral problems; balancing multiple contacts between patients and staff while needing to physically distance, and closure of allied services leading to difficulty discharging patients safely. In this editorial, we describe the impact of the COVID-19 pandemic on mental health service delivery on the island of Barbados. With an estimated population of 301,865 and a land mass of 166 square miles, Barbados is the most densely populated island of the eastern Caribbean. Dr. Emmanuel is Lecturer in Psychiatry, University of the West Indies, Barbados. Dr. Brathwaite-Drummond is Consultant Psychiatrist, Ministry of Health and Wellness, Barbados. Address correspondence to: Maisha Emmanuel, MBBS. E-mail: Maisha.Emmanuel@cavehill.uwi.edu.