DOI: 10.1192/j.eurpsy.2026.10942 ISSN: 0924-9338

Impact of Remote Service Model on Social Functioning of Chronic Mental Illness Patients in Community Psychiatric Rehabilitation Centers during the COVID-19 Pandemic: A Retrospective Cohort Study

Y.-C. Wu, N.-Y. Teng
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Introduction

The COVID-19 pandemic disrupted rehabilitation services for individuals with chronic mental illness, increasing the risk of social functional decline. Community psychiatric rehabilitation centers help maintain functional abilities, but interruptions can accelerate deterioration. During closures, some centers adopted remote rehabilitation to sustain activities and engagement, yet its long-term effectiveness in this setting is unclear. This study provides one of the first four-year longitudinal evaluations of remote service provision in such centers, spanning the pre-pandemic, peak-pandemic, and recovery phases.

Objectives

To compare changes in social functioning, measured by the Personal and Social Performance Scale (PSP), between patients receiving remote services and those without remote services during the COVID-19 pandemic.

Methods

A four-year retrospective cohort study was conducted on 139 patients with chronic mental illness from two community psychiatric rehabilitation centers. PSP was assessed every six months. During service interruptions, one center implemented remote rehabilitation while the other did not. Patients were categorized into three groups: remote-service participants (A1), non-participants in the same center (A2), and patients from a center without remote services (B). Longitudinal PSP score differences among groups were analyzed using Generalized Estimating Equations (GEE).

Results

The study included 139 patients (mean age = 63.95 ± 11.87 years; 48.2% male; 79.1% schizophrenia). PSP scores showed divergent trends during the pandemic: the remote-service group (A1) increased even at the pandemic peak, while B declined sharply. By T7 (mid-2023), A1 exceeded baseline levels, whereas A2 and B showed only partial recovery (Table 1).

Table 1.

GEE estimates (β, SE, p) of PSP social functioning across pandemic periods by group

Table 1. Long description.

Pandemic period (ref: T0)
A1, N=25, 216 obs.
A2: N=54, 448 obs. B: N=59, 472 obs.
β
SE P VALUE β SE P VALUE β SE P VALUE
T1
0.60
0.46 0.195 0.63 0.40 0.113 –0.61 0.20 0.002
T2
1.95 0.87 0.024 1.07 0.47 0.022 –1.77 0.56 0.002
T3
2.70 1.42 0.057 0.52 0.91 0.569 –1.86 1.04 0.075
T4
8.02 2.06 <0.001 1.37 1.25 0.271 –5.55 1.50 <0.001
T5
10.81 2.43 <0.001 4.91 2.11 0.020 –1.08 1.25 0.390
T6
7.83 1.92 <0.001 0.34 0.95 0.723 –4.54 1.34 <0.001
T7
8.61 2.06 <0.001 0.70 1.06 0.506 –1.32 1.31 0.312
T8
8.65 2.19 <0.001 –0.06 1.34 0.964 –0.97 1.22 0.424

Conclusions

Remote service provision during the COVID-19 pandemic was linked to better preservation and recovery of social functioning in chronic mental illness patients in community psychiatric rehabilitation. Findings support integrating remote rehabilitation into routine care to ensure continuity and protect functional outcomes in future public health crises.

Disclosure of Interest

None Declared

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