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The COVID-19 pandemic significantly changed the lives of a majority of the world's population. People have been encouraged to implement social distancing behaviors enforced by governments, and have experienced loss of employment or changes to their usual working environment. In the mental health sector, psychologists and psychiatrists have been forced to alter the standard care of patients without compromising safety. This article documents the experiences of the authors – mental health professionals in four countries, Canada, Russia, Australia and Japan – at the time of the COVID-19 pandemic, and offers recommendations on how clinical, training, and research practices may need to be adjusted to deal with lockdown situations. Clinicians adapted their usual best practices by learning new skills and updating their knowledge base. Mental health clinicians noticed that the pandemic led to symptomatic changes in some of their patients. Most clinicians moved towards providing telemental health services, such as conducting assessments and treatments remotely. Those who continued seeing patients in person employed personal protective equipment with various impacts on the clinician–patient relationship. The dilemmas of mass quarantines need to be carefully examined, as their effects on numerous health and psychosocial variables appear to be far-reaching. [ABSTRACT FROM AUTHOR]

Around the world, adults with serious illnesses or chronic conditions account for a disproportionate share of national health care spending. We surveyed patients with complex care needs in eleven countries (Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States) and found that in all of them, care is often poorly coordinated. However, adults seen at primary practices with attributes of a patient-centered medical home-where clinicians are accessible, know patients' medical history, and help coordinate care-gave higher ratings to the care they received and were less likely to experience coordination gaps or report medical errors. Throughout the survey, patients in Switzerland and the United Kingdom reported significantly more positive experiences than did patients in the other countries surveyed. Reported improvements in the United Kingdom tracked with recent reforms there in health care delivery. Patients in the United States reported difficulty paying medical bills and forgoing care because of costs. Our study indicates a need for improvement in all countries through redesigning primary care, developing care teams accountable across sites of care, and managing transitions and medications well. The United States in particular has opportunities to learn from diverse payment innovations and care redesign efforts under way in the other study countries. [ABSTRACT FROM AUTHOR]