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Mental Health Service Preparedness during a Pandemic: A Delphi Study in Slovenia Cover

Mental Health Service Preparedness during a Pandemic: A Delphi Study in Slovenia

Open Access
|Jun 2026

Figures & Tables

Figure 1.

Overview of the Delphi study procedure.

Figure 2.

Identified vulnerable groups relevant to the organisation of mental health services during a pandemic in Slovenia.

Figure 3.

Identified stakeholders relevant to the organisation of mental health services during a pandemic in Slovenia.

Participants' professional and working background

Professional backgroundWorking fieldPopulation they are working withNumber of experts
Public health expertNational Institute of Public HealthChildren, adolescents and adults3

Child and adolescent psychiatristUniversity medical centreChildren and adolescents1

PsychiatristCommunity mental health centreAdults1
Psychiatric hospitalAdults1
Psychiatric clinicAdults1

PsychologistHealth promotion centreAdults1

Clinical psychologistCommunity mental health centreChildren and adolescents1
General hospitalAdults1
University Rehabilitation Institute of the Republic of SloveniaAdults1

Final consensus-based recommendations for the organisation of mental health services during a pandemic in Slovenia, structured by implementation phase_

MeasureActivity
System-strengthening measures – Implementation before the onset of a pandemic

Systemic measuresEnsure funding for healthcare services (including appropriate costs for labour and materials) and infrastructure (including premises, ICT equipment, vehicles).
Establish a legal framework for work in the field of mental health (psychotherapy, psychiatry, psychological services).
Ensure appropriate ventilation of the premises.
Develop standards for ICT equipment needed for telemedicine.
Encourage collaboration and coordination among stakeholders, professionals, and service users across all service types and levels; ensure effective design, development, and delivery of services.
Ensure access to services for all residents of Slovenia across all levels of care.
Establish preventive services and activities to protect and strengthen public mental health.
Strengthen services at the primary level of healthcare.
Strategically plan human resources in the field of healthcare (including backup staff for emergencies).
General measuresEstablish or adapt cooperation protocols between different mental health services.
Establish or adapt cross-sectoral stepped care protocols for people with mental health problems.
Establish or adapt clinical guidelines, clinical and care pathways for treating a range of mental health conditions during a pandemic.
Establish protocols for access to pharmacotherapy based on the epidemiological situation.
Promotion and prevention measuresImplement activities to raise awareness and literacy in the field of mental health.
Include mental health topics in various professional guidelines.
Implement destigmatisation initiatives in the field of mental health (with an emphasis on vulnerable groups).
Education measuresProvide additional training for mental health professionals in evidence-based interventions to address mental health problems during crisis situations.
Train non-mental health professionals in psychosocial support, psychological first aid, and the recognition of symptoms of stress and/or trauma.
Treatment measuresExpert guidelines for the provision of mental health services during crisis situations have been prepared by relevant professionals.
Telemedicine measuresDevelop telemedicine as part of the overall system, not as a separate service.
Train professional staff to deliver services via telemedicine.
Address potential inequalities in access to telemedicine.

Crisis-specific measures – Implementation at the onset of a pandemic

Systemic measuresEnsure sufficient protective equipment for unhindered service delivery in line with professional recommendations.
Ensure sufficient space for service delivery.
Encourage, at the level of policy and implementation during a pandemic, the collection, exchange, and use of data among stakeholders, including mental health data.
General measuresIdentify vulnerable groups and their mental health needs.
Provide systemic support for identified vulnerable groups and their mental health needs.
Involve mental health experts in the development of key public messages related to the pandemic.
Involve mental health experts in pandemic strategy development and measure implementation.
Work organisation measuresIntroduce staff rotation across work assignments based on stress levels and employee risk factors, while ensuring continuity of multidisciplinary care.
Pair experienced with less experienced staff (to guarantee intrapersonal support), with the option of regular supervision.
During escalating situations, ensure continuous and optimal service delivery at all levels of care.
Minimise, insofar as possible, the redeployment of mental health professionals.
Provide additional professional support (supervision) for professionals providing psychosocial support.
Promotion and prevention measuresDeliver psychoeducational activities for the general population, especially for vulnerable groups.
Ensure cross-sector collaboration for early detection of mental health issues.
Provide psychosocial support to the population, especially to vulnerable groups.
Disseminate professional content for safeguarding and strengthening mental health via various communication channels to different population groups.
Treatment measuresEnsure continuity of care for existing patients.
Ensure continuous psychosocial support for patients, especially for vulnerable groups.
Follow instructions for preventive (self)protective measures during service delivery.
Ensure safe, continuous contact of hospitalised patients with their loved ones in accordance with the epidemiological situation and professional recommendations.
Limit hospitalisations to urgent cases and keep stays short, without compromising the care quality standards.
Support patients in managing their mental health issues independently.

Crisis-specific measures – Implementation during a pandemic

Work organisation measuresIf hospitalisations are low, hospital staff should support primary care where emergency cases are treated within 24 hours.
Organise a hierarchical crisis response based on professional competence profiles and levels of distress.
Telemedicine measuresMaintain face-to-face care where possible, with a gradual introduction of hybrid and telemedicine services as the crisis worsens, in line with professional guidelines.
DOI: https://doi.org/10.2478/sjph-2026-0011 | Journal eISSN: 1854-2476 | Journal ISSN: 0351-0026
Language: English
Page range: 83 - 93
Submitted on: Jun 12, 2025
Accepted on: Apr 10, 2026
Published on: Jun 1, 2026
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2026 Špela Selak, Nuša Crnkovič, Janja Horvat, Irena Makivić, published by National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution 4.0 License.