Mental health has significantly worsened in UK after pandemic lockdown

The mental health of the U.K. population significantly worsened after the first month of the COVID-19 pandemic compared with before, according to results of a longitudinal probability sample survey published in The Lancet Psychiatry.

“This is the first peer-reviewed study to track changes in U.K. population mental health from before the COVID-19 pandemic and into the subsequent lockdown period,” Matthias Pierce, PhD, of the Centre for Women’s Mental Health at the University of Manchester, and colleagues wrote. “Previous studies have focused on specific groups, such as key workers, rather than a random sample of the whole population. Many have used non-validated measures of mental health or lacked comparable pre-COVID-19 baseline data against which to measure change.”

A study conducted among U.S. adults showed increased rates of psychological distress in April of this year compared with these rates in 2018.

To determine the mental health of the U.K. population before and during the pandemic, Pierce and colleagues conducted a secondary analysis of the national, longitudinal cohort U.K. Household Longitudinal Study, which has been tracking the mental health of U.K. residents at annual intervals for over 10 years. Specifically, they analyzed data of waves eight or nine of the study, which included all members aged 16 years or older in April. A total of 17,452 individuals completed a COVID-19 web survey between April 23 and 30, one month after the U.K. lockdown began. The investigators excluded those who were unable to make an informed decision because of incapacity, or whose postal addresses or addresses abroad were unknown. They used the 12-item General Health Questionnaire (GHQ-12) to assess mental health, repeated cross-sectional analyses to examine temporal trends and fixed-effects regression models to identify within-person change compared with preceding trends.

Results showed a significant rise in population prevalence of clinically significant levels of mental distress, from 18.9% (95% CI, 17.8-20) in 2018 to 2019 to 27.3% (95% CI, 26.3-28.2) in April 2020. During this time, mean GHQ-12 score increased from 11.5 (95% CI, 11.3-11.6) in 2018 to 2019 to 12.6 (12.5-12.8) in April 2020. The researchers noted this rise was 0.48 (95% CI, 0.07-0.9) points higher than anticipated after accounting for upward trends between 2014 and 2018.

After comparing GHQ-12 scores within individuals, as well as adjusting them for time trends and significant predictors of change, Pierce and colleagues observed several significant increases:

• 2.69 points (95% CI, 1.89-3.48) among those aged 18 to 24 years;

• 1.57 points (95% CI, 0.96-2.18) among those aged 25 to 34 years;

• 0.92 points (95% CI, 0.5-1.35);

• 1.45 points (95% CI, 0.79-2.12) among those living with young children; and

• 0.63 points (95% CI, 0.2-1.06) among those employed prior to the pandemic.

“The problems for mental health from COVID-19 and governmental responses to the pandemic are not necessarily new; instead, pre-existing mental health inequalities could become more entrenched and tackling them might be even more challenging,” Pierce and colleagues wrote. “The pandemic has brought people’s differing life circumstances into stark contrast: access to outside and inside space, household crowding, lack of school provision and childcare, food insecurity, domestic violence, addiction, access to internet and maintenance of social connectivity, as well as economic reserves are all relevant to mental health. An appropriate, proportionate response to mitigate and manage additional needs requires more high-quality information to be included in public health messaging about mental health during the pandemic, alongside adequately resourced services.”