July 21, 2020

expert reaction to study looking at mental health, lockdown and the COVID-19 pandemic in the UK

A study, published in The Lancet Psychiatry, has looked at the effects on mental health of lockdown and the COVID-19 pandemic in the UK.

Dr Nilu Ahmed, Lecturer in Social Sciences, University of Bristol, said:

“This is a strong paper using a robust longitudinal data set which allows the authors to compare mental wellbeing over time.  The authors rightly recognise a further spike may emerge with the economic and long-term impact of this pandemic that overstretched mental health services are not equipped to deal with.

“A crucial area that emerges is the lack of comparable data for BAME communities.  The authors report: ‘There were too few responses to examine changes in mental health within ethnic groups from before and after the pandemic. However, average mental distress scores were higher for Asian people than white British… but the study was not powered to detect a change for other ethnic groups’.  This means we do not know the level of change within BAME groups so cannot understand how much more or less distress they have experienced as a result of the pandemic.

“The lack of this key data is alarming, and points to an urgent need for studies on the mental health of BAME groups during Covid.  As the group most disproportionately affected by Covid, the ramifications for further entrenching and extending inequalities are immense.  BAME communities are already overrepresented in low income households and precarious employment sectors.  During Covid they are more likely to have experienced bereavement and lost the main earner.  Coupled with the fact they have poorer access to mental health services, and a dearth of BAME mental health specialists who can provide linguistically and culturally appropriate services, this is an area that needs further investigation and support to avoid disproportionately poor mental health.

“Alongside the need for more data on BAME communities, the authors rightfully call for more research for other groups.  Given the elevated risk to men of Covid and the known higher rates of completed suicide by men, it is wise to investigate this further.  In my psychotherapy work I have witnessed the increased frustration and distress young people are feeling trapped in lockdown as they struggle to balance their freedom and sense of social responsibility.”

Prof Elaine Fox, Professor of Psychology & Affective Neuroscience, University of Oxford, said:

“This is an important and interesting study that provides rich data from over 17,000 respondents.  An advantage of the study is that assessments were available from before the pandemic and lockdown and so the increase in clinically significant signs of distress is especially informative.  Pre-existing vulnerabilities were magnified during the lockdown although it was a pity that there was insufficient data to comment on racial inequalities.

“What we don’t know is how the increase in mental health problems during the early stages of the pandemic will translate into longer-term mental health problems.  Research following major disasters typically show that most people are resilient and relatively few develop on-going mental health problems.  However, what the current research does highlight is that certain groups of people (e.g., those with young children) may be particularly at risk.”

Prof Dame Til Wykes FMedSci, Vice Dean Psychology and Systems Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, said:

“This is a large well-documented study on the effects of lockdown and the dramatic increases in Covid-19 deaths in April.  By comparing data with previous surveys they can see trends which are not obvious from a single cross-sectional survey.

“These results replicate other studies which all show mental health problems resulting from the lockdown and increasing death toll in April.  So is it surprising?  Mental health problems can result from changes in social conditions and this shows that effect clearly.

“We get something extra in this large study of a threshold effect – the number of people who have clinically significant problems.  These are the people we need to keep an eye on and may need specific mental health support.  But this study cannot give us precise estimates of who needs what intervention as their measure is very general.  I expect it is mainly anxiety and depression.

“Over time people will have adapted to this new lifestyle, worked out a home schooling and work routine.  It is probably too optimistic to expect the rate of problems to fall over time because some people will be facing new social and financial problems since April also leading to serious mental health consequences.

“We had a mental health crisis before this pandemic with people waiting months for treatment.  The pandemic has only highlighted it.  We responded to the physical health crisis, we now need a Nightingale solution for mental health.”

‘Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population’ by Matthias Pierce et al. was published in The Lancet Psychiatry on Tuesday 21 July 2020.

DOI: 10.1016/S2215-0366(20)30308-4

Declared interests

None received.