Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population

Publication type

Journal Article

Authors

Publication date

October 15, 2020

Summary:

Background:
The potential impact of the COVID-19 pandemic on population mental health is of increasing global concern. We examine changes in adult mental health in the UK population before and during the lockdown.
Methods:
In this secondary analysis of a national, longitudinal cohort study, households that took part in Waves 8 or 9 of the UK Household Longitudinal Study (UKHLS) panel, including all members aged 16 or older in April, 2020, were invited to complete the COVID-19 web survey on April 23–30, 2020. Participants who were unable to make an informed decision as a result of incapacity, or who had unknown postal addresses or addresses abroad were excluded. Mental health was assessed using the 12-item General Health Questionnaire (GHQ-12). Repeated cross-sectional analyses were done to examine temporal trends. Fixed-effects regression models were fitted to identify within-person change compared with preceding trends.
Findings:
Waves 6–9 of the UKHLS had 53 351 participants. Eligible participants for the COVID-19 web survey were from households that took part in Waves 8 or 9, and 17 452 (41·2%) of 42 330 eligible people participated in the web survey. Population prevalence of clinically significant levels of mental distress rose from 18·9% (95% CI 17·8–20·0) in 2018–19 to 27·3% (26·3–28·2) in April, 2020, one month into UK lockdown. Mean GHQ-12 score also increased over this time, from 11·5 (95% CI 11·3–11·6) in 2018–19, to 12·6 (12·5–12·8) in April, 2020. This was 0·48 (95% CI 0·07–0·90) points higher than expected when accounting for previous upward trends between 2014 and 2018. Comparing GHQ-12 scores within individuals, adjusting for time trends and significant predictors of change, increases were greatest in 18–24-year-olds (2·69 points, 95% CI 1·89–3·48), 25–34-year-olds (1·57, 0·96–2·18), women (0·92, 0·50–1·35), and people living with young children (1·45, 0·79–2·12). People employed before the pandemic also averaged a notable increase in GHQ-12 score (0·63, 95% CI 0·20–1·06).
Interpretation:
By late April, 2020, mental health in the UK had deteriorated compared with pre-COVID-19 trends. Policies emphasising the needs of women, young people, and those with preschool aged children are likely to play an important part in preventing future mental illness.

Published in

The Lancet Psychiatry

Volume and page numbers

Volume: 7 , p.883 -892

DOI

https://doi.org/10.1016/S2215-0366(20)30308-4

ISSN

22150366

Subjects

Notes

Covered by over 10 media outlets

Is referenced by: Academy of Medical Sciences (2020) ‘Preparing for a challenging winter 2020/21’. London: Academy of Medical Sciences. ; Public Health Scotland (2021) 'COVID-19 shielding programme (Scotland) rapid evaluation: full report.' Edinburgh: Public Health Scotland. ; Observatoire National du Suicide (2022) 'Suicide: mesurer l'impact de la crise sanitaire liée au Covid-19 - 5e rapport'. [Paris]: Direction de la recherche, des études, de l’évaluation et des statistiques.

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