Lockdown Orders Impacting Mental Health in the UK

Mental health remains on the growing list of problems linked to the ongoing coronavirus disease 2019 (COVID-19) pandemic.

However, it remains difficult to quantify just how damaging both the stress of the situation and the government mandated shelter-in-place orders put in place in the UK and the US.

A team, led by Mattias Pierce, PhD, Centre for Women's Mental Health, Faculty of Biology, Medicine and Health Sciences, University of Manchester, examined the changes in adult mental health in the UK both prior to and during the shelter-in-place orders during the COVID-19 pandemic.

Researchers have grown increasingly concerned by the potential impact of the pandemic on the collective mental health of the population.

In the secondary analysis of a national, longitudinal cohort study, the investigators reviewed data from households that took part in Waves 8 or 9 of the UK Household Longitudinal Study (UKHLS) panel, including all members at least 16 years old. Each eligible participant was asked to complete the COVID-19 web survey between April 23-30.

Participants who were unable to make an informed decision as a result of incapacity or who had an unknown postal address or addresses abroad were excluded.

The investigators assessed mental health using the 12-item General Health Questionnaire (GHQ-12) and repeated cross-sectional analyses were done to examine temporal trends.

They also fitted fixed-effects regression models to identify within-person change compared with preceding trends.

A total of 17,452 individuals participated in the web survey.

Overall, the 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% (95% CI, 26.3-28.2) in April, just 1 month following the lockdown put in place by the UK government.

In addition, the mean GHQ-12 score increased between the 2 time periods, from 11.5 (95% CI, 11.3-11.6) in 2018-19 to 12.6 (95% CI, 12.5-12.8) in April.

This result was 0.48 (95% CI, 0.07-0.90) points higher than expected when accounting for previous upward trends between 2014-2018.

By comparing GHQ-12 scores within different variables, after adjusting for time trends and significant predictors of change, the investigators found the greatest increases in 18-24 year old individuals (2.69 points; 95% CI, 1.89-3.48), 25-34 year old participants (1.57 points; 95% CI, 0.96-2.18), women (0.92 points; 95% CI, 0.50-1.35), and people living with young children (1.45 points; 95% CI, 0.79-2.12).

The investigators also found a notable GHQ-12 score increase in people employed prior to the pandemic (0.63 points; 95% CI, 0.20-1.06).

“By late April 2020, mental health in the UK had deteriorated compared with pre-COVID-19 trends,” the authors wrote. “Policies emphasizing the needs of women, young people, and those with preschool aged children are likely to play an important part in preventing future mental illness.”

The study, “Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population,” was published online by The Lancet Psychiatry.