Mental health recovery slow during COVID-19 pandemic

Mental health of most adults in the UK remained resilient or returned to around the same level prior to the coronavirus disease 2019 (COVID-19) pandemic, although around one in nine had deteriorating or consistently poor mental health, results of a recent latent class trajectory analysis have shown. 

“Compared with results of previous rapid convenience surveys that suggested a rapid adjustment of mental health of individuals in the UK to the social changes surrounding the COVID-19 pandemic, our study’s findings imply more of a prolonged deterioration in mental health, with relatively little psychological adjustment or habituation until July 2020, coinciding with revocation of national lockdown measures,” said the authors. [Lancet Psychiatry 2021;doi:S2215-0366(21)00151-6]

“Our study’s findings have important implications for mental health policy makers and service planners. Preventive interventions might be required to target vulnerable groups of people, including those who struggle financially, and those with pre-existing conditions or severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] infection. In advance of further lockdowns or future pandemics, public mental health should be set as a priority, with mental health support focused on deprived communities, while social welfare services should be targeted at deprived families and individuals,” they suggested.

Results of the study revealed five distinct mental health trajectories between late April and early October 2020. More than 35 percent of individuals had either consistently very good (39.3 percent) or consistently good (37.5 percent) mental health throughout the COVID-19 period. Mental health recovery (ie, worsened mental health during the initial shock of the pandemic with recovery of mental health to around pre-pandemic level) was reported in 12 percent of individuals.

The other two groups were characterized by poor mental health throughout the observation period. For instance, 4.1 percent of individuals had consistently very poor mental health, characterized by sustained initial worsening of mental health, as reflected by highly elevated General Health Questionnaire (GHQ-12) scores. Seven percent of individuals had deteriorating mental health, characterized by a steady and sustained decline in mental health over time, despite little initial acute mental health deterioration.

In the deteriorating and consistently very poor mental health groups, significantly greater proportions of individuals with pre-existing mental or physical ill health (<0.0001) lived in deprived neighbourhoods (<0.001), and were of Asian, Black or mixed ethnicity (<0.001).

Infection with SARS-CoV-2, local lockdown and financial difficulties were associated with a 2.08-fold (95 percent confidence [CI], 1.06 to 3.10), 0.24-fold (95 percent CI, 0.01 to 0.46) and 0.59-fold (95 percent CI, 0.12 to 1.06) increase in mean change in GHQ-12 score, respectively, suggestive of a deterioration in mental health.

The researchers analyzed data of 19,763 individuals (≥16 years of age, 58.1 percent; female, 58.1 percent) who participated in at least one of the five COVID-19 web surveys of the UK Household Longitudinal Study between late April and early October 2020, and compared their mental health with pre-pandemic data recorded from 2018–2019.