People who had higher pre-pandemic levels of depression or
anxiety have been more severely affected by disruption to jobs
and healthcare during the pandemic, according to a new study
co-led by UCL researchers.
The study, published in The British Journal of
Psychiatry and funded by UKRI, looked at data from 59,482
people who are surveyed regularly as part of 12 ongoing
longitudinal studies in England. It found that people whose
survey responses before the pandemic suggested higher levels of
anxiety and depression symptoms were 24% more likely to have had
delays to medical procedures, 12% more likely to lose their job,
and 33% more likely to have had disruption to prescriptions or
medication during the first eight to 10 months of the pandemic
than those with average levels of anxiety and depression
symptoms.
Those with more severe symptoms of depression or
anxiety experienced a much greater likelihood of disruptions to
jobs, income and healthcare, the study found.
Dr Praveetha Patalay (UCL), senior author of the
paper, said: “Our findings highlight that the wider health and
economic impacts of the pandemic have been disproportionately
experienced by those with mental health difficulties, potentially
leading to worsening longer-term outcomes, even post-pandemic,
for those already experiencing poor mental health.”
Professor Nishi Chaturvedi (MRC Unit for Lifelong
Health and Ageing at UCL), who co-leads the Covid-19 Longitudinal
Health and Wellbeing National Core study, said: “The anxiety and
depression experienced by the participants of the study go beyond
the mental ill-health reported to GPs and healthcare services.
This is a largely hidden group of people vulnerable to
potentially long-lasting health and socioeconomic consequences of
the pandemic.”
Lead author Dr Giorgio Di Gessa (UCL Institute of
Epidemiology & Healthcare) said: “Policymakers should take
these findings into account in the provision of future health
care and economic support, as failing to address these
disruptions risks widening health inequalities further. Special
care should be taken by pharmacists and primary care staff to
ensure people with mental health difficulties do not miss
appointments, procedures and prescriptions.
“It is also important to note that pre-pandemic
psychological distress was generally more common among women,
younger generations, ethnic minorities, and those with fewer
qualifications, meaning the overall impact of disruption on these
groups is larger.”
Lead author Dr (University of
Glasgow) said: “During the pandemic, many people lost their jobs
or lost their income and faced disruptions to healthcare*. Our
study shows that this disruption was particularly likely to
affect people with prior mental ill health.
“We need to ensure that healthcare and support for
economic hardship are not overly difficult to access for these
vulnerable people, especially as existing pandemic economic
supports like furlough are removed.”
The work was conducted as part of the COVID-19
Longitudinal Health and Wellbeing National Core study, led by UCL
researchers and funded by UKRI. The study involved
researchers at UCL, King’s College London, the University of
Glasgow, the University of Leicester, the University of
Edinburgh, and the University of Bristol.
In each of the longitudinal studies, respondents
answered questionnaires designed to assess mental health about
three years before the pandemic on average. They later reported
the disruptions they experienced between March and December last
year.
The researchers compared disruptions faced by people
whose responses showed “average” levels of anxiety and depression
to disruptions affecting people with more anxiety and depression
than average, regardless of whether they had a clinical diagnosis
or were seeking treatment for a mental illness.
The research team looked at the disruptions of the
pandemic in three areas: healthcare (medication access,
procedures or surgeries, and appointments); economic activity
(employment, income, or working hours); and housing (change of
address or household composition). They found that people with
prior mental ill health were more likely to face economic and
healthcare disruption, but had no greater likelihood of housing
disruption.
Professor Chaturvedi added: “UKRI support has enabled
collaboration across 12 longitudinal cohort studies, allowing us
to address critical pandemic-related questions that could not be
answered any other way.”
* According to an Institute of Fiscal Studies (IFS)
briefing note, during the early stage of the pandemic one in six
people over the age of 50 reported having hospital treatment
cancelled, with an additional one in 10 unable to visit or speak
to their GP: https://ifs.org.uk/publications/15160
Notes to Editors
Giorgio Di Gessa, Jane Maddock, Michael J. Green et al.,
“Pre-pandemic mental health and disruptions to healthcare,
economic, and housing outcomes during COVID –19: evidence from 12
UK longitudinal studies”, will be published in The British
Journal of Psychiatry on Thursday 30 September, 06:00 UK
time and is under a strict embargo until this time.
doi.org/10.1192/bjp.2021.132
COVID-19 Longitudinal
Health and Wellbeing National Core Study - UCL – University
College London
