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Covid-19: How has mental health been affected?


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What has changed, and who it has changed for

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Implications for a wellbeing-based recovery

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Measures and resources you can use

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What has changed?

A global pandemic that has led to dramatic and immediate changes to our way of life, coupled with deep uncertainty about the future has inevitably affected our mental health. 

  • Almost half of the population of Great Britain (49.6%) reported high levels of anxiety at the start of lockdown, compared with 21% in the last quarter of 2019.

  • A survey of psychiatrists found a 43% increase in urgent and emergency mental health cases 

  • Around half a million more people in the UK will experience a mental health difficulty over the next year as a result of the pandemic, according to an estimate from the Centre for Mental Health. This has led to Psychiatrists and the World Health Organisation warning of an unprecedented increase in mental health referrals following the Covid-19 pandemic.

Not everyone is at equal risk however. And in recent months, anxiety levels in the UK have fallen as many people adjust to this ‘new normal’. 
 

Who is most at risk?

We have been looking through studies and surveys conducted in recent months to identify the people most at risk of mental health impacts.

  • People who experienced poor mental health before the pandemic generally suffered the largest deterioration in mental health, both in absolute and percentage terms:

    • Almost a third (32%) of young people with a history of mental illness agreed it had made their mental health much worse.

  • Fear of contracting Covid-19 and the illness or death of family members affect mental health. People, families, and communities more at risk from the direct effects of the disease itself are more at risk of mental health impacts too. This includes:

    • people over the age of 70

    • those with underlying health issues (overweight, uncontrolled diabetes, severe Asthma)

    • ethnic minorities

    • People living in poverty, and the children in these households.

  • People who are financially impacted by the pandemic show far higher levels of anxiety and feelings of not coping well with stress. One in five unemployed people reported suicidal thoughts in the previous fortnight. This compared with 9% of those in employment.

  • Over 1 in 5 people who are anxious now said that their work had been affected because they were finding working from home difficult.

  • Young people, including children as young as four, are more likely to have experienced poor mental health during lockdown than adults. Over two thirds of young people (68%) have said their mental health got worse during lockdown. Young people have been particularly affected by loneliness too. Feeling lonely was the factor most strongly associated with reporting high anxiety and just under three-quarter of young people (72%) said loneliness had made their mental health worse.

Life satisfaction rose among some groups of manual labourers and the underemployed during the lockdown. This could be due to fewer lifestyle changes or extra support policies like the eviction ban for example. The relatively good mental health outcomes for this group during lockdown could provide one explanation for the somewhat unexpected reduction in suicides that has been seen in some countries during the pandemic.

We are continuing to collect evidence on how people have been affected and invite more contributions here, and are using this to build an overall picture of the unequal impact of covid-19 on wellbeing in the UK.

Why this matters for wellbeing and wellbeing inequalities

  • Our perception of our health matters. Self reported bad health, including mental health, is the strongest factor associated with the poorest personal wellbeing.

  • A widening gap between people’s experience of mental health could increase wellbeing inequality. If we experienced poor mental health to start with - particularly with a diagnosed condition - we are likely to have seen our mental health worsen more than our mentally healthy peers. This increases health and associated wellbeing inequalities across the UK.

  • There is an overlap in risk profiles that could entrench inequality. People most at risk of worsening mental health are likely to have a similar profile to those at risk of the physical health impacts from catching the virus and the economic and social impacts from job losses and social distancing measures. These compounding factors exacerbate the wellbeing inequalities already apparent in the UK.

  • Young people have been particularly affected by impacts to their mental health. This can have long term wellbeing impacts, affecting everything from their academic attainment, to adult wellbeing outcomes.

“Covid-19 is a collective trauma that has changed all of our lives. But while we are all in it together, we’re not all experiencing it the same way. And there is clear and compelling evidence that people experiencing the biggest disadvantages and injustices before the pandemic are being affected more severely by both the virus and its effects on our mental health.
 
The extent of the impact of Covid-19 on the nation’s mental health will take time to gauge. And it will depend on whether we see a resurgence of the virus, what support is put in place to safeguard people’s lives and livelihoods, and how big a recession follows. But it is already evident that inequalities in health, wealth and power are important in determining how it affects our mental health.
 
It is therefore vital that national governments, local authorities and health services put the public’s mental health first in responding to the crisis. It must not be an afterthought and cannot be left to chance.”

Andy Bell, Deputy Chief Executive - Centre for Mental Health

How can this evidence shape a wellbeing-based recovery?

  • Support and restore access to mental health services. Particularly for the health vulnerable, out of work and young people.

  • Scale up mental health services  as a means to improve wellbeing and reduce inequalities. Even before the pandemic hit, scaling up the treatment of mental health illnesses was highlighted as a powerful and cost effective way to improve wellbeing in the UK. 

  • Nurture the restorative and positive impacts on mental health that have resulted from changes to our way of life, such as the increase in exercise, sleep and visits to green spaces that some people have experienced.
  • Build connective infrastructure. Plan to sustain local engagement and social capital created during the pandemic and subsequent response.

Research has identified four types of engagement: 

  • Everyday neighbourliness - smiles and chats between neighbours who previously hadn’t engaged
  • Practical volunteering - for example shopping, sewing scrubs and delivering meals
  • Relationship-based helping - visits to neighbours and ‘checking in’ with other people in the community, especially those seen to be at higher risk of being affected by Covid or Covid measures
  • Heightened awareness of others’ experiences, for example donating money, food, clothing, toys and IT equipment.   

Measures and resources 

Measures that matter

  • Public Health England's Fingertips Tool, has wellbeing inequality data for low life satisfaction, low happiness and high anxiety, 

  • The Warwick-Edinburgh Mental Wellbeing Scales (WEMWBS) can be used to measure of mental wellbeing in the population and to evaluate projects and policies which aim to improve mental wellbeing

  • It is important to measure the extent to which people with mental illness are able to live as normal a life as possible by looking at their levels of employment. One indicator to measure this is the percentage point difference between the rate of employment in the general population of working age (16-64) and the rate of employment amongst adults of working age with a mental illness.

Resources you can use

Both these infographics reflect research that finds that mental health and wellbeing lie on a dual continuum: that it’s possible to have high levels of wellbeing (with appropriate support) even if we experience specific mental health problems, and vice versa.

See all our infographics on a range of issues available for you to use.
Copyright © 2020 What Works Centre for Wellbeing, All rights reserved.


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