As part of our #Co90sDiscoveries series, Dr. Alex Kwong tells us how mental health changed across the pandemic and for whom. 

‌‌The speed with which we were able to gather evidence of how the pandemic escalated anxiety levels was instrumental in urging the UK government to improve mental health services and public guidance. 

Mental health and COVID-19: Influencing policy and public understanding

In March 2020, to address the COVID-19 pandemic, the UK government enforced a full lockdown requiring everyone to ‘stay at home’, with businesses and schools shut. Children of the 90s research showed that this and subsequent lockdowns had a profound impact on mental health. Our data revealed a quarter of young people experienced moderate levels of anxiety, double the pre-pandemic level, providing valuable evidence for policymakers and Public Health England (now known as UK Health Security Agency).

Unique access to data

“We know the COVID-19 pandemic affected some people’s mental health; there were several stories coming out about how the pandemic – and the various mitigation measures – were negatively affecting people’s mental wellbeing,” says co-lead researcher Dr Alex Kwong, Senior Research Associate in Psychiatric Genetic Epidemiology at the University of Bristol.

“We wanted to use the rich data from Children of the 90s to know if mental health had worsened during the pandemic.”

Thanks to the wealth of mental health data collected from thousands of people over many years before the pandemic, researchers had an important benchmark against which to compare the present situation. This was done by comparing historic data with findings from two COVID-19 questionnaires conducted by Children of the 90s in 2020.

Exposing inequalities

The analysis showed that the number of young people with anxiety had doubled from a moderate 13% prior to the pandemic, to an alarming 24% during the early stages of COVID-19 and the first UK lockdown. By January 2021, that figure had risen to 27%.

These findings were observed in both younger and older generations and replicated in an additional group of over 4,000 Scottish individuals – implying these effects may not just be specific to individuals in the South West. Alongside the data from Children of the 90s, researchers examined data from another longitudinal study, Generation Scotland.

The rise in adverse mental health issues was attributed to the pandemic itself, and the likely knock-on effect of the societal and economic fallout that sprung from lockdown measures used to control the spread of the virus.

The most at-risk groups were identified as people with pre-existing mental and physical health problems, people who lived alone, those with financial problems, and women.

Interestingly, researchers saw some specific effects for people living alone where they were more likely to have higher levels of depression rather than anxiety. And when restrictions eased, the numbers showed no obvious signs of declining, prompting Dr Kwong and his colleagues to emphasise the pandemic may have lasting effects and the urgency of public health interventions.

Shaping public guidance in real time

“Many studies don’t have pre-pandemic questions on mental health making it difficult to determine if there has really been a deterioration in mental health,” says Dr Kwong. “This is one of the reasons why we were able to share our results with SAGE (the Government’s Scientific Advisory Group for Emergencies) and theUK Health Security Agency, in an attempt to quickly impact on policy and government guidance. It is likely that our findings such as individuals living alone during the pandemic being at greater risk of depression, contributed to changes in policy regarding the formation of social ‘bubbles’.

“However, it’s important to stress that COVID is not simply going to go away, it is important to continue tracking mental health throughout the pandemic to understand why mental health issues increased and for whom. We need to make sure we have appropriate responses in place in the event of further waves or future pandemics.

“This is why we are continuing to follow up mental health throughout the pandemic and joining with other longitudinal studies to get a more global picture of what has happened and how to help those affected.”

Looking forwards – a more positive future

The Children of the 90s study has been collecting data throughout the COVID-19 pandemic, with data collections often coinciding with changes in restrictions. As such, new results using data collected in the summer of 2021 point towards a more positive future as the number of young people with moderate levels of anxiety decreased to around 20%. The improvement in depression was even greater, with some of the lowest levels of depression seen in over a decade.

“These new findings really show that mental health is closely aligned with changes in COVID-19 restrictions, and that people do have the ability to recover during a sustained period of eased COVID restrictions, unlike in the summer of 2020 when changes in restrictions were highly transient.” says Dr Kwong.

“These findings are helpful as they give us some hope to be optimistic about the future, but of course we need to continue monitoring changes in mental health and ensure that support is given to those who need it the most.”