It will come as little surprise that the COVID-19 pandemic has profoundly altered society and many individuals perception of it and their place within it. Previous work by Dr Alex Kwong and his colleagues provided clear evidence that, in some people, mental health during COVID-19 worsened during the pandemic. This was particularly true for young adults, but it was unclear for how long this worsening would persist.

However, new work, funded by the Elizabeth Blackwell Institute and the Rosetrees Trust Mental Health Research Funding Call 2020 and overseen by Dr Kwong, aimed to give a clearer picture of the effect of the pandemic on mental health, both during lockdowns and the aftermath.

ALSPAC and mental health

Dr Kwong and his team collected data on mental health and its related treatments on over 4000 young people across the early 2020 lockdowns, the winter lockdown of late 2020 and then again when restrictions were eased in the summer of 2021. The team used data from the Children of the 90s study, also known as the Avon Longitudinal Study of Parents and Children (ALSPAC), to gather information on depression, anxiety, mental wellbeing, antidepressant use and other therapy treatments.

“We were able to compare these data with our previous results,” said Dr Kwong, “and we found that the number of people with moderate levels of anxiety increased during the 2020/2021 winter lockdown, compared to pre-pandemic levels and the earlier lockdowns of March and April 2020.”

However, there was some positive news from the work funded by the Elizabeth Blackwell Institute and the Rosetrees Trust which showed that mental health improved once the restrictions eased in the UK in the summer of 2021,” Dr Kwong continued. “Our results show that whilst mental health worsened across the early 2020 and winter 2020/2021 lockdowns, there were improvements in mental health when restrictions were eased for a considerable time in the summer of 2021. These findings 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”. 

SAGE advice

The initial data the team found were shared with Public Health England (PHE) and the Scientific Advisory Groups for Emergencies (SAGE) in a series of reports designed to assist in the formulation of future strategies.

The team also collaborated with an initiative led by University College London, and combined their data with other UK longitudinal studies to corroborate and extend their findings across the UK.

“We also shared these results with other longitudinal studies from across the United Kingdom to examine a more global impact of the pandemic. Together, we found very similar results from this work, suggesting that the COVID-19 had worsened mental health compared to pre-pandemic levels, and that the poorer mental health was worse during the winter of 2020/2021.” said Dr Kwong, “We were also able to assess the extent to which mental health changes following COVID-19 infection.” Read more about this research. 

“Lastly, we’re also looking at antidepressant and mental health therapy use before and during the pandemic. Our final results are also in process, but we have found that antidepressant use has increased throughout the pandemic. However, the relationship between the pandemic and therapy usage is harder to untangle, as treatment use has been increasing year on year since 2015.”

After the storm

In the aftermath of the pandemic, it has become clear that the restrictions which were put in place were necessary to slow down the spread of the disease and to protect as many people as possible, but they came at a cost. Data such as those gathered by Dr Kwong and his team will be invaluable to ensure that, when such measures become necessary in the future, they can be implemented with sufficient foresight and the appropriate facilities in place to assist those who need help the most.

“The work is still ongoing - and PhD student Holly Fraser is currently analysing the antidepressant use data to examine if these are related to improvements in mental health - so there’s still more scope for the data to make a real impact, and hopefully to inform future policy strategies,” said Dr Kwong.

Our current Next Steps project, funded by Elizabeth Blackwell Institute, is going to look at how mental health changes in day-to-day settings to identify promising targets for mental health interventions. We are recruiting participants with and without a history of depression and will follow them daily for three weeks to see how if there are specific patterns between different groups of people.

Watch a film about Alex Kwong's CO90s COVID-19 mental health research.