Mental health presentations across healthcare setting during the first 9 months of the COVID-19 pandemic in England: Retrospective observational study

Smith, Gillian E., Harcourt, Sally E., Hoang, Uy, Lemanska, Agnieszka, Elliott, Alex J., Morbey, Roger A., Hughes, Helen E., Lake, Iain ORCID:, Edeghere, Obaghe, Oliver, Isabel, Sherlock, Julian, Amlôt, Richard and de Lusignan, Simon (2022) Mental health presentations across healthcare setting during the first 9 months of the COVID-19 pandemic in England: Retrospective observational study. Journal of Medical Internet Research, 8 (8). ISSN 1439-4456

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Background: The COVID-19 pandemic has resulted in unprecedented impact on the day to day lives of people, with several features potentially adversely affecting mental health. There is growing evidence of the size of the impact of COVID-19 on mental health, but much of this is from ongoing population surveys using validated mental health scores. Objective: This study investigated the impact of the pandemic and control measures on mental health conditions presenting to a spectrum of national healthcare services monitored using real-time syndromic surveillance in England. Methods: We conducted a retrospective observational descriptive study of mental health presentations (those calling the national medical helpline, NHS 111, consulting general practitioners in and out-of-hours, calling ambulance services and attending emergency departments) between 1 January 2019 to 30 September 2020. Estimates for the impact of lockdown measures were provided using an interrupted time series analysis. Results: Mental health presentations showed a marked decrease during the early stages of the pandemic. Post-lockdown, attendances for mental health conditions reached higher than pre-pandemic levels across most systems; a rise of 10% compared to expected for NHS 111 and 21% for GP out-of-hours whilst the number of consultations to in-hours GPs was 13% lower compared to the same time last year. Increases were observed in calls to NHS 111 for sleep problems. Conclusions: These analyses showed marked changes in the healthcare attendances and prescribing for common mental health issues, across a spectrum of healthcare provision, with some of these changes persisting. The reasons for such changes are likely to be complex and multifactorial. The impact of the pandemic on mental health may not be fully understood for some time, and therefore these syndromic indicators should continue to be monitored.

Item Type: Article
Additional Information: Funding: GES, AJE, RM, IRL and RA receive support from the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King's College London in partnership with UK Health Security Agency (UKHSA), in collaboration with the University of East Anglia. IO receives support from the NIHR HPRU in Behavioural Science and Evaluation at the University of Bristol. GES, AJE, HH, IRL and OE receive support from the NIHR HPRU in Gastrointestinal Infections at the University of Liverpool. AL received support from the National Physical Laboratory (NPL), UK through the cross-theme National Measurement Strategy under the Life Sciences & Healthcare theme (Digital Health [122471] Data Curation programme) which was funded by the Department for Business, Energy and Industrial Strategy (BEIS). The views expressed are those of the author(s) and not necessarily those of the NIHR, UKHSA or the Department of Health and Social Care.
Uncontrolled Keywords: anxiety,covid-19,health care,health care service,health surveillance,mental health,pandemic,public health,sleep problems,syndromic surveillance,public health, environmental and occupational health,health informatics,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2739
Faculty \ School: Faculty of Science > School of Environmental Sciences
UEA Research Groups: University of East Anglia Schools > Faculty of Science > Tyndall Centre for Climate Change Research
Faculty of Science > Research Centres > Tyndall Centre for Climate Change Research
Faculty of Science > Research Groups > Environmental Social Sciences
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Depositing User: LivePure Connector
Date Deposited: 30 May 2022 10:30
Last Modified: 22 Oct 2022 07:51
DOI: 10.2196/32347


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