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Pre-pandemic mental health and disruptions to healthcare, economic and housing outcomes during the COVID-19 pandemic: evidence from 12 UK longitudinal studies

journal contribution
posted on 04.10.2021, 16:21 by Giorgio Di Gessa, Jane Maddock, Michael J Green, Ellen J Thompson, Eoin McElroy, Helena L Davies, Jessica Mundy, Anna J Stevenson, Alex SF Kwong, Gareth J Griffith, Srinivasa Vittal Katikireddi, Claire L Niedzwiedz, George B Ploubidis, Emla Fitzsimons, Morag Henderson, Richard J Silverwood, Nish Chaturvedi, Gerome Breen, Claire J Steves, Andrew Steptoe, David J Porteous, Praveetha Patalay
Background
The COVID-19 pandemic has disrupted lives and livelihoods, and people already experiencing mental ill health may have been especially vulnerable.

Aims
Quantify mental health inequalities in disruptions to healthcare, economic activity and housing.

Method
We examined data from 59 482 participants in 12 UK longitudinal studies with data collected before and during the COVID-19 pandemic. Within each study, we estimated the association between psychological distress assessed pre-pandemic and disruptions since the start of the pandemic to healthcare (medication access, procedures or appointments), economic activity (employment, income or working hours) and housing (change of address or household composition). Estimates were pooled across studies.

Results
Across the analysed data-sets, 28% to 77% of participants experienced at least one disruption, with 2.3–33.2% experiencing disruptions in two or more domains. We found 1 s.d. higher pre-pandemic psychological distress was associated with (a) increased odds of any healthcare disruptions (odds ratio (OR) 1.30, 95% CI 1.20–1.40), with fully adjusted odds ratios ranging from 1.24 (95% CI 1.09–1.41) for disruption to procedures to 1.33 (95% CI 1.20–1.49) for disruptions to prescriptions or medication access; (b) loss of employment (odds ratio 1.13, 95% CI 1.06–1.21) and income (OR 1.12, 95% CI 1.06 –1.19), and reductions in working hours/furlough (odds ratio 1.05, 95% CI 1.00–1.09) and (c) increased likelihood of experiencing a disruption in at least two domains (OR 1.25, 95% CI 1.18–1.32) or in one domain (OR 1.11, 95% CI 1.07–1.16), relative to no disruption. There were no associations with housing disruptions (OR 1.00, 95% CI 0.97–1.03).

Conclusions
People experiencing psychological distress pre-pandemic were more likely to experience healthcare and economic disruptions, and clusters of disruptions across multiple domains during the pandemic. Failing to address these disruptions risks further widening mental health inequalities.

History

Citation

The British Journal of Psychiatry , 2021 DOI: https://doi.org/10.1192/bjp.2021.132

Author affiliation

Department of Neuroscience, Psychology and Behaviour, College of Life Sciences

Version

AM (Accepted Manuscript)

Published in

The British Journal of Psychiatry

Publisher

Royal College of Psychiatrists

issn

0007-1250

eissn

1472-1465

Copyright date

2021

Available date

30/03/2022

Language

en