November 17, 2021

expert reaction to study looking at mental health concerns during the pandemic

A study published in Nature looks at calls to mental health helplines to measure mental health concerns during the COVID-19 pandemic.

Professor Dame Til Wykes, Head of the School of Mental Health and Psychological Sciences (MHaPS), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, said:

“This is an interesting study using callers to mental health helplines across the world which produces the obvious question of whether these individuals are representative of people who have mental health problems – the answer is probably not as people with the most serious mental health difficulties are probably not going to pick up a phone. However, this doesn’t mean the data are unimportant.

“Lockdowns increased distress about loneliness and fear of infection and more so when they were lockdowns were stringent. Even though the volume of calls increased, the lockdown issues seemed to replace the usual topics like suicide and addiction.

“An interesting and important finding is the effect of a factor that decreased helpline calls. The generosity of financial support was the key factor. In terms of policy this may have a profound effect. People with mental health problems often fall out of the labour force and so this cost might actually be spent on supporting people to reduce the chances of this happening. In the UK the extra £20 in Universal Credit and furlough schemes may well have helped to ease some of the worst UK lockdown effects. The treasuries of all the countries involved in this study might consider now and in the future to offset the increased need for mental health services – a need that services couldn’t meet before the pandemic and will have even greater difficulties meeting after it.”

Lea Milligan, the CEO for MQ Mental Health Research, said:

“Even before the pandemic we were seeing an alarming rise in mental illnesses, especially among children. Understanding the full impact of the pandemic on mental health, and particularly who has been most vulnerable and at risk, is key if we are to better protect people in the future. This study demonstrates that having access to high quality, anonymised data, is a vital tool for researchers if we are to get an accurate view of the nations mental health.”

Dr Jo Daniels, Senior Lecturer in Clinical Psychology, University of Bath, said:

“The press release broadly reflects the science.

“One of the key strengths of this study is the large international dataset and longitudinal design, tracking call frequency and content alongside the stringency of public health measures and infection rates. The findings are consistent with our own UK based research from the initial weeks of the pandemic which reflected elevated rates of health related anxiety across all groups, with higher rates of anxiety increasing with age (Rettie & Daniels, 2020 – Coping and tolerance of uncertainty: Predictors and mediators of mental health during the COVID-19 pandemic. (apa.org)). In consideration of long-term impact, we know that some of these concerns such as loneliness, isolation and financial problems are associated with poorer mental health; this work reinforces the need to ensure provision of mental health services globally moving forward – it is far from over, from this perspective. 

“Despite the strengths, it is evident that not all calls were answered which gives an incomplete picture and we have no sense of whether the callers are a ‘new’ cohort of callers with COVID-19 related concerns, or if these callers are representative of the usual profile of pre-pandemic callers. This calls into question whether callers have ‘replaced rather than exacerbated underlying anxieties’ as we have no baseline information on callers to comment on change or information on other potential sources of support; there is a great deal of COVID-19 research reflecting that previous mental health difficulties and concerns about mental and physical health are related to higher rates of distress during the pandemic (Rettie & Daniels 2020, Roberts et al. 2020, e049680.full.pdf (bmj.com).

“In regards to calls of a domestic violence nature, these findings must be interpreted with some caution;  there is a body of evidence which has pointed to an increase in domestic violence during the pandemic. It is likely the stay at home mandate during this early period will have influenced the frequency of calls regarding domestic violence due to the potential relative impact of making these calls while in enforced close proximity of others, which should also be taken into account, particularly in context of the increased provision of online support for domestic violence and other difficulties over the pandemic. It is likely that the prolonged, repeated and cumulative stress of ‘lockdowns’ and changing restrictions, alongside loss of usual coping strategies, are key contributors to issues increases in domestic violence and addiction but perhaps over a longer period of time – this may not present in the first six weeks of the pandemic, and victims of domestic violence may not immediately seek help. 

“This research contributes to what we already have already established in our knowledge of the pandemic, using other sources to reinforce the need for the provision of support for those experiencing psychological difficulties during the pandemic, and beyond. Future provision and policy development must be driven by science; we are replicating the findings of previous pandemics, we must now learn from this and prepare for the future while still mitigating the impact of this pandemic, which will cast an undoubtedly long shadow.”

‘Mental health concerns during the COVID-19 pandemic as revealed by helpline calls’ by Marius Brülhart et all was published in Nature at 16:00 UK time on Wednesday 17 November.

DOI: https://doi.org/10.1038/s41586-021-04099-6

All our previous output on this subject can be seen at this weblink:

www.sciencemediacentre.org/tag/covid-19

Declared interests

None received.