Mental health impact of Covid-19 ‘not as substantial as predicted’

The impact of the Covid pandemic on mental health in Europe was “not as substantial as many people had predicted”, according to the author of a new major review of evidence.

Dr Nafiso Ahmed, lead author of the study, explains that while the pandemic had a “considerable effect” on mental health, this impact was long as long-lasting as experts predicted.

Indeed, many believed that we would see a ‘second pandemic’ of mental health problems, however, no major increase has been seen at a population level, according to the researchers.

Even so, they highlight that the pandemic did have “devastating consequences” for many people, and it is vital that we continue to improve mental health services as much as possible.

Lack of new mental health diagnoses likely caused by service disruption

The study, which was published in The Lancet Psychiatry, pulled together evidence from 177 studies in 20 European countries to assess how the Covid-19 pandemic affected mental health across the continent for the first two years after lockdowns began.

The researchers found a small rise in anxiety, depression and other common mental health problems after the onset of the pandemic. They say this could have been an acute response to a global event which caused widespread disruption, fear, financial hardship, and grief.

They found that this increase fell back to normal levels fairly quickly, but then fluctuated repeatedly throughout the pandemic, which may have been in response to new guidance, rules and lockdown measures.

The researchers found that people accessed mental health services significantly less in the early stages of the pandemic due to the disruption of service provision, and this is likely to have caused the drop in new diagnoses of mental illness.

Service use increased later in 2020 and through 2021, however, rates did not return to pre-pandemic levels for many services and even now, some services still have not recovered.

The researchers found no clear pattern of improvement or worsening of mental health problems for those with pre-existing conditions, likely due to a large variation between different people with different circumstances, although they did find some evidence of worsening symptoms for children and young people with pre-existing mental health problems.

Suicidal behaviour did not appear to change significantly overall, when pre-pandemic levels were compared to various timepoints in 2020 and 2021.

Provision of mental health services lagging behind demand

The authors caution that gaps between mental health needs and service provision may cause problems in the future, as Senior author Professor Sonia Johnson (UCL Psychiatry), Director of the Mental Health Policy Research Unit, explains:

“The disparity we found between increased prevalence of mental health problems and reduced service use suggests that the pre-existing treatment gap in addressing mental health problems may have increased, which could have potential long-term repercussions.

“Globally, provision of mental health services has long lagged behind demand, and in recent years this demand has continued to rise without sufficient increase in service provision; while the pandemic may have played a role in worsening this treatment gap, societal factors may play a greater role in driving rates of mental illness than the pandemic itself.”

The authors warn that their research may have missed trends from certain groups (such as high-risk groups and those with certain mental health problems, such as psychosis or bipolar), and say that further research is now needed to understand the long-term impact of the pandemic on mental health.