Published: 11 January 2021
The number of people seeking help for mental illness or self-harm during April 2020, while the UK was in full lockdown, dropped by more than a third, according to NIHR-funded research.
Forecasts suggest that millions of people in England will require new or additional mental health support as a result of the COVID-19 pandemic. However, this research showed marked reductions in people seeking help for mental health problems during the early stages of the pandemic.
The researchers used data from 14 million people across the four nations of the UK to analyse the first time people sought medical help for their mental health, either at their general practice or at a hospital A&E department.
In April 2020, the first full month of the UK wide lockdown, the number of incidents of depression recorded in general practice records in England dropped by 43%, and anxiety disorders dropped by 47.8%.
In addition, the number of people presenting with self-harm was 37.6% lower than expected in April. The reduction was greatest for women and people aged under 45.
By September 2020, reported rates of depression, anxiety disorder and self-harm were either close to, or had reached, expected levels.
The research also uncovered significant drops in treatment, such as prescribing of antidepressants. This was greatest for people of working age and those registered at general practices in more deprived areas, where the reduction in diagnoses coded was greatest.
The research, published in The Lancet Public Health, was jointly funded by the NIHR and UK Research and Innovation and conducted by the NIHR Greater Manchester Patient Safety Translational Research Centre (GM PSTRC).
Dr Matthew Carr, study lead at the NIHR GM PSTRC, said: “It is widely believed that there was an increase in the number of people with symptoms of mental illness in April due to the extra pressures from the lockdown. However, our research has revealed a sharp reduction in recorded illness diagnoses and self-harm episodes.
“This research is so important because it shows the scale of the drop in the number of people seeking help, and, crucially, the treatment gaps.”
Dr Sarah Steeg, Presidential Fellow in mental health epidemiology at The University of Manchester, who jointly led the research, said: “It is understandable that people didn’t seek help at the height of the pandemic in the spring of 2020. However, GPs moved quickly to offer remote consultations for many appointments. The consequences of patients not receiving help when they need it could result in further struggles for those individuals, and therefore they must be encouraged to seek support if they are worried about their mental health.”
Professor Carolyn Chew-Graham, a GP in Manchester, Professor of General Practice Research at Keele University, and part of the research team, said: "This research mirrors my clinical experience. Consultation rates reduced in April and May, with people following the ‘Save the NHS’ message. Since the early summer we have noticed increasing demand and, particularly, increasing distress in patients.
“The impact of this work for primary care is that we need to make it as easy as possible for people who are distressed to consult their GP, but balance this with the need to keep footfall as low as possible in the practice, in accordance with NHSE guidance and COVID-19 restrictions.”
Professor Dame Til Wykes, Senior NIHR Mental Health Researcher, said: "As this research makes clear, now is not the time to suffer in silence. More than ever, people experiencing depression, anxiety and other mental health issues should seek the help they need from the health service, and family and friends.
“NIHR have recognised the challenges that mental health issues have posed during COVID-19 so have funded this project with UKRI as well as other research to investigate and reduce the impact of the COVID-19 pandemic on mental health.”
Find out more on the Greater Manchester Patient Safety Translational Research Centre blog.