A large-scale review of research suggests that previous findings showing a detrimental effect on people’s mental health were often drawn from poor quality studies
"Mental health in Covid-19 is much more nuanced than people have made it out to be. Claims that the mental health of most people has deteriorated significantly during the pandemic have been based primarily on individual studies that are ‘snapshots’ of a particular situation, in a particular place, at a particular time. They typically don’t involve any long-term comparison with what had existed before or came after.” Brett Thombs, psychiatry professor, McGill University
The adverse effect of the Covid-19 pandemic on people’s mental health may not have been as great as previously believed, new research reported in the Guardian suggests.
A review of 137 studies from different countries, published in the BMJ, found that the pandemic resulted in “minimal” changes in mental health symptoms among the general population.
Brett Thombs, a psychiatry professor at McGill University in Canada and senior author on the study, said: “Mental health in Covid-19 is much more nuanced than people have made it out to be. Claims that the mental health of most people has deteriorated significantly during the pandemic have been based primarily on individual studies that are ‘snapshots’ of a particular situation, in a particular place, at a particular time. They typically don’t involve any long-term comparison with what had existed before or came after.”
The research team said their findings were consistent with the largest study on suicide during the pandemic, which found no increase, and applied to most groups, including both sexes and people of different ages. It also applied regardless of whether people had pre-existing conditions. Three-quarters of the research studies focused on adults, mostly from middle- and high-income countries.
Thombs said that some of the public narrative around the mental health impacts of Covid-19 were based on “poor-quality studies and anecdotes”, which became “self-fulfilling prophecies”.
The researchers acknowledged, however, that “among subgroups, women or female participants were the only group that experienced a worsening of symptoms across outcome domains; all by small amounts.” These symptoms included worsening anxiety and depression as well as general mental health symptoms. They say this may have been because they were juggling more family responsibilities, or because more women work in health or social care. In some cases it may have been caused by domestic abuse.
They also noted that depression symptoms had worsened by “minimal to small amounts” for older adults, university students, people who self-identified as belonging to a sexual or gender minority group and parents.
Governments and health agencies need to produce better quality and more timely mental health data to better target resources, the researchers said, adding that governments should continue to properly fund services, especially for the groups worst affected by the pandemic.
Other research, however, has suggested the mental health impact of the pandemic has been much more severe. A 2021 study by University of Queensland researchers found that anxiety and depression increased dramatically in 2020. In 2022 NHS leaders warned of a “second pandemic” of depression, anxiety, psychosis and eating disorders. Certainly in the UK there has been a rise in numbers seeking mental health help.
Gemma Knowles, from the Centre for Society and Mental Health at King’s College London, said the findings echoed other research showing that some people’s mental health improved and others’ deteriorated during the pandemic. She argued, however, that because the McGill study took a broad view, it risked “obscuring important effects among the most affected and disadvantaged groups and, from that, obscuring possible widening of inequalities in mental distress that occurred because of the pandemic”.
Roman Raczka, chair of the British Psychological Society’s division of clinical psychology, said that further studies were needed “into the impact of the pandemic on groups experiencing longstanding social and health inequities. We do know that overstretched and underfunded mental health services have been unable to meet soaring demand in recent years. It is vital that the government adequately funds services to deliver the support that is needed.”
Peter Tyrer, emeritus professor in community psychiatry at Imperial College London, said the McGill work was “of good quality” and that he agreed with the researchers’ conclusion that the pandemic had a similar positive effect on resilience to wars because “social cohesion, despite the handicaps of lockdown and social distancing, improves when there is a common enemy”.
These results are, on the face of it, surprising. Data over the past two-to-three years show rising rates of mental health referrals in the UK, particularly among young people. Because this was such a large-scale review, however, it seems possible that, as Gemma Knowles says, some people’s mental health improved during the pandemic. We know that there were those who enjoyed the opportunity that lockdown gave them to spend more time at home with their families, away from the stresses of a daily commute and the tensions of office life. It seems likely that the improved mental health experienced by some acted to cancel out the worse mental health experienced by certain other groups, showing little change overall.