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Open accessJournal ArticleDOI: 10.1007/S00127-021-02051-7

Experiences of living with mental health problems during the COVID-19 pandemic in the UK: a coproduced, participatory qualitative interview study.

04 Mar 2021-Social Psychiatry and Psychiatric Epidemiology (Springer Berlin Heidelberg)-Vol. 56, Iss: 8, pp 1447-1457
Abstract: Research is beginning to quantify the impact of COVID-19 on people with pre-existing mental health conditions. Our paper addresses a lack of in-depth qualitative research exploring their experiences and perceptions of how life has changed at this time. We used qualitative interviews (N = 49) to explore experiences of the pandemic for people with pre-existing mental health conditions. In a participatory, coproduced approach, researchers with lived experiences of mental health conditions conducted interviews and analysed data as part of a multi-disciplinary research team. Existing mental health difficulties were exacerbated for many people. People experienced specific psychological impacts of the pandemic, struggles with social connectedness, and inadequate access to mental health services, while some found new ways to cope and connect to the community. New remote ways to access mental health care, including digital solutions, provided continuity of care for some but presented substantial barriers for others. People from black and ethnic minority (BAME) communities experienced heightened anxiety, stigma and racism associated with the pandemic, further impacting their mental health. There is a need for evidence-based solutions to achieve accessible and effective mental health care in response to the pandemic, especially remote approaches to care. Further research should explore the long-term impacts of COVID-19 on people with pre-existing mental health conditions. Particular attention should be paid to understanding inequalities of impact on mental health, especially for people from BAME communities.

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Topics: Mental health (64%), Qualitative research (51%)
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10 results found


Open accessPosted ContentDOI: 10.1101/2020.12.01.20241067
03 Dec 2020-medRxiv
Abstract: Background People with mental health conditions have been identified as particularly vulnerable to poor mental health and wellbeing during the coronavirus disease 2019 (COVID-19) pandemic. However, why this population have faced these adverse effects, how they have experienced them and how they have coped during the pandemic remains under-explored. Aims To explore how the COVID-19 pandemic affected the mental health of people with existing mental health conditions, and to identify protective factors and coping strategies applied to support positive mental health. Method Semi-structured qualitative interviews and thematic analysis with 22 people with pre-existing mental health conditions. Results Five pandemic related factors contributed to a deterioration in mental health: i) feeling safe but isolated at home ii) disruption to mental health services, iii) cancelled plans and changed routines iv) uncertainty and lack of control, and v) rolling media coverage. Five coping strategies and protective factors were identified for maintaining mental health: i) previous experience of adversity ii) feeling less accountable to others iii) engaging in hobbies and activities, iv) staying connected with others, and v) perceived social support. Conclusions Particular challenges were identified that were a direct result of the pandemic and people with severe mental illnesses were particularly negatively affected. However, some participants found this period a time of respite, were able to draw upon reserves of resilience and adapt their coping strategies to maintain positive wellbeing.

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Topics: Mental health (66%), Social support (53%), Population (51%) ... read more

13 Citations


Open accessJournal ArticleDOI: 10.3389/FPSYT.2021.622562
Ola Demkowicz1, Margarita Panayiotou1, Sam Parsons2, Amy Feltham  +9 moreInstitutions (6)
Abstract: In the face of the COVID-19 pandemic, the swift response of mental health research funders and institutions, service providers, and academics enabled progress toward understanding the mental health consequences. Nevertheless, there remains an urgent need to understand the true extent of the short- and long-term effects of the COVID-19 pandemic on mental health, necessitating ongoing research. Although the speed with which mental health researchers have mobilized to respond to the pandemic so far is to be commended, there are valid concerns as to whether speed may have compromised the quality of our work. As the pandemic continues to evolve, we must take time to reflect on our initial research response and collectively consider how we can use this to strengthen ensuing COVID-19 mental health research and our response to future crises. Here, we offer our reflections as members of the UK mental health research community to discuss the continuing progress and persisting challenges of our COVID-19 response, which we hope can encourage reflection and discussion among the wider research community. We conclude that (1) Fragmentation in our infrastructure has challenged the efficient, effective and equitable deployment of resources, (2) In responding quickly, we may have overlooked the role of experts by experience, (3) Robust and open methods may have been compromised by speedy responses, and (4) This pandemic may exacerbate existing issues of inequality in our workforce.

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Topics: Mental health (56%)

3 Citations


Open accessJournal ArticleDOI: 10.1016/J.DRUGPO.2021.103391
Joanna M Kesten1, Adam Holland1, Myles-Jay Linton1, Hannah Family1  +8 moreInstitutions (2)
Abstract: Background People who inject drugs (PWID) are a high-risk group for COVID-19 transmission and serious health consequences. Restrictions imposed in the UK in response to the pandemic led to rapid health and housing service alterations. We aimed to examine PWID experiences of: 1) challenges relating to the COVID-19 public health measures; 2) changes to opioid substitution therapy (OST) and harm reduction services; and 3) perceived effects of COVID-19 on drug use patterns and risk behaviour. Methods Telephone semi-structured interviews were conducted with 28 PWID in Bristol, Southwest of England. Analysis followed a reflexive thematic analysis. Results Concern about COVID-19 and adherence to public health guidance varied. Efforts made by services to continue providing support during the pandemic were appreciated and some changes were preferred, such as less frequent OST collection, relaxation of supervised consumption and needle and syringe programmes (NSP) home delivery. However, remote forms of contact were highlighted as less beneficial and more difficult to engage with than in-person contact. Public health guidance advising people to ‘stay home’ led to increased isolation, boredom, and time to ruminate which impacted negatively on mental health. Lockdown restrictions directly impacted on sources of income and routine. Changes in drug use were explained as a consequence of isolation and fewer interactions with peers, problems accessing drugs, reduced drug purity and reduced financial resources. Conclusion This study captures the significant impacts and challenges of the COVID-19 pandemic on the lives of PWID. While rapid adaptations to service delivery to help mitigate the risks of COVID-19 were appreciated and some changes such as relaxation of supervised daily OST consumption were viewed positively, barriers to access need further attention. Going forwards there may be opportunities to harness the positive aspects of some changes to services.

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1 Citations


Open accessPosted ContentDOI: 10.1101/2021.05.24.21257694
25 May 2021-medRxiv
Abstract: AimsTo explore: how satisfied people with severe mental illness (SMI) are with the support received during the pandemic; understand any difficulties encountered when accessing both mental health and primary care services; consider ways to mitigate these difficulties; and assess the perceived need for future support from mental health services. Materials and MethodsA representative sample was drawn from a large transdiagnostic clinical cohort of people with SMI, which was recruited between April 2016 and March 2020. The sample was re-surveyed a few months after the beginning of the restrictions. Descriptive frequency statistics were used to analyse the quantitative data. The free text responses were analysed thematically. Results367 participants responded to the survey. Two thirds were receiving support from mental health services with the rest supported in primary care or self-managing. A quarter thought they would need more mental health support in the coming year. Half had needed to used community mental health services during the pandemic and the majority had been able to get support. A minority reported that their mental health had deteriorated but they had either not got the supported they wanted or had not sought help. The biggest service change was the reduction in face-to-face appointments and increasing use of phone and video call support. Nearly half of those using mental health services found this change acceptable or even preferred it; acceptability was influenced by several factors. Participants were more likely to be satisfied with support received when seen in person. DiscussionAlthough most participants were satisfied with the mental health support they had received, a minority were not. This, couple with findings on future need for mental health support has implications for post pandemic demand on services. Remote care has brought benefits but also risks that it could increase inequalities in access to services.

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Topics: Mental health (63%), Mental illness (58%)

Open accessPosted ContentDOI: 10.1101/2021.08.23.21262469
Eleonore Batteux1, Jo Taylor1, Holly Carter1Institutions (1)
25 Aug 2021-medRxiv
Abstract: Background There is evidence that the COVID-19 pandemic has affected the mental health of the UK population, but this needs synthesising to guide effective policy recommendations and ensure support is targeted to populations most at risk. We conducted a rapid systematic review of the evidence of the impact of COVID-19 and associated restrictions on the mental health of UK adults, including risk and protective factors. Method A range of databases were searched to identify eligible studies. Studies were eligible if they reported primary quantitative or qualitative research on the mental health of UK adults between March 2020 and March 2021. Journal publications and pre-prints were included. Reviews, position papers, protocol papers and studies published in languages other than English were excluded. The study authors screened papers for eligibility and included 102 papers in the analysis. Results The evidence from this review indicates that the mental health of UK adults has declined since the start of the pandemic, with different populations being unequally affected. Populations particularly affected are women, young adults, ethnic minorities, people from lower socio-economic backgrounds, people with pre-existing conditions and people who have had COVID-19. Other risk factors include having to isolate and time spent watching pandemic related news. Protective factors include social contact and maintaining healthy behaviours, such as physical activity. Conclusions Policy should aim to discourage risky behaviours while ensuring support is available for people to engage in protective behaviours. Interventions should be directed towards populations that have been most adversely affected. Addressing the decline in mental health across the UK population since the COVID-19 pandemic will require increasing mental health provision and ensuring equitable access to support.

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Topics: Psychological intervention (60%), Mental health (58%), Population (52%)

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23 results found


Journal ArticleDOI: 10.1191/1478088706QP063OA
Virginia Braun1, Victoria Clarke2Institutions (2)
Abstract: Thematic analysis is a poorly demarcated, rarely acknowledged, yet widely used qualitative analytic method within psychology. In this paper, we argue that it offers an accessible and theoretically flexible approach to analysing qualitative data. We outline what thematic analysis is, locating it in relation to other qualitative analytic methods that search for themes or patterns, and in relation to different epistemological and ontological positions. We then provide clear guidelines to those wanting to start thematic analysis, or conduct it in a more deliberate and rigorous way, and consider potential pitfalls in conducting thematic analysis. Finally, we outline the disadvantages and advantages of thematic analysis. We conclude by advocating thematic analysis as a useful and flexible method for qualitative research in and beyond psychology.

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77,018 Citations


Open accessJournal ArticleDOI: 10.1016/S2215-0366(20)30168-1
Emily A. Holmes1, Emily A. Holmes2, Rory C. O'Connor3, V. Hugh Perry4  +22 moreInstitutions (17)
Abstract: The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuroscientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the UK in March, 2020. We urge UK research funding agencies to work with researchers, people with lived experience, and others to establish a high level coordination group to ensure that these research priorities are addressed, and to allow new ones to be identified over time. The need to maintain high-quality research standards is imperative. International collaboration and a global perspective will be beneficial. An immediate priority is collecting high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19. Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuroscientific aspects of the pandemic are required. Rising to this challenge will require integration across disciplines and sectors, and should be done together with people with lived experience. New funding will be required to meet these priorities, and it can be efficiently leveraged by the UK's world-leading infrastructure. This Position Paper provides a strategy that may be both adapted for, and integrated with, research efforts in other countries.

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Topics: Mental health (60%), Psychological intervention (59%), Global health (55%) ... read more

2,378 Citations


Open accessJournal ArticleDOI: 10.17169/FQS-13.1.1801
Jarg Bergold1, Stefan ThomasInstitutions (1)
Abstract: Dieser Beitrag soll in die FQS-Schwerpunktausgabe "Partizipative qualitative Forschung" einfuhren. Partizipative Forschungsstrategien finden in neuerer Zeit wieder groseres Interesse. Die Aufsatze aus unterschiedlichen Disziplinen befassen sich auf dem Hintergrund von konkreten empirischen Forschungsprojekten mit verschiedenen konzeptionellen Uberlegungen und methodischen Herangehensweisen. Uber die Lekture dieser Beitrage und in Auseinandersetzung mit den Forderungen der Autor/innen sind wir dazu angeregt worden, auf jene Bereiche besonders einzugehen, in denen unserer Ansicht nach weitergearbeitet werden sollte. Dies betrifft Grundlagen partizipativer Forschung wie demokratietheoretische Uberlegungen, das Konzept des "sicheren Raums", Fragen der Partizipation oder der Ethik, aber auch forschungspraktische Fragen zur Rolle und zu den Aufgaben der verschiedenen Teilnehmenden, zu besonderen methodischen Herangehensweisen bis zur Frage der Gutekriterien, die hier als Rechtfertigungsargumente verstanden werden. Damit soll zu einer breiten Diskussion angeregt werden, die nicht nur auf den engeren Bereich partizipativer Forschung bezogen sein sollte. Da partizipative Methodik manche Fragen nach Erkenntnis und Forschung radikal stellt, birgt sie in sich auch die Chance, auf bisher vernachlassigte Bereiche in der qualitativen Methodik hinzuweisen und ihre weitere Entwicklung anzuregen. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1201302

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785 Citations


Open accessJournal ArticleDOI: 10.1016/S2215-0366(20)30308-4
Matthias Pierce1, Holly Hope1, Tamsin Ford2, Stephani L. Hatch3  +7 moreInstitutions (7)
Abstract: Summary Background The potential impact of the COVID-19 pandemic on population mental health is of increasing global concern. We examine changes in adult mental health in the UK population before and during the lockdown. Methods In this secondary analysis of a national, longitudinal cohort study, households that took part in Waves 8 or 9 of the UK Household Longitudinal Study (UKHLS) panel, including all members aged 16 or older in April, 2020, were invited to complete the COVID-19 web survey on April 23–30, 2020. Participants who were unable to make an informed decision as a result of incapacity, or who had unknown postal addresses or addresses abroad were excluded. Mental health was assessed using the 12-item General Health Questionnaire (GHQ-12). Repeated cross-sectional analyses were done to examine temporal trends. Fixed-effects regression models were fitted to identify within-person change compared with preceding trends. Findings Waves 6–9 of the UKHLS had 53 351 participants. Eligible participants for the COVID-19 web survey were from households that took part in Waves 8 or 9, and 17 452 (41·2%) of 42 330 eligible people participated in the web survey. Population prevalence of clinically significant levels of mental distress rose from 18·9% (95% CI 17·8–20·0) in 2018–19 to 27·3% (26·3–28·2) in April, 2020, one month into UK lockdown. Mean GHQ-12 score also increased over this time, from 11·5 (95% CI 11·3–11·6) in 2018–19, to 12·6 (12·5–12·8) in April, 2020. This was 0·48 (95% CI 0·07–0·90) points higher than expected when accounting for previous upward trends between 2014 and 2018. Comparing GHQ-12 scores within individuals, adjusting for time trends and significant predictors of change, increases were greatest in 18–24-year-olds (2·69 points, 95% CI 1·89–3·48), 25–34-year-olds (1·57, 0·96–2·18), women (0·92, 0·50–1·35), and people living with young children (1·45, 0·79–2·12). People employed before the pandemic also averaged a notable increase in GHQ-12 score (0·63, 95% CI 0·20–1·06). Interpretation By late April, 2020, mental health in the UK had deteriorated compared with pre-COVID-19 trends. Policies emphasising the needs of women, young people, and those with preschool aged children are likely to play an important part in preventing future mental illness. Funding None.

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Topics: Mental distress (60%), Longitudinal study (55%), Mental health (54%) ... read more

784 Citations


Open accessJournal ArticleDOI: 10.1016/S2215-0366(20)30307-2
Carmen Moreno1, Til Wykes2, Til Wykes3, Silvana Galderisi4  +23 moreInstitutions (24)
Abstract: The unpredictability and uncertainty of the COVID-19 pandemic; the associated lockdowns, physical distancing, and other containment strategies; and the resulting economic breakdown could increase the risk of mental health problems and exacerbate health inequalities. Preliminary findings suggest adverse mental health effects in previously healthy people and especially in people with pre-existing mental health disorders. Despite the heterogeneity of worldwide health systems, efforts have been made to adapt the delivery of mental health care to the demands of COVID-19. Mental health concerns have been addressed via the public mental health response and by adapting mental health services, mostly focusing on infection control, modifying access to diagnosis and treatment, ensuring continuity of care for mental health service users, and paying attention to new cases of mental ill health and populations at high risk of mental health problems. Sustainable adaptations of delivery systems for mental health care should be developed by experts, clinicians, and service users, and should be specifically designed to mitigate disparities in health-care provision. Thorough and continuous assessment of health and service-use outcomes in mental health clinical practice will be crucial for defining which practices should be further developed and which discontinued. For this Position Paper, an international group of clinicians, mental health experts, and users of mental health services has come together to reflect on the challenges for mental health that COVID-19 poses. The interconnectedness of the world made society vulnerable to this infection, but it also provides the infrastructure to address previous system failings by disseminating good practices that can result in sustained, efficient, and equitable delivery of mental health-care delivery. Thus, the COVID-19 pandemic could be an opportunity to improve mental health services.

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Topics: Mental health (69%)

426 Citations