In a recent study published in JAMA Network Open, researchers estimated patterns of psychological distress and differences by sociodemographic characteristics among adult individuals in England between 2020 and 2022.
The coronavirus disease 2019 (COVID-19) pandemic has led to a mental health crisis in England, causing increased living costs and stressors such as infection risk, work closures, and financial strain.
The pandemic has also exacerbated international emergencies, such as the climate crisis and the Ukraine war, causing psychological distress in vulnerable groups. Understanding long-term shifts in mental health burden is crucial for service needs.
Study: Trends in Psychological Distress Among Adults in England, 2020-2022. Image Credit: Stock-Asso/Shutterstock.com
About the study
In the present cross-sectional study, researchers investigated mental health changes among adults residing in England between 2020 and 2022.
Data were obtained from the National Smoking and Alcohol Toolkit survey-based study, conducted monthly among households of adult residents of England aged ≥18.0 years from April 2020 to December 2022. The study outcome measure was previous-month psychological distress, assessed using the Kessler Psychological Distress Scale (K10).
The team modeled trends in psychological distress of moderate-severe intensity (scores ≥five) and severe intensity (scores ≥13.0), testing interactions with participants’ age, sex, smoking habits, occupational grade, alcohol consumption, and pediatric family member count.
In total, 1,509 individuals (2.80%) were excluded from the analysis due to inadequate data on psychological distress.
Log-binomial regression modeling was performed to determine the associations between psychological distress and the calendar month, and the prevalence ratios (PRs) were calculated. Alcohol intake was assessed using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C).
Results and discussion
Data were obtained from 51,861 adult individuals whose mean age was 49, and 51% (n=26,609) were female. Among the participants, 30.0% and 6.2% experienced any-intensity and severe-intensity psychological distress, respectively.
Younger, female, and less socioeconomically privileged adults were more likely to experience psychological distress, in accordance with previous studies.
The team observed a minor reduction in participants documenting psychological distress (35% to 32%; PR, 0.9) over the study period.
A significant decrease was observed in any-intensity discomfort from April 2020 to December 2022 among individuals aged ≥65.0 years (PR, 0.6), women (PR, 0.9), those belonging to occupational social grade C1 (PR, 0.9), those having no children (PR, 0.9), non-smokers or former-smokers (PR, 0.9), and non-drinkers or light alcohol drinkers (PR, 0.9). In contrast, the percentage of individuals experiencing severe psychological discomfort was 46% higher (PR, 1.5).
The patterns varied by sociodemographic factors, alcohol intake, and smoking; however, the rise in severe psychological distress was noted among all subgroups (PR values ranged between 1.2 and 2.2), except for older individuals aged ≥65.0 years (PR, 0.8); the worsening of distress was especially pronounced from late 2021 onwards among individuals aged below 25.0 years, from 14.0% to 20.0% from December of 2021 to December of the following year.
In addition, severe distress increased among current smokers and individuals belonging to social grades D and E.
Smaller increases were reported for distress among 25-to-34-year-olds (from 10% in December 2021 to 12% in December 2022), 35-to-49-year-olds (from 6.00% in December 2021 to 7.20% in December of the following year), and 50-to-64-year-olds (from 5.00% in December 2021 to 6.20% in December of the next year).
However, the rates remained unaltered among individuals aged ≥65.0 years (2.50% at both time points). Between April 2022 and December 2022, severe psychological distress among heavy drinkers increased from 6.2% to 10%, whereas the levels remained stable among non- or light drinkers.
Severe psychological distress was least prevalent among individuals aged ≥65 and most prevalent among individuals aged between 18 and 24.
Older adults may have benefited the most from COVID-19 vaccinations, and younger adults may have been more impacted than older ones by stressors such as the increased financial crisis (since they usually have less disposable income), the Ukraine war, and climatic changes.
Irrespective of the reason, the fact that one in five young individuals experienced severe distress is concerning and warrants appropriate actions by policymakers.
The increased prevalence of distress among the most socioeconomically deprived could be because they were hit earlier by the economic crisis. Increased stress from having children could be due to the additional burden on household budgets and concerns over climate hazards.
The increase in distress levels among alcohol consumers could be because the individuals may have used alcohol as a coping strategy for stressors.
Conclusion
Overall, the study findings showed that the percentage of adults reporting psychological distress in December 2022 was similar to that in April 2020, an extremely uncertain period of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak. Still, the percentage reporting severe psychological distress increased by 46%.
The findings indicated a worsening of mental health among residents of England, emphasizing the importance of addressing the root cause and effectively funding mental health care.
