Christine E. Parsons, Kirstin. L. Purves, Molly R. Davies, Jessica Mundy, Shannon Bristow, Thalia C. Eley, Gerome Breen, Colette R. Hirsch, Katherine S. Young
The COVID-19 pandemic brought about dramatic changes in how patients access healthcare from its outset. Lockdown restrictions and remote working led to a proliferation of digital technologies and services, which also impacted mental health provisions. Against the backdrop of new and changing support services, along with an unprecedented emphasis on mental health, relatively little is known about how adults sought out and received support for their mental health during this period. With a sample of 27,574 adults assessed longitudinally online over 12 months of the pandemic in the UK, we analysed reports of help-seeking for mental health, as well as sources of treatment or support and the perceived helpfulness of treatments received.
From the earliest days of the first pandemic lockdown in the UK and globally, the common mantra was to ‘flatten the curve’ to ensure healthcare systems could function within their capacities . Patients were encouraged to avoid unnecessary face-to-face appointments and many routine healthcare visits were initially cancelled or postponed. Against this backdrop of pressed healthcare systems, there have been concerns about the impact of pandemic restrictions and the pandemic itself on population mental health .
Materials and method
We combined data from two cohorts, the COVID-19 Psychiatry and Neurological Genetics (COPING) study and the Repeated Assessment of Mental Health in Pandemics (RAMP) study. Full details of the COPING and RAMP study procedures are reported elsewhere . All participants were UK residents aged 16 years or above. COPING recruited from existing participant cohorts via the National Institute for Health and Care Research BioResource, including a large proportion of individuals from the Genetic Links to Anxiety and Depression (GLAD) Study . There were a number of methods for initial recruitment to the NIHR BioResource, including through blood donation centres and other National Health Service sites.
We report the frequency of five outcomes. These were: treatment seeking, treatment receipt (i.e., what proportion of individuals reported seeking a specific treatment and whether they said they received it or not), reasons for treatment seeking or not seeking, reasons for non-receipt, and perceived helpfulness of treatment received.
We did not find evidence for large fluctuations in treatment-seeking for mental health in periods of tighter or more relaxed restrictions in the UK. Treatment seeking in this sample appeared relatively stable across the 12 months from July 2020 onwards, with a 4% difference between the months with the highest reported treatment seeking and the lowest (17% in November 2020, 13% in December 2020). Most individuals were seeking treatment for a continuation or worsening of an existing mental health difficulty. However, we did note larger differences for treatment receipt, with the lowest levels recorded corresponding to the 3rd national lockdown (53%, January 2021), compared to the highest, where social gathering restrictions were eased (66%, May 2021). Whether these small fluctuations were related to COVID restrictions or not cannot be determined by the present data, but our findings are in general alignment with other data sources on treatment-seeking.
Across 12 months of the pandemic in the UK, the majority (57%) of adults who reported seeking help in our sample received it. For our participants, online talking therapy was one of the most frequently sought out sources of help. In contrast, self-guided online therapy was one of the least frequently sought sources. Not only were online talking therapies frequently sought, but they were also rated typically as being extremely or very helpful to those who did access them. Our findings underline online talking therapies as an acceptable, widely sought source for mental health support, of importance when considering the current NHS waiting lists.
We gratefully acknowledge contributions from staff at the Department of Health and Social Care (DHSC), UK in the design of the questionnaire used in this study. The views expressed are those of authors and not necessarily those of the NHS, NIHR, King’s College London or the Department of Health.
Citation: Parsons CE, Purves KL, Davies MR, Mundy J, Bristow S, Eley TC, et al. (2023) Seeking help for mental health during the COVID-19 pandemic: A longitudinal analysis of adults’ experiences with digital technologies and services. PLOS Digit Health 2(12): e0000402. https://doi.org/10.1371/journal.pdig.0000402
Editor: Haleh Ayatollahi, Iran University of Medical Sciences, IRAN (ISLAMIC REPUBLIC OF)
Received: April 7, 2023; Accepted: November 4, 2023; Published: December 6, 2023
Copyright: © 2023 Parsons et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: Data includes sensitive information about mental and physical health. As stated in documentation approved by King's College London Research ethics committee: "access to fully anonymised data will be granted at the discretion of study PIs to other researchers and collaborators for data analysis purposes". Any requests for access to data should follow the procedures outlined here: https://gladstudy.org.uk/researchers/data-access-and-recontacts.
Funding: KSY and CH were supported by MQ; Transforming Mental Health (MQF20/24). TCE and GB are part funded by a program grant from the UK Medical Research Council (MR/V012878/1). CEP is funded by a grant from the Carlsberg Foundation (Semper Ardens: Accelerate CF19-0715). CH, TCE, GB and KSY receive/received salary support from the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.