People with previous mental ill health hit harder by pandemic disruption

People with higher levels of depression or anxiety before the pandemic have been more affected by job and healthcare disruption during the pandemic, according to a new study including Generation Scotland volunteer data.

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The study, co-led by University College London (UCL) researchers, looked at data from 59,482 people, including 3,179 of our volunteers. All participants involved are surveyed regularly, as part of 12 ongoing longitudinal studies in the UK.

About 3 years before the pandemic, the volunteers in each of the studies answered questionnaires designed to understand their mental health. They later reported the disruptions they experienced between March and December 2020. The researchers compared disruptions faced by people whose responses showed “average” levels of anxiety and depression to people with more anxiety and depression than average. This was regardless of whether they had a clinical diagnosis or were seeking treatment for a mental illness.

It found that, during the first 8 to 10 months of the pandemic, people who reported higher levels of anxiety and depression symptoms before the pandemic were:

  • 24% more likely to have had delays to medical procedures
  • 13% more likely to lose their job
  • 33% more likely to have had disruption to prescriptions or medication

compared to those with average levels of anxiety and depression symptoms.

Those with more severe symptoms of depression or anxiety experienced a much greater chance of job, income and healthcare disruption. 

Our findings highlight that the wider health and economic impacts of the pandemic have been disproportionately experienced by those with mental health difficulties, potentially leading to worsening longer term outcomes, even post-pandemic, for those already experiencing poor mental health.

Dr Praveetha Patalay
Senior Author, University College London

The work was conducted as part of the COVID-19 Longitudinal Health and Wellbeing National Core study, led by UCL researchers and funded by UKRI. The study involved researchers at UCL, King’s College London, the University of Glasgow, the University of Leicester, the University of Edinburgh, and the University of Bristol.

The research team looked at the disruptions of the pandemic in three areas:

  • Healthcare (medication access, procedures or surgeries, and appointments)
  • Economic activity (employment, income, or working hours)
  • Housing (change of address or household composition).

They found that people with previous mental ill health were more likely to face economic and healthcare disruption, but had no greater likelihood of housing disruption.

The anxiety and depression experienced by the participants of the study go beyond the mental ill health reported to GPs and healthcare services. This is a largely hidden group of people vulnerable to potentially long-lasting health and socioeconomic consequences of the pandemic.

Professor Nishi Chaturvedi
Co-lead, Covid-19 Longitudinal Health and Wellbeing National Core study

Policymakers should take these findings into account in the provision of future health care and economic support, as failing to address these disruptions risks widening health inequalities further. Special care should be taken by pharmacists and primary care staff to ensure people with mental health difficulties do not miss appointments, procedures and prescriptions.

“It is also important to note that pre-pandemic psychological distress was generally more common among women, younger generations, ethnic minorities, and those with fewer qualifications, meaning the overall impact of disruption on these groups is larger.

Dr Giorgio Di Gessa, 
Lead Author, UCL Institute of Epidemiology & Healthcare

The study was published in The British Journal of Psychiatry and funded by UKRI. The full paper can be found at:

Pre-pandemic mental health and disruptions to healthcare, economic and housing outcomes during the COVID-19 pandemic: evidence from 12 UK longitudinal studies