Mental health in the general population over 1 year of the Covid-19 pandemic: findings from Ireland

Abstract Background The effects of the Covid-19 pandemic and associated public health measures on mental health is a cause of increasing concern. We have measured indices of mental health among adults in the general population in the Republic of Ireland (ROI) during the period of May 2020-April 2021. Methods Nationally representative cross-sectional telephone survey with data collected in ROI during four study waves involving 3,920 participants: Wave 1: May 26-June 17, 2020 (N = 969), Wave 2: July 1-23, 2020 (N = 1014), Wave 3: September 5-28, 2020 (N = 1008), Wave 4: April 16-28, 2021 (N = 929). Participants were recruited from adults resident in RoI, aged 18 years+ using random-digit-dialling of land lines and mobile phones and interviewed by a professional market research organisation (Ipsos MRBI). Data from Waves 1-4 will be presented including trends over the 12-month period. Finding from Waves 1 and 2 are presented here. Mental health was assessed using the Patient Health Questionnaire Anxiety Depression Scale (PHQ-ADS), including standard questions on self-harm and/or suicidal thoughts. Results Of the 1,983 participants from Waves 1-2, 27.7% (n = 549; 95%CI:0.26%-30%) reported symptoms of depression and anxiety, 74 (3.8%;95%CI:3%-5%) disclosed self-harm and/or suicidal thoughts. Female participants (RR:1.60, 95%CI:1.37-1.87), employed individuals experiencing work change (RR:1.50,95%CI:1.24-1.82), participants cocooning due to a health condition (RR:1.34,95%CI:1.08-1.66), those self-isolating (RR:1.25,95%CI:1.03-1.51) and those reporting moderate-heavy drinking (RR:1.27,95%CI:1.09-1.47) were at increased risk of depression and anxiety symptoms. Participants aged 18-29 and those in the two lowest income categories were most likely to report self-harm and/or suicidal thoughts. Conclusions The prevalence of țanxiety and depression in the general population has increased relative to pre-pandemic estimates in response to the Covid-19 pandemic and associated public health measures. Key messages In nationally representative telephone surveys of Irish adults conducted following the onset of the Covid-19 pandemic, the prevalence of anxiety and depression is estimated at approximately 30%. Higher than average levels of anxiety or depression were reported in females, those who had experienced a change in their work, individuals cocooning and those with moderate to heavy drinking.

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Assessing and protecting the mental health of the nation: A study protocol

HRB Open Research ◽

10.12688/hrbopenres.13207.1 ◽

2021 ◽

Vol 4 ◽

pp. 5

Author(s):

Philip Hyland ◽

Frédérique Vallières

Keyword(s):

Public Health ◽

Mental Health ◽

General Population ◽

Mental Health Disorders ◽

Self Report ◽

First Year ◽

Cross Sectional ◽

Health Disorders ◽

Nationally Representative ◽

Quota Sampling

Background: Coronavirus disease 2019 (COVID-19) and the public health measures enacted to control its spread may affect the mental health of the general population of Ireland. Funded under the Health Research Board’s COVID-19 Pandemic Rapid Response Funding Call, this protocol outlines the aims of a project to assess and protect the mental health of the population of Ireland during this pandemic. We will determine (i) the prevalence of common mental health disorders at various times during the first year of the pandemic, (ii) changes in the prevalence of mental health disorders during the first year of the pandemic, (iii) if there are distinct groups of people experiencing different mental health responses to the pandemic, and (iv) the factors associated with different mental health reactions. Methods: This quantitative study uses cross-sectional and longitudinal designs. Data have been collected from a nationally representative sample of Irish adults at four assessments: Wave 1 (N = 1,041) occurred during the first week of lockdown in March 2020, Wave 2 in May, Wave 3 in August, and Wave 4 in December. Wave 5 is planned for March 2021. Participants from Wave 1 have been recontacted at each wave to produce a longitudinal dataset. New participants were recruited using quota sampling to ensure the availability of nationally representative samples at each wave. Self-report measures of demographic, economic, psychological, and mental health variables were completed. Conclusion: This design will allow us to determine whether there has been a change in mental health disorders in the general population during the first year of the pandemic, and if so, what variables are associated with changes in mental health. Results will be used to inform the government’s ongoing response to this crisis, to better protect the mental health of the nation during this and any future public health emergency.

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Mental health following an initial period of COVID-19 restrictions: findings from a cross-sectional survey in the Republic of Ireland

HRB Open Research ◽

10.12688/hrbopenres.13400.1 ◽

2021 ◽

Vol 4 ◽

pp. 130

Author(s):

Maria Isabela Troya ◽

Mary Joyce ◽

Ali Khashan ◽

Claire Buckley ◽

Kasturi Chakraborti ◽

...

Keyword(s):

Mental Health ◽

Initial Period ◽

Anxiety Symptoms ◽

Depression And Anxiety ◽

Suicidal Thoughts ◽

Cross Sectional ◽

Republic Of Ireland ◽

Self Harm ◽

The Republic ◽

The Impact

Background: We assessed the mental health of individuals in the general population, during an initial period of easing of COVID-19 restrictions in the Republic of Ireland (RoI). Methods: Data were collected through a nationally representative cross-sectional telephone survey, during the first period of easing of restrictions during the COVID-19 pandemic between May and July 2020. Mental health was examined using the Patient Health Questionnaire Anxiety Depression Scale. Poisson regression analyses were conducted to estimate risk ratios with robust variance estimation of the association between selected demographic factors and the risk of having depression and anxiety symptoms. Results: Of the 1,983 participants, 27.7% (n = 549; 95% CI: 0.26 - 0.30) reported depression and anxiety symptoms, while 74 (3.8%; 95% CI: 0.03 - 0.05) disclosed self-harm and/or suicidal thoughts. Females (RR: 1.60, 95% CI: 1.37 - 1.87, p < 0.0005), employed individuals who experienced a change in work status (RR: 1.50, 95% CI: 1.24 - 1.82, p < 0.0005), participants cocooning due to a health condition (RR: 1.34, 95% CI: 1.08 - 1.66, p< 0.01), participants who were self-isolating (RR: 1.25, 95% CI: 1.03 - 1.51, p=0.025) and moderate-heavy drinkers (RR: 1.27, 95% CI: 1.09 - 1.47, p<0.01) were at increased risk of depression and anxiety. Young people aged 18-29 years and those in the two lowest income categories were most likely to report self-harm and/or suicidal thoughts. Conclusion: As the COVID-19 pandemic continues, with further waves and associated restrictions, the impact on mental health in the population as a whole and in specific subgroups must be considered. Study protocol registration: doi.org/10.12688/hrbopenres.13103.2

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Emotional and Mental Wellbeing Following COVID-19 Public Health Measures on People Living With Dementia and Carers

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/0891988721996816 ◽

2021 ◽

pp. 089198872199681

Author(s):

Kerry Hanna ◽

Clarissa Giebel ◽

Hilary Tetlow ◽

Kym Ward ◽

Justine Shenton ◽

...

Keyword(s):

Public Health ◽

Mental Health ◽

Social Support ◽

Support Services ◽

Mental Wellbeing ◽

Daily Lives ◽

Health Measures ◽

Social Support Services ◽

The Uk ◽

The Impact

Background: To date, there appears to be no evidence on the longer-term impacts caused by COVID-19 and its related public health restrictions on some of the most vulnerable in our societies. The aim of this research was to explore the change in impact of COVID-19 public health measures on the mental wellbeing of people living with dementia (PLWD) and unpaid carers. Method: Semi-structured, follow-up telephone interviews were conducted with PLWD and unpaid carers between June and July 2020. Participants were asked about their experiences of accessing social support services during the pandemic, and the impact of restrictions on their daily lives. Results: 20 interviews were conducted and thematically analyzed, which produced 3 primary themes concerning emotional responses and impact to mental health and wellbeing during the course of the pandemic: 1) Impact on mental health during lockdown, 2) Changes to mental health following easing of public health, and 3) The long-term effect of public health measures. Conclusions: The findings from this research shed light on the longer-term psychological impacts of the UK Government’s public health measures on PLWD and their carers. The loss of social support services was key in impacting this cohort mentally and emotionally, displaying a need for better psychological support, for both carers and PLWD.

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Gendered experiences of unemployment, suicide and self-harm: a population-level record linkage study

Psychological Medicine ◽

10.1017/s0033291721000994 ◽

2021 ◽

pp. 1-9

Author(s):

R. Cunningham ◽

A. Milner ◽

S. Gibb ◽

V. Rijnberg ◽

G. Disney ◽

...

Keyword(s):

Mental Health ◽

Employment Status ◽

Mental Health Problems ◽

Labour Force ◽

Antidepressant Medication ◽

Population Level ◽

Related Factors ◽

Data Infrastructure ◽

Increased Risk ◽

Self Harm

Abstract Background Unemployment and being not in the labour force (NILF) are risk factors for suicide, but their association with self-harm is unclear, and there is continuing debate about the role of confounding by prior mental health conditions. We examine associations between employment status and self-harm and suicide in a prospective cohort, taking into account prior mental-health-related factors. Methods We used linked data from the New Zealand Integrated Data Infrastructure. The outcomes were chosen to be hospital presentation for self-harm and death by suicide. The exposure was employment status, defined as employed, unemployed, or NILF, measured at the 2013 Census. Confounders included demographic factors and mental health history (use of antidepressant medication, use of mental health services, and prior self-harm). Logistic regression was used to model effects. Analyses were stratified by gender. Results For males, unemployment was associated with an increased risk of suicide [odds ratio (OR): 1.48, 95% confidence interval (CI): 1.20–1.84] and self-harm (OR: 1.55, 95% CI: 1.45–1.68) after full adjustment for confounders. NILF was associated with an increased risk of self-harm (OR: 1.43, 95% CI: 1.32–1.55), but less of an association was seen with suicide (OR: 1.19, 95% CI: 0.94–1.49). For females, unemployment was associated with an increased risk of suicide (OR: 1.30, 95% CI: 0.93–1.80) and of self-harm (OR: 1.52, 95% CI: 1.43–1.62), and NILF was associated with a similar increase in risk for suicide (OR: 1.31, 95% CI: 0.98–1.75) and self-harm (OR: 1.32, 95% CI: 1.26–1.40). Discussion Exclusion from employment is associated with a considerably heightened risk of suicide and self-harm for both men and women, even among those without prior mental health problems.

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Association of source country gender inequality with experiencing assault and poor mental health among young female immigrants to Ontario, Canada

BMC Public Health ◽

10.1186/s12889-021-10720-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Michael Lebenbaum ◽

Therese A. Stukel ◽

Natasha Ruth Saunders ◽

Hong Lu ◽

Marcelo Urquia ◽

...

Keyword(s):

Mental Health ◽

Violence Against Women ◽

Gender Inequality ◽

Poor Mental Health ◽

Sub Saharan Africa ◽

Source Country ◽

Community Based Research ◽

Increased Risk ◽

Female Immigrants ◽

Self Harm

Abstract Background Gender inequality varies across countries and is associated with poor outcomes including violence against women and depression. Little is known about the relationship of source county gender inequality and poor health outcomes in female immigrants. Methods We used administrative databases to conduct a cohort study of 299,228 female immigrants ages 6–29 years becoming permanent residence in Ontario, Canada between 2003 and 2017 and followed up to March 31, 2020 for severe presentations of suffering assault, and selected mental health disorders (mood or anxiety, self-harm) as measured by hospital visits or death. Poisson regression examined the influence of source-country Gender Inequality Index (GII) quartile (Q) accounting for individual and country level characteristics. Results Immigrants from countries with the highest gender inequality (GII Q4) accounted for 40% of the sample, of whom 83% were from South Asia (SA) or Sub-Saharan Africa (SSA). The overall rate of assault was 10.9/10,000 person years (PY) while the rate of the poor mental health outcome was 77.5/10,000 PY. Both GII Q2 (Incident Rate Ratio (IRR): 1.48, 95% Confidence Interval (CI): 1.08, 2.01) and GII Q4 (IRR: 1.58, 95%CI: 1.08, 2.31) were significantly associated with experiencing assault but not with poor mental health. For females from countries with the highest gender inequality, there were significant regional differences in rates of assault, with SSA migrants experiencing high rates compared with those from SA. Relative to economic immigrants, refugees were at increased risk of sustaining assaults (IRR: 2.96, 95%CI: 2.32, 3.76) and poor mental health (IRR: 1.73, 95%CI: 1.50, 2.01). Higher educational attainment (bachelor’s degree or higher) at immigration was protective (assaults IRR: 0.64, 95%CI: 0.51, 0.80; poor mental health IRR: 0.69, 95% CI: 0.60, 0.80). Conclusion Source country gender inequality is not consistently associated with post-migration violence against women or severe depression, anxiety and self-harm in Ontario, Canada. Community-based research and intervention to address the documented socio-demographic disparities in outcomes of female immigrants is needed.

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COVID-19 pandemic related long-term chronic stress on the prevalence of depression and anxiety in the general population

BMC Psychiatry ◽

10.1186/s12888-021-03385-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tian Qi ◽

Ting Hu ◽

Qi-Qi Ge ◽

Xiao-Na Zhou ◽

Jia-Mei Li ◽

...

Keyword(s):

Mental Health ◽

General Population ◽

Chronic Stress ◽

Protective Factor ◽

Mental Health Problems ◽

Anxiety Symptoms ◽

Binary Logistic Regression Analysis ◽

Depression And Anxiety ◽

Factors Associated

Abstract Background The COVID-19 pandemic has lasted for more than 1 year, causing far-reaching and unprecedented changes in almost all aspects of society. This study aimed to evaluate the long-term consequences of the COVID-19 pandemic on depression and anxiety, and explore the factors associated with it. Methods A cross-sectional study using an online survey was conducted to assess mental health problems from February 2 to February 9, 2021 by using patient health questionnaire-9 (PHQ-9) and generalized anxiety disorder-7 (GAD-7). The insomnia severity index (ISI), demographic data and COVID-19 related variables were measured by a self-designed questionnaire. The factors associated with depressive and anxiety symptoms were identified by Pearson chi-square test and binary logistic regression analysis. Results In the study that 1171 participants enrolled, the overall prevalence of depressive and anxiety symptoms among general people was 22.6 and 21.4% respectively in the present study. Living alone was a potential risk factor for depressive symptoms, while regular exercises was a potential protective factor. The prevalence of depressive and anxiety symptoms was significantly associated with the severity of insomnia symptoms and the negative feelings about pandemic. Conclusion COVID-19 pandemic- related chronic stress has brought about profound impacts on long-term mental health in the general population. The level of insomnia and a negative attitude towards the pandemic are significantly correlated with unfavorable mental health. However, we failed to found a significant association of age and gender with the mental health symptoms, although they were recognized as well-established risk factors during the outbreak by some other studies. This discrepancy may be because the acute and chronic effects of the pandemic are influenced by different factors, which reminds that more attention should be paid to the intrinsic psychological factors and physical reactions towards COVID-19.

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Exploiting Administrative Data to Understand the Mental Health of Children Known to Social Services

International Journal for Population Data Science ◽

10.23889/ijpds.v4i3.1192 ◽

2019 ◽

Vol 4 (3) ◽

Author(s):

Sarah McKenna ◽

Aideen Maguire ◽

Dermot O'Reilly

Keyword(s):

Mental Health ◽

General Population ◽

Health Outcomes ◽

Social Services ◽

Social Care ◽

Mental Health Outcomes ◽

Health And Social Care ◽

Self Harm ◽

Children In Care ◽

Care System

Background Research has consistently found a high prevalence of mental ill-health among children in out-of-home care. However, results have varied significantly by study location, type of care intervention, sample population and mental health measurement, and concerns have been raised about appropriate reference populations. In addition, little is known about children known to social services who remain with their birth families. Aim To examine mental ill-health amongst children known to social services based on care exposure including those who remain at home, those placed in foster care, kinship care or institutional care and the general population not known to social services. Methods Northern Ireland is unique in that has an integrated health and social care system and holds data centrally on all children known to social services. Social services data (1995-2015) will be linked to hospital discharge data (2010-2015), prescribed medication data (2010-2015), self-harm data (2010-2015) and death records (2010-2015) to investigate mental health outcomes in terms of psychiatric hospital admissions, psychotropic medication uptake, self-harm and suicide. Results Data cleaning has been completed and analysis is underway. Preliminary results will be available by December 2019. Descriptive statistics will provide a mental health profile of children in care compared not only to children in the general population but to those who are known to social services but remain in their own home. Regression models will determine which factors are most associated with poor mental health outcomes. Conclusion This project is the UK’s first population-wide data linkage study examining the mental health of children in the social care system, including looked-after children and those known to social services who remain in their own home. Project partners in the Department of Health recognise the potential of these findings to inform future policy relating to targeting interventions for children in receipt of social care services.

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Social services Interventions and the Mental Health and Mortality of care leavers: a population based data linkage study in Northern Ireland and Finland

International Journal for Population Data Science ◽

10.23889/ijpds.v4i3.1252 ◽

2019 ◽

Vol 4 (3) ◽

Author(s):

Aideen Maguire ◽

Anne Kouvonen ◽

Dermot O'Reilly ◽

Hanna Remes ◽

Joonas Pitkänen ◽

...

Keyword(s):

Mental Health ◽

Northern Ireland ◽

Health Outcomes ◽

Social Services ◽

Psychiatric Hospital ◽

Poor Mental Health ◽

Mental Health Outcomes ◽

Care Intervention ◽

Increased Risk ◽

Self Harm

BackgroundResearch has highlighted the poor mental health of looked after children compared to those never in care. However, little is known on what becomes of these children and their mental health trajectories after they leave the care of social services. In addition, previous studies are limited in their ability to differentiate between type of social care intervention received; kinship care, foster care or residential care. AimTo utilise nationwide social services data from two countries (Northern Ireland (NI) and Finland), with similar populations but different intervention policies, linked to a range of demographic and health datasets to examine the mental health outcomes of young adults in the years following leaving care. MethodsData from both countries on children born 1991-2000 were linked to social services data, hospital admissions, prescribed medication data and death records. Mental health outcomes were defined after the age of 18years (when statutory care provision ends) examined by care intervention and included admissions to psychiatric hospital, for self-harm and death by suicide. ResultsThe gender split in care in Finland is reflective of the population but more males are in care in NI. Initial results from Finnish data suggest those exposed to care in childhood have an increased risk of self-harm, psychiatric hospital admission and suicide after the age of 18years compared to those never in care. After adjusting for gender, age of entry to care and deprivation at birth those exposed to any care intervention had 3 times the risk of suicide (HR=3.06, 95% CI 1.18,7.98). Risk increased with duration in care but was equivalent across care intervention types. Analysis on the NI data is underway. ConclusionFull results will be available December 2019 and will explore which care pathways are most associated with poor mental health outcomes informing discussion around intervention opportunities and policy.

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Life, lifestyle and location: examining the complexities of psychological distress in young adult Indigenous and non-Indigenous Australians

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174417000162 ◽

2017 ◽

Vol 8 (5) ◽

pp. 541-549 ◽

Cited By ~ 6

Author(s):

B. Davison ◽

T. Nagel ◽

G. R. Singh

Keyword(s):

Mental Health ◽

Young Adults ◽

Psychological Distress ◽

Suicidal Ideation ◽

Emotional Health ◽

Well Being ◽

Indigenous Australians ◽

Physical And Mental Health ◽

Increased Risk ◽

Self Harm

Mental health is fundamental to an individual’s health and well-being. Mental health disorders affect a substantial portion of the Australian population, with the most vulnerable time in adolescence and young adulthood. Indigenous Australians fare worse than other Australians on almost every measure of physical and mental health. Cross-sectional data from young adults (21–27 years) participating in the Life Course Program, Northern Territory, Australia, is presented. Rates of psychological distress were high in remote and urban residing Indigenous and urban non-Indigenous young adults. This rate was more pronounced in young women, particularly in Indigenous remote and urban residing women. Young adults with high psychological distress also had lower levels of positive well-being, higher perceived stress levels, experienced a higher number of major life events and were at an increased risk of suicidal ideation and/or self-harm. This study supports the need for a continued focus on early screening and treatment at this vulnerable age. The significant association seen between psychological distress and other markers of emotional well-being, particularly risk of suicidal ideation and/or self-harm, highlights the need for a holistic approach to mental health assessment and treatment. A concerted focus on improving the environs of young adults by lowering levels of stress, improving access to adequate housing, educational and employment opportunity, will assist in improving the emotional health of young adults.

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Suicide and Self-inflicted Injury in Diabetes: A Balancing Act

Journal of Diabetes Science and Technology ◽

10.1177/1932296819891136 ◽

2019 ◽

Vol 14 (6) ◽

pp. 1010-1016 ◽

Cited By ~ 2

Author(s):

Katharine D. Barnard-Kelly ◽

Diana Naranjo ◽

Shideh Majidi ◽

Halis K. Akturk ◽

Marc Breton ◽

...

Keyword(s):

Glycemic Control ◽

General Population ◽

Complication Rates ◽

Psychological Burden ◽

The United Kingdom ◽

Use Of Technology ◽

Diabetes Technology ◽

Increased Risk ◽

Control And Prevention ◽

Self Harm

Glycemic control in type 1 diabetes mellitus (T1DM) remains a challenge for many, despite the availability of modern diabetes technology. While technologies have proven glycemic benefits and may reduce excess mortality in some populations, both mortality and complication rates remain significantly higher in T1DM than the general population. Diabetes technology can reduce some burdens of diabetes self-management, however, it may also increase anxiety, stress, and diabetes-related distress. Additional workload associated with diabetes technologies and the dominant focus on metabolic control may be at the expense of quality-of-life. Diabetes is associated with significantly increased risk of suicidal ideation, self-harm, and suicide. The risk increases for those with diabetes and comorbid mood disorder. For example, the prevalence of depression is significantly higher in people with diabetes than the general population, and thus, people with diabetes are at even higher risk of suicide. The Center for Disease Control and Prevention reported a 24% rise in US national suicide rates between 1999 and 2014, the highest in 30 years. In the United Kingdom, 6000 suicides occur annually. Rates of preventable self-injury mortality stand at 29.1 per 100 000 population. Individuals with diabetes have an increased risk of suicide, being three to four times more likely to attempt suicide than the general population. Furthermore, adolescents aged 15 to 19 are most likely to present at emergency departments for self-inflicted injuries (9.6 per 1000 visits), with accidents, alcohol-related injuries, and self-harm being the strongest risk factors for suicide, the second leading cause of death among 10 to 24 year olds. While we have developed tools to improve glycemic control, we must be cognizant that the psychological burden of chronic disease is a significant problem for this vulnerable population. It is crucial to determine the psychosocial and behavioral predictors to uptake and continued use of technology in order to aid the identification of those individuals most likely to realize benefits of any intervention as well as those individuals who may require more support to succeed with technology.

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