Abstract
The most immediate response of the research community to COVID-19 has been a focus on understanding the effects, treatment and prevention of infection. Of equal and ongoing importance is elucidating the impact of mitigation measures, such as lockdown, on the well-being of societies. Research about mental health and lockdown in the UK has predominately involved large surveys that are likely to encounter self-selection bias. Further, self-reporting does not constitute a clinical judgement. To (a) compare the age, gender and ethnicity of patients experiencing mental health emergencies prior compared with during lockdown, (b) determine whether the nature of mental health emergencies has changed during compared with before lockdown, (c) explore the utility of emergency medical service data for identifying vulnerability to mental health emergencies in real time during a pandemic. A total of 32 401 clinical records of ambulance paramedics attending mental health emergencies in the East Midlands of the UK between 23 March and 31 July 2020 and the same period in 2019 were analysed using binary logistic regression. People of younger age, male gender and South Asian and Black ethnicity are particularly vulnerable to acute mental health conditions during lockdown. Patients with acute cases of anxiety have increased during lockdown whereas suicide and intentional drug overdose have decreased. Self-reported data may underrepresent the true impact of lockdown on male mental health and ethnic minority groups. Emergency medical data can be used to identify vulnerable communities in the context of the extraordinary circumstances surrounding the current pandemic, as well as under more ordinary circumstances.
Highlights
The most immediate response of the research community to COVID-19 has been a focus on understanding the effects, treatment and prevention of infection
People of younger age, male gender and South Asian and Black ethnicity are vulnerable to acute mental health conditions during lockdown
The statistical analysis reported in the following addresses: the first aim of the research related to whether the demographic characteristics of patients experiencing mental health emergencies were different during the first phase of national lockdown in the UK compared with the same period for the year prior, and the second aim of the research about whether the nature of mental health emergencies occurring during lockdown were different compared with the year prior
Summary
The most immediate response of the research community to COVID-19 has been a focus on understanding the effects, treatment and prevention of infection. In the early weeks of March 2020, the World Health Organization addressed the mental health risks associated with the coronavirus disease 2019 (COVID-19) pandemic, encouraging people in isolation to maintain social networks virtually, practice mindfulness and limit access to news reports that might produce anxiety.[1] The most immediate response of the research community to COVID-19 has, necessarily, been a focus on understanding the infection, its treatment and prevention.[2] Understanding the impact of transmission mitigation strategies, such as social distancing and ‘lockdown’ restrictions, on the mental health and well-being of people and populations is of equal importance.[3] Here we explore the demographic characteristics of mental health patients requiring ambulance attendance, and the changing nature of mental health emergencies during ‘lockdown’ in the East Midlands of the UK. Emergency medical service (EMS) data offer novel opportunities to understand the impact of the current pandemic on the health and well-being of populations in real time,[4] as well as to optimise the delivery of strained healthcare services.
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