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• Social phobia concerns could rise again ahead of restrictions lifting.
• Findings highlight the fact that an easing of restrictions will have a complex effect on mental health.

ieso's new study has analysed the largest available set of digital mental health conversations in relation to Covid-19 over the past 12 months and has revealed that general anxiety levels have steadily increased during the pandemic. This has sparked concerns of further pressures on mental well-being as the country emerges from Government restrictions.

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We have been reviewing psychological trends in patients already coming forward for treatment over the period of the pandemic. The digital nature of their work means a living and large-scale anonymised dataset can be examined providing rapid insight into what patients are experiencing. This allows better understanding of the on-going impact of the pandemic on patients’ mental health and may point to broader trends in the UK population.

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The analysis of nearly 70,000 patients referrals across England between January 2019 and February 2021, has shown several trends have emerged. These relate to the symptoms that patients have identified when first referred for treatment and when asked at the start of each therapy session.

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• General anxiety disorder is at a much higher rate at the start of this year compared to 2020 and 2019. This follows on from having been at a consistently higher level from March 2020 onwards, compared to 2019.
• Social phobias decreased significantly during 2020 as the need to keep a distance, the mass cancellation of events and the various lockdowns meant mixing with others was limited. However, as the country moves to a more sustained level of normality social phobia concerns may start to reappear.
• The analysis also showed that patients feeling afraid as if something awful might happen spiked during the first lockdown before easing and then rapidly increasing again at the end of 2020 and into 2021.

Shazna Khanom, Clinical Director at ieso, said: “We’ve observed increased and sustained levels of general anxiety throughout the pandemic, both during lockdown and when restrictions were eased. People will be approaching the rest of this year with mixed emotions. While many are looking forward to returning to normality and what that means for all aspects of their lives, a significant proportion will be feeling anxious about the lifting of lockdown.

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“People may also be conflicted within themselves. We may feel happy and excited that we can start to meet up with friends and family we have not seen in a long time while also still anxious and nervous about the virus and our vulnerabilities perhaps when returning to an office. We may also feel sad and low about the things we have missed out on over the past year and it is possible to feel all these things at the same time.

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For our patients, some aspects of mental health have undoubtedly got worse during the pandemic whilst others have improved. Our analysis shows that as a society we must be enormously cognisant on the lasting impact of mental health and not assume that a return to a ‘new normal’ means people will not require on-going support and help to cope. Analysis of large data sets allows us to look more holistically at trends and their impact. We also need to consider the effect of physical health on mental health as the true extent of long-Covid is better understood.”

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At the start of every session, patients are asked about nine aspects of their state of mind to help monitor the severity of their depression and response to treatment. Analysis of the completed questionnaires yielded some interesting trends.

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• Some areas of mental health improved during 2020. Thoughts of self-harm or suicide among patients, for example, fluctuated but in general were lower in 2020 than in 2019.
• Similar patterns were observed in other areas: ‘feeling tired or having less energy’, ‘poor appetite or overeating’, and ‘feeling bad about yourself or that you are a failure or have let your family down’. In particular, during the summer months a significant gap opened up following the first lockdown with the number of patients expressing these feelings falling compared to 2019.
• Since the end of 2020 and now in 2021, there are worrying increases in two areas. More patients report trouble falling asleep, staying asleep or sleeping too much, as well as trouble concentrating on things such as reading or watching TV.

For information on how to cope with heightened levels of anxiety in the context of the lifting of restrictions please visit our blog