Previously submitted to: JMIR Public Health and Surveillance (no longer under consideration since Jun 19, 2025)
Date Submitted: Jan 14, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Demand for mental health services before during and after the COVID-19 pandemic: Retrospective observational study in England
ABSTRACT
Background:
During COVID-19, WHO reported a 25% increase in anxiety and depression, and multiple studies indicated that COVID-19 experiences might increase the prevalence of mental illness with subsequent high demands on mental health (MH) services.
Objective:
Using data from multiple MH services in England, this study documents the changes in demand for MH services over COVID-19.
Methods:
Retrospective observational descriptive study of mental healthcare demand from national health services, via national telephone line, primary care, emergency department consultations and ambulance calls. Study period was 01/01/2019 to 20/04/2022. Using data from before and after the pandemic, negative binomial models generated expected MH demand. Expected and observed MH demand were compared. Data were sub-grouped by service, gender, age, and MH indicators.
Results:
Demand for MH services decreased during COVID-19, including when the analysis was stratified. Demand decreased for in-person services (emergency departments and in-hours primary care) but later on increased for out-of-hours primary care and telephone advice. Increasing anxiety consultations amongst the young were observed later in the pandemic. Females were differentially consulting for anxiety more than males throughout.
Conclusions:
COVID-19 was associated with net decreases in demand for MH services. However, this does not imply a change in MH as healthcare seeking behaviour differs from clinical MH diagnosis. Healthcare seeking behaviour may be influenced by factors including changes to healthcare seeking advice. Further research needs to understand the reasons for these changes and whether they reflect changes in MH prevalence. During crisis periods remotely accessible MH services are important.
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.