Abstract
Importance: In the last 3 years, people in England have lived through a pandemic and cost-of-living and health care crises, all of which may have contributed to worsening mental health in the population.
Objective: To estimate trends in psychological distress among adults over this period and to examine differences by key potential moderators.
Design, Setting, and Participants: A monthly cross-sectional, nationally representative household survey of adults aged 18 years or older was conducted in England between April 2020 and December 2022.
Main Outcomes and Measures: Past-month distress was assessed with the Kessler Psychological Distress Scale. Time trends in any distress (moderate to severe, scores ≥5) and severe distress (scores ≥13) were modeled, and interactions with age, gender, occupational social grade, children in the household, smoking status, and drinking risk status were tested.
Results: Data were collected from 51861 adults (weighted mean [SD] age, 48.6 [18.5] years; 26609 women [51.3%]). There was little overall change in the proportion of respondents reporting any distress (from 34.5% to 32.0%; prevalence ratio [PR], 0.93; 95% CI, 0.87-0.99), but the proportion reporting severe distress increased by 46%, from 5.7% to 8.3% (PR, 1.46; 95% CI, 1.21-1.76). Although trends differed by sociodemographic characteristics, smoking, and drinking, the increase in severe distress was observed across all subgroups (with PR estimates ranging from 1.17 to 2.16), with the exception of those aged 65 years and older (PR, 0.79; 95% CI, 0.43-1.38); the increase was particularly pronounced since late 2021 among those younger than 25 years (increasing from 13.6% in December 2021 to 20.2% in December 2022).
Conclusions and Relevance: In this survey study of adults in England, the proportion reporting any psychological distress was similar in December 2022 to that in April 2020 (an extremely difficult and uncertain moment of the COVID-19 pandemic), but the proportion reporting severe distress was 46% higher. These findings provide evidence of a growing mental health crisis in England and underscore an urgent need to address its cause and to adequately fund mental health services.
| Original language | English |
|---|---|
| Article number | E2321959 |
| Number of pages | 14 |
| Journal | JAMA Network Open |
| Volume | 6 |
| Issue number | 7 |
| Early online date | 6 Jul 2023 |
| DOIs | |
| Publication status | Published - 6 Jul 2023 |
Data Availability Statement
Data will be available from the corresponding author on reasonable request.Funding
This work was supported by the UK Prevention Research Partnership (grant MR/S037519/1), which is funded by the British Heart Foundation, Cancer Research UK, Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Health and Social Care Research and Development Division (Welsh Government), Medical Research Council, National Institute for Health Research, Natural Environment Research Council, Public Health Agency (Northern Ireland), and The Health Foundation and Wellcome. Cancer Research UK (PRCRPG-Nov21\100002) funded the core Smoking and Alcohol Toolkit Study data collection and Dr Jackson’s salary.
ASJC Scopus subject areas
- General Medicine
