Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Dec 19, 2021; 11(12): 1346-1365
Published online Dec 19, 2021. doi: 10.5498/wjp.v11.i12.1346
Impact of lockdown relaxation and implementation of the face-covering policy on mental health: A United Kingdom COVID-19 study
Shanaya Rathod, Saseendran Pallikadavath, Elizabeth Graves, Mohammad Mahbubur Rahman, Ashlea Brooks, Mustafa G Soomro, Pranay Rathod, Peter Phiri
Shanaya Rathod, Elizabeth Graves, Ashlea Brooks, Peter Phiri, Department of Research and Development, Southern Health NHS Foundation Trust, Southampton SO30 3JB, Hampshire, United Kingdom
Shanaya Rathod, Portsmouth-Brawijaya Centre for Global Health, Population and Policy, University of Portsmouth, Portsmouth PO1 2DT, United Kingdom
Saseendran Pallikadavath, Mohammad Mahbubur Rahman, School of Health and Care Professions, University of Portsmouth, Portsmouth PO1 2DT, Hampshire, United Kingdom
Mustafa G Soomro, Mental Health, Solent NHS Trust, Portsmouth P03 6AD, United Kingdom
Pranay Rathod, PPI, PPI Representative, London SO30 3JB, United Kingdom
Peter Phiri, Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton SO16 5ST, United Kingdom
Author contributions: Rathod S, Rathod P and Phiri P developed the study protocol and questionnaire; Rathod S, Phiri P, Soomro MG, and Rahman MM contributed to the manuscript development; Rahman MM conducted the analysis; all authors reviewed and approved the final version of the manuscript.
Institutional review board statement: The study received ethics and HRA approval. IRAS project ID: 282858; REC reference: 20/HRA/1934 from London-Westminster Research Ethics Committee on 27 April 2020.
Informed consent statement: All study participants, provided informed consent prior to study enrollment.
Conflict-of-interest statement: Dr Rathod reports others from Janssen, other from Otsuka, other from Lundbeck, outside the submitted work. Dr Phiri reports other from Queen Mary University London, other from Stanford University School of Medicine, other from John Wiley and Blackwell, outside the submitted work. All other authors report no conflict of interest.
Data sharing statement: Data will not be shared.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shanaya Rathod, MBBS, MD, MRCP, Professor, Department of Research and Development, Southern Health NHS Foundation Trust, Moorgreen Hospital Botley Road, West End, Southampton SO30 3JB, Hampshire, United Kingdom. Shanaya.rathod@southernhealth.nhs.uk
Received: June 17, 2021
Peer-review started: June 17, 2021
First decision: July 14, 2021
Revised: August 4, 2021
Accepted: October 20, 2021
Article in press: October 20, 2021
Published online: December 19, 2021
Research background

The global pandemic caused by coronavirus disease 2019 has led to wide spread changes in people’s day to day lives.

Research motivation

The changes in people’s lives and livelihoods due to the global pandemic, associated lockdowns and government guidance is anticipated to have a great impact on people’s emotional and social wellbeing.

Research objectives

Positive association of lockdown relaxation and face covering policies on the Mental Health of various population sub-groups is reported.

Research methods

A regression discontinuity design was used to analyse data gathered on people’s health and wellbeing during different time periods and restrictions via online survey platform.

Research results

In comparison to other key workers and non-key workers during lock down, professional groups and health workers had lower generalised anxiety disorder (GAD-7) scores indicating lower anxiety levels. Similar findings were noted for the impact of events scale-revised (IES-R) scores with health workers, indicating lower levels of distress. During the compulsory face covering phase, there were improvements in mental health scores for all three professional groups assessed by GAD-7 and IES-R. Greater improvements in mental health scores were found among non-key workers than key workers. Gender was associated with different mental health outcomes during the lockdown, with females scoring higher on the GAD-7 and IES-R scales in comparison to males. However, both groups showed a significant improvement in mental health status during the period of face covering, with slightly higher improvements noted in males.

Research conclusions

An impact on people’s wellbeing was found, with anxiety and depression levels improving when relaxations in restrictions happened.

Research perspectives

Further investigation into pandemic preparedness for those with pre-existing conditions such as anxiety, depression or obsessive-compulsive disorders and modifying psychological interventions in this population is warranted.