Mental Health of Keyworkers in the UK during the COVID-19 Pandemic: a Cross-sectional Analysis of a Community Cohort

  1. Kieran Ayling
  2. Ru Jia
  3. Trudie Chalder
  4. Adam Massey
  5. Elizabeth Broadbent
  6. Carol Coupland
  7. Kavita Vedhara

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Abstract

Objectives

Previous pandemics have resulted in high levels of psychological morbidity among frontline workers. Here we report on the early mental health impact of the COVID-19 pandemic on keyworkers in the UK, as assessed during the first six weeks of nationwide social distancing measures being introduced. Comparisons are made with non-keyworkers, and psychological factors that may be protective to keyworkers’ mental health are explored.

Design

Cross-sectional analysis of a community cohort study.

Methods

During April 2020, keyworkers (n=1559) and non-keyworkers (n=1436) completed online measures of depression, anxiety, and stress levels as well as explanatory demographic and psychological factors hypothesised to be related to these mental health outcomes.

Results

Keyworkers reported significantly higher depression, anxiety, and stress than pre-pandemic population norms. Compared to non-keyworkers, keyworkers were more likely to worry about COVID-19 and perceived they were at higher risk from the virus. This was particularly evident for health and social care keyworkers. Younger keyworkers and those in a clinically increased risk group were more likely to report poorer mental health. Lower positive mood, greater loneliness and worrying more about COVID-19 were all associated with poorer mental health outcomes amongst keyworkers.

Conclusions

The mental health impact of the COVID-19 pandemic on keyworkers in the UK has been substantial. Worry about COVID-19 and perceived risk from COVID-19 in keyworkers are understandable given potential increased exposure to the virus. Younger and clinically vulnerable keyworkers may benefit most from any interventions that seek to mitigate the negative mental health impacts of the pandemic.

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  1. ScreenIT

    SciScore for 10.1101/2020.11.11.20229609: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Eligibility criteria stated that participants should be: aged 18 and over; able to give informed consent; able to read English and residing in the UK at the time of completing the survey.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analysis: Statistical analyses were performed using STATA (version 16).
    STATA
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and Limitations: In this study we report on the mental wellbeing of over 1,500 keyworkers during the early phases of the COVID-19 restrictions in the UK. The cohort was set up and recruited rapidly in response to the COVID-19 pandemic. As such, this is one of only a few studies that can contribute to the relatively sparse mental health data available from this time in the UK and will prove useful for understanding the trajectory of the pandemic’s effect on mental health moving forward. However, it is important to acknowledge the study’s limitations. First, the cross-sectional analyses reported here, which represent data collected during the first wave of a longitudinal community cohort study, only provide a snapshot of the keyworkers’ mental health during April 2020. As such, our findings cannot speak to the persistence or otherwise of these elevated levels of distress. This is important to track because while elevated stress and feelings of pressure may be a normal response to the pandemic (World Health Organization, 2020a), longer term distress can be particularly detrimental to both psychological and physical health (J. Cohen, 2000; Juster, McEwen, & Lupien, 2010; Mulligan et al., 2014; O’Connor, Thayer, & Vedhara, 2020). Recent reports have noted levels of depression, anxiety and stress in frontline workers remained high during May 2020 (Couper et al., 2020), and future waves from the present cohort study will further contribute to this knowledge base. A further...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.11.11.20229609v1 on medRxiv