Context

For many Londoners, the COVID-19 pandemic has represented the most challenging period of our lives, taking a heavy toll on mental health and wellbeing. The uncertain nature of the virus and the restrictions in place have impeded on natural and usual resources for wellbeing, as well as coping mechanisms and opportunities for social interaction.[1]

Thrive LDN has established a public mental health research and community insights function to analyse and present findings from available data, intelligence, and capture insights from Londoners to inform Thrive LDN engagement and activities and wider stakeholders involved in public mental health across London.

Now, over two years after the pandemic emerged and as London continues to respond and promote recovery from this crisis, we have taken stock of how Londoners’ mental health and wellbeing have been impacted in a nuanced and complex manner.

The following intelligence outlines the evidence, research and insights captured across a range of areas through Thrive LDN’s research and community insights’ function. Information has been synthesised and summarised to give a current view of public mental health in London, how Londoners have been impacted by the pandemic, and anticipate what lies ahead.

Update & Overview

Population mental health

Overall, trends in population mental health throughout the pandemic appeared to broadly follow trends of the virus and restrictions in place to control it[2].  Rates of depression and anxiety as well as overall happiness and life satisfaction aligned closely with patterns of national lockdowns, with people’s wellbeing being lowest during periods with the tightest restrictions and returning to a level closer to pre-pandemic levels once these restrictions were eased. Now that the government has released its ‘Living with COVID-19 Plan’ to remove all restrictions and manage the disease through widespread vaccination and public health advice, we can begin to shift our focus to other aspects of society that may impact population mental health.

Across the insights captured as part of Thrive LDN’s community engagement activities,10 struggling with uncertainty for the future has been a persistently common theme. However, there has also been a definite theme of hope. Communities disproportionately affected by the coronavirus pandemic identified the positive significance of family and support structures as well as the support offered by the wider community and faith groups.

Equity

The mental health impacts of crisis events have traditionally fallen unequally across society. Some groups, including racialised and minoritised communities, young people, and Londoners with pre-existing mental health conditions, have experienced more critical mental health concerns as a result of the pandemic, with the effects more likely to persist for longer periods of time.

Findings from community insights indicate that for many communities across London, the coronavirus pandemic has represented one of the most significant crisis events in a recent crisis trend – a steadily worsening series of situations faced by disadvantaged communities across London. These series of crises continue to persist and emerge on an ongoing basis, as we have seen more recently with regards to the rising cost of living, climate change, and geopolitical issues around the world such as global conflicts and humanitarian crises.

Direct impacts

COVID-19 itself has a direct impact on mental health and wellbeing for many Londoners. Careful consideration must be given to survivors of the virus and the bereaved, along with collective trauma associated with the pandemic, the ongoing vaccination programme and the exacerbated issue of digital exclusion. Whilst it is necessary to consider these factors independently as part of the response to the pandemic, it is vital to put prevention of poor mental health at the centre of recovery and ensure that Londoners who need help and support receive it.

Financial impact

We know that the UK entered the pandemic from a position of stagnant income growth and low levels of financial resilience[3]. The pandemic has compounded mental health and economic hardship[4] and the accelerating pace of social, financial, and geographic inequalities has widened the gap in mental wellbeing and future health outcomes for Londoners. We are now anticipating a rising cost of living crisis within London as prices surge on essentials such as food, energy, and fuel, all of which is expected to impact those from the lowest income households the most, who have experienced a slower and more difficult recovery from the financial impacts of the coronavirus pandemic.

Future trends and forecasting

Various forecasting models indicate that the prevalence of poor mental health is expected to increase and that this could impact on demand for mental health services over the next three years. Research from the King’s Fund[5] conducted in February 2021 suggested that up to 75% of the population will experience normal distress as a result of the pandemic that should resolve with the right support but could escalate if left unaddressed. The research goes on to suggest that 15-20% of the population will experience mild to moderate disorder and 3-4% severe disorder. Already, intelligence from the health and social care system confirms increased demand for specialist services and more complex cases, such as young people with eating disorders, and self-harm, has increased.

As the pandemic evolves, it is important to reflect on the effects of coping with and responding to COVID-19. The London response during the first national lockdown was largely rooted in voluntary and community action, with swift and heroic efforts in March and April 2020 resulting in innovation and transformation at a scale and speed never seen before. Anecdotal insights suggest that the wellbeing and resilience of voluntary organisations and community groups has been worn down over time. That, along with changing public mood and reduced confidence in government, may mean that the voluntary and community response is not at the same scale as it was during the first national lockdown. If that is the case, any future crisis will impact London’s most vulnerable the most.

 

[1] Thrive LDN Research & Insights Function (2021) https://thriveldn.co.uk/research-and-insights/

[2] Population Mental Health (2021) https://thriveldn.co.uk/resources/population-mental-health/

[3] Tinson, A (2020) Living in poverty was bad for your health before COVID-19 The Health Foundation: https://www.health.org.uk/sites/default/files/2020-07/Living%20in%20poverty%20was%20bad%20for%20your%20health%20before%20COVID-19.pdf

[4] Health Foundation (2021) Unequal pandemic, Fairer Recover: https://health.org.uk/publications/reports/unequalpandemic-fairer-recovery 

[5] The King’s Fund (2021) Covid-19 recovery and resilience: what can health and care learn from other disasters? https://features.kingsfund.org.uk/2021/02/covid-19-recovery-resilience-health-care/

Context and Scope
Drivers of inequity
Indicators of population mental health
Direct impacts of COVID-19
Financial impact and ongoing financial challenges