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?:abstract
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To date, there is a paucity of information regarding the effect of COVID-19 or lockdown on mental disorders We aimed to quantify the medium-term impact of lockdown on referrals to secondary care mental health clinical services We conducted a controlled interrupted time series study using data from Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), UK (catchment population ~0 86 million) The UK lockdown resulted in an instantaneous drop in mental health referrals but then a longer-term acceleration in the referral rate (by 1 21 referrals per day per day, 95% confidence interval [CI] 0 41-2 02) This acceleration was primarily for urgent or emergency referrals (acceleration 0 96, CI 0 39-1 54), including referrals to liaison psychiatry (0 68, CI 0 35-1 02) and mental health crisis teams (0 61, CI 0 20-1 02) The acceleration was significant for females (0 56, CI 0 04-1 08), males (0 64, CI 0 05-1 22), working-age adults (0 93, CI 0 42-1 43), people of White ethnicity (0 98, CI 0 32-1 65), those living alone (1 26, CI 0 52-2 00), and those who had pre-existing depression (0 78, CI 0 19-1 38), severe mental illness (0 67, CI 0 19-1 15), hypertension/cardiovascular/cerebrovascular disease (0 56, CI 0 24-0 89), personality disorders (0 32, CI 0 12-0 51), asthma/chronic obstructive pulmonary disease (0 28, CI 0 08-0 49), dyslipidemia (0 26, CI 0 04-0 47), anxiety (0 21, CI 0 08-0 34), substance misuse (0 21, CI 0 08-0 34), or reactions to severe stress (0 17, CI 0 01-0 32) No significant post-lockdown acceleration was observed for children/adolescents, older adults, people of ethnic minorities, married/cohabiting people, and those who had previous/pre-existing dementia, diabetes, cancer, eating disorder, a history of self-harm, or intellectual disability This evidence may help service planning and policy-making, including preparation for any future lockdown in response to outbreaks
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