COVID-19 – Impact on Children and Young People
The emergence of COVID-19 in 2020 has paved the way for urgent and immediate research into the virus, its impact, and long-term effects. The Departments of Psychiatry and Experimental Psychology launched the first study, COVID-19 Supporting Parents, Adolescents, and Children in Epidemics (Co-SPACE), in March.
Professor Cathy Creswell, co-lead author, said:
‘This series of studies, Co-SPACE, Co-SPYCE and partner studies in other countries including Ireland, Iran, Denmark, US, and Australia, is so important to help us understand the experiences of families currently and how this crisis is impacting on them. Our findings will help us determine the global impact of this pandemic and know how to best support families going forward.’
The original study now has 12,300 parents/carers and 1,300 adolescents who have participated, and it has already provided 13 reports detailing the feelings and experiences of parents, children and young people. The next step is to use these findings to develop and inform the best resources to support families. The findings of the UK Co-SPACE study have not only received attention from British policy makers and media, but also been reported on internationally by media in Indonesia, Slovenia, India, and Spain.
Dr Polly Waite, co-lead author, said: ‘We’re about to embark on qualitative interviews with young people, parents/carers and professionals working with young people to gain a more in-depth understanding of people's experiences. We are also working on making the data open access.’
The Oxfordshire Online Mental Health and Wellbeing Survey 2020 (OxWELL study) investigated school pupils’ health and wellbeing, examining over 200 key factors in the lives and expectations of young people aged 8-18 years. The 19,000 students from 237 schools who completed the survey have helped to reveal vital information about risks to adolescents in terms of isolation, online behaviours, and anxiety, as well as patterns of seeking support during the COVID-19 crisis.
Talking to children about illness and the death of a loved one has become a part of many families’ lives during 2020. Communicating effectively with children involves both tailoring the factual information to their developmental understanding, and including the emotional implications of the news. Professor Alan Stein, Dr Elizabeth Rapa and Dr Louise Dalton produced a series of guides and advice for families, care staff and healthcare professionals on how to talk to children about the serious illness or death of someone they cared about. This information has been translated into a number of languages including Urdu, Tagalog, Spanish and Portuguese, and these free communication resources are being distributed globally by the Pan American Health Organization (PAHO), UNICEF, the Intensive Care National Audit and Research Centre (ICNARC) and the International Society for Quality in Health Care (ISQua).
A collaboration from researchers at the Department of Psychiatry, Oxford University, Imperial College London and two third-sector organisations, Youth Era and The McPin Foundation, has co-designed, delivered and tested online peer support training for young people aged 16-18 in the UK.
COVID-19 – Impact on Adults
The PHOSP-COVID study is investigating the long-term health impacts of COVID-19 on hospitalised patients. A consortium of leading researchers and clinicians from across the UK is working together to share expertise and help assess the impact of COVID-19 on patient health and recovery. The True Colours platform, developed over a decade ago in the Department of Psychiatry, has been adapted for the PHOSP-COVID study to collect health outcomes over time. Oxford investigators are at the forefront in progressing this study with lead investigators in the NIHR Leicester Biomedical Research Centre (BRC).
Professor John Geddes, lead for the mental health component of the study, said:
‘It is very important that mental health and neurological problems are being assessed alongside other health outcomes. We will then be able to develop and test new ways of preventing and treating these problems to make sure that people recover as quickly as possible.’
The largest study so far on links between COVID-19 and psychiatric diagnosis, led by Professor Paul Harrison and Dr Max Taquet, used the electronic health records of 69 million people in the USA, including over 62,000 cases of COVID-19. The study suggests that having COVID-19 increases a person’s risk of developing psychiatric disorders, and that having a psychiatric disorder increases the chance of getting COVID-19. The study shows that almost 1 in 5 people diagnosed with COVID-19 receive a psychiatric diagnosis within the next three months. More than 800 mentions in international coverage, reaching an audience of more than 900 million, helped to raise awareness of the real impact of COVID-19 on people’s mental health.
This study, published in The Lancet Psychiatry is officially the all-time #1 paper in psychiatry in terms of the number of media outlets in which it was featured. #2 in terms of the Altmetric score.
During the first lockdown in April 2020, Professor Catherine Harmer, Dr Susannah Murphy and Dr Amy Gillespie from the Psychopharmacology & Emotion Research Laboratory (PERL) launched the Oxford COSIE (COvid-19, Social Isolation and Emotion) study. The aim was to identify factors associated with risk and resilience, as well as depression and anxiety during the pandemic, using cognitive tests of emotional bias to capture early vulnerability and explore mechanisms. Members of the NIHR Oxford Health Biomedical Research Centre (BRC) Patient and Public Involvement community contributed to the potential risk and resilience factors. In September, early results were presented at the European College of Neuropsychopharmacology (ECNP) Congress. Taking a statin, having access to outdoor space and high levels of behavioural activation (e.g. engaging in enjoyable activities or having a routine) were all associated with lower levels of negative emotional bias – i.e. protective of later depression. High levels of loneliness, being at risk of COVID-19, and current symptoms of depression were all associated with higher levels of negative bias – i.e. risk factors for later depression.
A study exploring the effects of online cultural experiences on mental health used the opportunity of the first lockdown in the UK and social distancing to gather new evidence. Online Active Community Engagement for Mental Health and Wellbeing (O-ACE) is a series of studies aiming to optimise online cultural resources for mental health. The first was a survey of online culture and mental health on the Ashmolean Museum website. Dr Rebecca Syed Sheriff, study lead, then conducted a series of qualitative studies examining the ways in which online culture could be enhanced for mental health in people aged 16-24. The team has now developed an intervention and aims to test it using scientifically rigorous methodologies in young adults.
Researchers from the Precision Psychological Therapies theme in the NIHR Oxford Health BRC, led by Professor Anke Ehlers, have published guidelines and free resources for treating patients experiencing post-traumatic stress disorder (PTSD) following admission to an intensive care unit (ICU) during the COVID-19 pandemic.
Professor Daniel Freeman led research into coronavirus conspiracy beliefs, mistrust, and compliance with government guidelines in England, during the first lockdown in May 2020. The findings showed that a high number of adults in England did not agree with the scientific and governmental consensus on the coronavirus pandemic, with those who believe in conspiracy theories less likely to follow government guidance – for example, staying 2m apart from other people – as well as less likely to accept a vaccination, take a diagnostic test, or wear a facemask. The second Oxford Coronavirus Explanations, Attitudes, and Narratives Survey (OCEANS II) ran later in the year, focusing on the important issue of COVID-19 vaccine hesitancy.
COVID-19 Impact on Students
This year’s U-Flourish Student Wellbeing and Academic Success survey launched in the autumn and is available to all students at Oxford, with the aim of better understanding the factors that contribute to student wellbeing, mental health, and academic success, and particularly how the COVID-19 pandemic has affected students and their learning. The results will be shared next year with the University and the local NHS to help inform how they develop resources and services for Oxford students.
The Social and Psychological Impact of COVID-19 on Medical Students (SPICE-19) is a multicentre prospective cohort study that systematically explores the impact of the crisis on medical students. Data gathered will guide current strategy, resource allocation and wellbeing support within medical schools and foundation training, and inform policy for future pandemics and epidemics. This project was student-led, using a network of students across the country with participation from most medical schools. The main publication is currently under review.
Associate Professor Kate Saunders said:
‘Medical students have faced an enormous disruption to their lives and studies as a result of the COVID-19 pandemic. Many are volunteering in the NHS, and those in their final years have foregone electives and graduated early in order to take up interim foundation doctor roles. These are unprecedented times for all in the medical profession, but the impact on students is likely to be particularly significant.’
Quality robust research into mental health has a significant impact on the understanding of illnesses and the development of evidence-based treatments and interventions, which all lead to improved health outcomes.
This research would not have been possible without the significant investment from our funding partners including UK Research and Innovation (UKRI), the National Institute for Health Research (NIHR) and the NIHR Oxford Health Biomedical Research Centre, the Westminster Foundation, Oxford University’s COVID-19 Research Response Fund, and the Higher Education Innovation Fund – Research England.