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Impact of COVID-19 on Mental Health

The term long-COVID has been spoken about in great depth despite leading healthcare professionals and scientists still being unsure about the use of the term and what it actually means and for whom. This year a vast amount of research into the ongoing impact of COVID-19 has been undertaken. Professor Paul Harrison, Department of Psychiatry, and Dr Maxime Taquet, Medical Sciences Division, have led innovative research analysis using the US-based TriNetX electronic health record network. They identified over a third of COVID-19 patients were diagnosed with at least one long-COVID symptom. In a separate study the team discovered that one in three COVID-19 survivors received a neurological or psychiatric diagnosis within six-months of infection with the SARS-CoV-2 virus.

The PHOSP-COVID study, which involves a number of Oxford researchers across a range of disciplines, found that seven in ten patients hospitalised with COVID-19 did not fully recover five months after discharge and continued to experience negative impacts on their physical and mental health, as well as their ability to work. The latest results show that these people show limited further recovery one year after hospital discharge.

Professor John Geddes said:

'The PHOSP-COVID study is a major achievement, pooling data and expertise from across the country to better understand the lasting physical and mental impacts of COVID-19 on hospitalised patients. More than half a million people have been admitted to hospital with COVID-19 in the UK, so as a country, we are looking at a significant proportion of the population at risk of persistent ill-health and reduced quality of life.'

The Medical Research Council (MRC) is funding the £2.3m COVID-19 Clinical Neuroscience Study (COVID-CNS), which is investigating 800 COVID-19 patients who had neurological or neuropsychiatric symptoms whilst acutely ill. Professor Paul Harrison and Professor Masud Husain, Nuffield Department of Clinical Neurosciences, lead work at the Oxford site, following up study participants. The study will run until autumn 2022.

The emergence of vaccines against COVID-19 has seen much discussion about vaccine take-up, with governments across the world encouraging populations to get the vaccination when available. Professor Daniel Freeman conducted a large-scale study, the Oxford Coronavirus Explanations, Attitudes, and Narratives Survey (OCEANS 111), which asked UK adults to rate their anxieties about needles and blood, and asked them about their willingness to receive a COVID-19 vaccine. The study found that a quarter of the UK adult population screens positive for a potential injection phobia and these individuals were twice as likely to report that they were COVID-19 vaccine hesitant – they would put off getting vaccinated or never get the jab. In addition, the survey tested the responses of a representative group of 18,885 UK adults to a variety of COVID-19 vaccine messaging. Findings suggest that emphasising the personal benefits of vaccination may be the most effective way to persuade people who are sceptical about the jab.

Children and Young People's Mental Health

The COVID-19 Supporting Parents, Adolescents, and Children in Epidemics (Co-SPACE) study showed that one year on from the beginning of the pandemic, parents/carers reported considerable change in their children's behavioural, emotional and attentional difficulties throughout the pandemic, increasing in times of national lockdown and decreasing as restrictions eased and schools reopened. On the basis of early Co-SPACE findings, further funding was also secured from UKRI and the MRC/NIHR for two major randomised controlled trials to support parents with their child's mental health, in public health and clinical settings. With support from the MRC and the Westminster Foundation the team also worked with the Mental Elf to produce guidance and webinars for parents and people that work with children and young people, and a range of evidence-based resources made with and for young people.

The OxWell school survey had 19,000 pupils participate in 2020 and 31,000 participate in 2021, with findings on subjects including the impact of the first lockdown on mental health in adolescents, as well as young people's willingness to have the COVID-19 vaccination. Findings suggest the importance of improved information for younger children and adolescents as they are the least willing to have the COVID-19 vaccination.

Research papers reporting on the Co-SPACE and OxWell studies have both been amongst the most highly cited in the Association for Child and Adolescent Mental Health (ACAMH) journals in 2021.

 

HRH the Duchess of Cambridge on a school visit to talk about SEEN. Dr Louise Dalton in the background.

©Kensington Palace

The Secondary Education around Early Neurodevelopment (SEEN) project, commissioned and funded by Kindred², involved nearly 4,000 children across the UK in three specially developed science lessons to educate pupils about brain development during early childhood. The work is part of a wider drive to increase public understanding of how early experiences can shape the adults we become.

Dr Elizabeth Rapa, co-investigator of SEEN and Senior Scientist, University of Oxford, said:

 

'This ground-breaking project could improve the lives of children for generations. We hope that the key principles of early child development into KS3/4 (aged 11-14) will now be taught in more schools.'

The development of a new project, Brainwaves, got under way this year. It is an ambitious project which will bring together education and mental health research through the recruitment of a large cohort of adolescents, as well as work to improve access to existing research findings in this area. Professors Mina Fazel and John Gallacher are leading the team and are drawing from expertise across the Department of Psychiatry. The project will launch in 2022.

The Identifying Child Anxiety Through Schools (ICATS) and Minimising Young Children's Anxiety Through Schools (MY-CATS) programmes, funded by the NIHR and the Kavli Trust respectively, are working with over 100 primary schools across England to evaluate the provision of providing early online support to parents and carers to prevent or treat anxiety problems in children.

UKRI Emerging Minds is a research network that aims to reduce the prevalence of mental health problems experienced by children and young people. The network team has worked with families and people that work with families to co-create a set of priorities for the research into child and adolescent mental health which is most important to them. The network has supported nine research projects, three cross-sector placements and 20 special interest research groups.

Adult Mental Health

Blank faced patient out walking with therapist in a street scene© Amber Anderson www.amberanderson.co.uk

Professor Daniel Freeman launched the new Feeling Safe – treatment programme for persecutory delusions, which promises a step change in the treatment of severe mental health problems. The clinical trial results showed that the Feeling Safe programme is the most effective psychological treatment for persecutory delusions, with 50 percent of patients achieving recovery.

Professor Daniel Freeman, the developer of the Feeling Safe programme, University of Oxford, said:

 

'Feeling Safe is the result of more than ten years of research and clinical practice. Its success has been built on listening carefully to patients, to really understand the causes of the problems they are facing. Over 20 sessions, the programme helps people to develop new memories of safety and addresses the factors that often maintain persecutory thoughts, such as worry, poor sleep, and low self-confidence. The challenge now is to reach the many thousands of people whose lives have been disrupted by severe paranoia.'

Professor Alan Stein's team led the first national UK survey focused on those bereaved during the COVID-19 pandemic. The survey findings informed important recommendations for service delivery of individualised, compassionate end-of-life care during a pandemic.

Lead author Dr Jeff Hanna said:

'Health and social care professionals have a pivotal role in facilitating vital interactions between relatives and their loved ones. Although numbers of COVID patients have decreased, all NHS staff now face the enduring legacy of the pandemic on the wider healthcare system.'