This study led by Public Health Wales was supported by the Centre for Population Health. The study was recently presented at the Public Health Science conference, and the conference abstract has been published in The Lancet.
The COVID-19 pandemic has had a damaging effect on children’s mental health. Due to strict public health restrictions, shielded children or those living with a shielded person might be particularly vulnerable to mental health difficulties. However, there is a lack of studies examining mental health outcomes in these children. This study aimed to bridge this research gap.
The research team linked the COVID-19 Shielded Patient List to demographic and healthcare datasets within the Secure Anonymised Information Linkage (SAIL). The study consisted of data from children aged 2–17 years living in Wales and registered with a general practitioner.
Findings from the study
- Before the COVID-19 pandemic, 155 of 3,721 shielded children received diagnoses or prescriptions for anxiety or depression, compared with 128 of 3,721 children during the pandemic.
- 71 of 3,566 children had new diagnoses or prescriptions during the pandemic.
For children in shielded households:
- These values were 489 of 19,954 children before COVID-19 and 301 of 19,954 children during COVID-19.
- 218 of 19,456 children had new diagnoses or prescriptions during the pandemic.
For the general population:
- These values were 8,001 of 411,680 children before COVID-19 and 5,420 of 411, 680 children during COVID-19.
- 4,070 of 403,679 children had new diagnoses or prescriptions during the pandemic.
The difference in the proportion of new diagnoses or prescriptions between shielded children and the general population was significant.
The study indicates a decrease in diagnoses or prescriptions for anxiety or depression during COVID-19, partly attributed to a reluctance to seek health care during this time. The prevalence of anxiety or depression was highest in shielded children, and the rate of new diagnoses or prescriptions during COVID-19 was significantly higher among shielded children.
Future research could involve following up with these children over a period to assess future health trends in healthcare use for mental health-related conditions and longer-term health and education outcomes among these groups.
Dr Laura Cowley, Senior Public Health Research Officer at Public Health Wales, and the Centre for Population Health said:
Our research to date has revealed that during the COVID-19 pandemic, in children with no history of anxiety or depression, shielded children were more likely than children in the general population to have a record for anxiety or depression in primary care. We have extended the study to examine anxiety and depression in children in secondary care. In addition, further analysis is underway examining anxiety and depression outcomes in clinically extremely vulnerable children in 2019, compared to the general population of children in Wales, prior to the pandemic when no shielding guidance was in place. This will help us to determine whether clinically extremely vulnerable children are at a higher risk of poor mental health regardless of the shielding intervention.