COVID-19: UK Experts Call for Mental Health Research

Liam Davenport

April 21, 2020

Urgent, coordinated research is needed into the mental health and potential neurological impacts of the COVID-19 pandemic, as well as the rapid roll-out of novel treatments, say UK experts in a landmark paper.

In the paper, published by Lancet Psychiatry on April 15th, 24 UK mental health experts explain that the pandemic could have effects both now and over the longer term, particularly for the most vulnerable in society.

Frontline Concerns

As reported by Medscape Medical News, they set out a roadmap for research into how to maintain mental health through the crisis, particularly for frontline medical staff and vulnerable groups.

Indeed, the results of two surveys of more than 3000 UK adults, published by the UK Academy of Medical Sciences, and the research charity MQ (mental health and quality of life): Transforming Mental Health, on April 15th, showed that the effects are already starting to be seen.

Respondents, who were asked as the UK’s lockdown came into force said that the COVID-19 pandemic is increasing concerns over anxiety, isolation, and access to care, as well as fears over becoming mentally unwell.

Co-author Professor Matthew Hotopf, Institute of Psychiatry, Psychology and Neuroscience, London, stressed in a webinar on the paper that the impact of the pandemic on mental health will not last only as long as the current outbreak.

He said that, in the short-term, "there’s an important question about acute anxiety" but, with the effect of the crisis on unemployment, poverty and homelessness, "I wouldn’t anticipate it to be a temporary blip".

"I’d anticipate it more to be a slow burn that will have significant consequences longer term."

Key Research Areas

While there were encouraging signs of people adopting coping strategies, the experts say that the results show the need for continuous monitoring of anxiety, depression, self-harm, suicide, and other mental health issues.

They also call for the rapid roll-out of remotely accessible evidence-based programmes and treatments that can be accessed remotely, and research into novel approaches tailored to particular groups.

This is alongside research into resilience in the face of the crisis, as well as the effects of the COVID-19 virus on the brain and nervous system, including a database to monitor neuropsychological effects.

Urgent and Strategic Action

Co-author Professor Ed Bullmore, Department of Psychiatry, University of Cambridge, underlined that COVID-19 "is likely to have a major impact on mental health now and into the future, and we need to start thinking about that immediately".

"That’s why we highlight the need for multidisciplinary research that cuts across the different areas of mental health sciences," he said.

"We’re calling for action now, to begin urgently and strategically to get research programmes running in a coordinated way across the country so we can properly assess the scale of the problems and workout the best ways to deal with them as quickly as possible.

"Mainly we need to know what we’re dealing with... and we need to find new ways of treating or preventing mental health problems that can be delivered digitally."

Organising Body

This, the authors stress, will require UK research funding agencies to work with researchers and individuals with experience of the mental health impact of the pandemic.

Prof Bullmore stressed that it is "important to spend research funding efficiently, and that’s one of the reasons we have emphasised that we think it would be best if the funding...was channelled through some sort of coordinating group".

He noted that there has been a "very large number of quite small scale, slightly scattergun papers" published in the wake of the COVID-19 epidemic.

"We think the questions around mental health are important enough that they need a more definitive research approach," Prof Bullmore said.

"We need to work at scale, we need to work in a way that’s coordinated across the multiple disciplines within mental health science, and that’s really why we're calling for a coordinating group to manage any additional investment that might come into this space."

Leveraging Existing Infrastructure

Prof Hotopf added that the UK has "exceptionally good research infrastructure for mental health research, with existing networks and a ‘team science’ approach, which I think is exactly what you need".

This was taken up by Dr Louise Wood, Director of Science, Research and Evidence at the Department of Health and Social Care (DHSC).

Reacting to the paper, she said that "this timely work by world-leading experts...will help to shape research into how this pandemic is affecting people’s mental health and wellbeing, and inform the discovery and refinement of effective interventions to address ill-health".

She also emphasised that "collecting high-quality data on the nation’s mental health is a crucial part of the efforts to respond to the COVID-19 crisis".

To those ends, she highlighted that funding from the National Institute for Health Research to address the research priorities "is available via the newly launched UK Research and Innovation/DHSC rolling call for COVID-19 research".

Professor Fiona Watt FRS FMedSci, executive chair of the Medical Research

Council, said that the paper "sets out an important framework for the prioritisation of mental health sciences research in the context of the COVID-19 pandemic".

"I fully endorse the emphasis on coordinating research efforts at a national and international level to support collaborative and rigorous research into mental health and neuroscience."

Helping the Most Vulnerable

Duncan Selbie, chief executive of Public Health England, said that the organisation is "very conscious of the distress this pandemic is having on our daily lives, with increased anxiety, isolation, people coping with sickness and death among family and friends, and the very real effects of social-distancing on our mental health".

He said that the most vulnerable, including frontline healthcare workers and people already living with poor mental or physical health, will be "particularly affected", alongside those supporting them.

"That is why this paper is so urgently needed, helping to support robust research into mental health and neuroscience, and deliver nuanced, timely and effective interventions."

However, co-author Professor Rory O’Connor, Suicidal Behaviour Research Laboratory, University of Glasgow, pointed out in the webinar that there is far less funding for mental health research than for other specialties.

He said that, if you take the example of cancer, "there is 25 times more research funding in cancer compared to mental health for every person affected".

Prof O’Connor noted "that was before COVID-19, and our really, really grave concern is that differential will be greater" afterwards.

"Of course we have to focus in on the physical symptoms and physical aspects of this pandemic initially, but [we] really need to be careful we don’t widen the [research] disparity."

The paper represents independent research part-funded by the National Institute for Health Research Biomedical Research Centre at Cambridge University Hospital NHS Trust and the University of Cambridge and South London and Maudsley NHS Foundation Trust and King’s College London.

Prof Hotopf reports grants from Innovative Medicines Initiative, outside the submitted work. He Is funded by the National Institute of Health Research Biomedical Research Centre at the Maudsley and a National Institute of Health Research Senior Investigator Award.

Prof O’Connor receives royalties from books, and occasional fees for workshops and invited addresses; and reports grants from Medical Research Foundation, the Mindstep Foundation, Chief Scientist Office, Medical Research Council, NHS Health Scotland, Scottish Government, and National Institute for Health Research.

No other conflicts of interest declared.

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