ArticleBMJ open2021
Changes in daily mental health service use and mortality at the commencement and lifting of COVID-19 'lockdown' policy in 10 UK sites: a regression discontinuity in time design.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Utilization of mental health services during the first year of the COVID-19 pandemic - a systematic review and meta-analysis.European psychiatry : the journal of the Association of European Psychiatrists · 2026Pooled it
- Access and use of general and mental health services before and during the COVID-19 pandemic: a systematic review and meta-analysis.BMJ open · 2025Pooled it
- Health and social care use, costs, and satisfaction among key workers accessing Resilience Hub support during the COVID-19 pandemic.BMC health services research · 2025Article
- Transparency in the existence, use, and output of a mental health data resource: a descriptive paper from the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre (BRC) Clinical Record Interactive Search (CRIS) Platform.International journal of population data science · 2025Article
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- Outpatient mental health care during high incidence phases of the COVID-19 pandemic in Germany - changes in utilization, challenges and post-COVID care.European archives of psychiatry and clinical neuroscience · 2024Article
- Article
- Regression discontinuity design for the study of health effects of exposures acting early in life.Frontiers in public health · 2024Review
- The impact of COVID-19 on mental health service utilisation in England.SSM. Mental health · 2023Article
- Article
- OpenSAFELY NHS Service Restoration Observatory 2: changes in primary care clinical activity in England during the COVID-19 pandemic.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Article
- Investigating time-dependent COVID-19 pandemic mental health data: Challenges and opportunities of using panel data analysis.PLoS medicine · 2023Article
- Relationship Between Coronavirus Disease 2019 Vaccination Rates and Rare But Potentially Fatal Adverse Events: A Regression Discontinuity Analysis of Western Countries.Journal of Korean medical science · 2023Article
- Article
- Article
- What happened to the predicted COVID-19-induced suicide epidemic, and why?The Australian and New Zealand journal of psychiatry · 2023Article
- Patterns of engagement in a digital mental health service during COVID-19: a cohort study for children and young people.Frontiers in psychiatry · 2023Article
- Dental Emergencies in an Italian Pediatric Hospital during the COVID-19 Pandemic.Healthcare (Basel, Switzerland) · 2022Article
- The prevalence, incidence, prognosis and risk factors for symptoms of depression and anxiety in a UK cohort during the COVID-19 pandemic.BJPsych open · 2022Article
- Enforced home-working under lockdown and its impact on employee wellbeing: a cross-sectional study.BMC public health · 2022Article
Corrections and comments
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Authors and funding
26 authors.
Funding
Abstract
objectivesTo investigate changes in daily mental health (MH) service use and mortality in response to the introduction and the lifting of the COVID-19 'lockdown' policy in Spring 2020.
designA regression discontinuity in time (RDiT) analysis of daily service-level activity. SETTING AND
participantsMental healthcare data were extracted from 10 UK providers. OUTCOME MEASURES: Daily (weekly for one site) deaths from all causes, referrals and discharges, inpatient care (admissions, discharges, caseloads) and community services (face-to-face (f2f)/non-f2f contacts, caseloads): Adult, older adult and child/adolescent mental health; early intervention in psychosis; home treatment teams and liaison/Accident and Emergency (A&E). Data were extracted from 1 Jan 2019 to 31 May 2020 for all sites, supplemented to 31 July 2020 for four sites. Changes around the commencement and lifting of COVID-19 'lockdown' policy (23 March and 10 May, respectively) were estimated using a RDiT design with a difference-in-difference approach generating incidence rate ratios (IRRs), meta-analysed across sites.
resultsPooled estimates for the lockdown transition showed increased daily deaths (IRR 2.31, 95% CI 1.86 to 2.87), reduced referrals (IRR 0.62, 95% CI 0.55 to 0.70) and reduced inpatient admissions (IRR 0.75, 95% CI 0.67 to 0.83) and caseloads (IRR 0.85, 95% CI 0.79 to 0.91) compared with the pre lockdown period. All community services saw shifts from f2f to non-f2f contacts, but varied in caseload changes. Lift of lockdown was associated with reduced deaths (IRR 0.42, 95% CI 0.27 to 0.66), increased referrals (IRR 1.36, 95% CI 1.15 to 1.60) and increased inpatient admissions (IRR 1.21, 95% CI 1.04 to 1.42) and caseloads (IRR 1.06, 95% CI 1.00 to 1.12) compared with the lockdown period. Site-wide activity, inpatient care and community services did not return to pre lockdown levels after lift of lockdown, while number of deaths did. Between-site heterogeneity most often indicated variation in size rather than direction of effect.
conclusionsMH service delivery underwent sizeable changes during the first national lockdown, with as-yet unknown and unevaluated consequences.
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