Evidence map›Paper›PMID 41928224›Full record

ArticleBMC health services research2026

Utilisation of mental health services before, during, and after COVID-19 restrictions: interrupted time-series analysis in England.

Campbell Robertson, Julii Brainard, Gillian E Smith, Sally E Harcourt, Uy Hoang, Alex J Elliot, Simon de Lusignan, Felipe J Colón-González, Iain R Lake

Abstract read
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In one paragraph

Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Campbell RobertsonNational Institute for Health and Care Research Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK. campbell.robertson@psych.ox.ac.uk.
Julii BrainardNational Institute for Health and Care Research Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK.
Gillian E SmithNational Institute for Health and Care Research Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK.
Sally E HarcourtReal-Time Syndromic Surveillance Team, Field Services, Chief Medical Advisor Group, UK Health Security Agency, Birmingham, UK.
Uy HoangNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Alex J ElliotNational Institute for Health and Care Research Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK.
Simon de LusignanNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Felipe J Colón-GonzálezSchool of Environmental Science, University of East Anglia, Norwich, UK.
Iain R LakeNational Institute for Health and Care Research Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDuring the Coronavirus Disease 2019 (COVID-19) pandemic, the World Health Organisation reported a 25% increase in anxiety and depression, and multiple studies indicated that COVID-19 experiences might increase the prevalence of mental illness with subsequent high demands on mental health (MH) services. However, few studies have focussed upon MH across the entire period of pandemic restrictions within England or considered implications for pandemic preparedness.

methodsWe conducted an interrupted time-series analysis of MH service utilisation across England’s National Health Service, including primary care consultations, emergency department attendances, and telephone advice line contacts. The study period was January 1st 2019 to April 20th 2022. Using data from before and after pandemic restrictions, negative binomial regression models generated expected MH utilisation if the pandemic had not occurred. Expected and observed MH utilisation were compared. MH service indicators were analysed both overall and stratified by age group.

resultsEarly restrictions saw significant declines in access to MH services, telephone calls for MH advice reduced by 36.8% (95% CI -42.0, -31.9) and general practitioner (GP) in-hours consultations for depression decreased by 64.6% (95% CI -77.8, -53.3). Later restrictions revealed an increase in consultations in primary care for anxiety, with an increase of 41.8% (95% CI 38.7, 44.7) in GP out-of-hours. By the final period of restrictions, most MH indicators had either returned to expected levels or were significantly above expected presentations. Young people (15–24) exhibited MH utilisation differences —sharply reduced anxiety and MH during initial restrictions but increasing anxiety in later restrictions within primary care.

conclusionsCOVID-19 restrictions were associated with overall decreases in the utilisation of MH services but increases from in person to remote services were observed. For future pandemic preparedness, remotely accessible MH services are important when in-person services are reduced and the surveillance sources used in this study offers the possibility of real-time decision making.

trial registrationThe data used in this study are based on patients accessing healthcare services in England and are therefore retrospectively registered.

Indexed as

COVID-19Mental Health ServicesPatient Acceptance of Health CareEmergency Room VisitsEnglandHumansInterrupted Time Series AnalysisPandemicsPrimary Health CareSARS-CoV-2State MedicineAnxietyCOVID-19DepressionITSAMental healthPandemic preparednessPrimary carePsychiatric epidemiologySyndromic surveillanceUtilisation

Identifiers

PMID41928224
PMCPMC13045032

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.