Mental health emergencies and COVID-19: the impact of ‘lockdown’ in the East Midlands of the UK.

Background: The most immediate response of the research community to COVID-19 has been a focus on understanding the effects, treatment and prevention of infection. Of equal and ongoing importance is elucidating the impact of mitigation measures, such as lockdown, on the wellbeing of societies. Research about mental health and lockdown in the UK has predominately involved large surveys that are likely to encounter self-selection bias. Further, self-reporting does not constitute a clinical judgement. Aims: To 1) compare the age, gender and ethnicity of patients experiencing mental health emergencies prior, compared to during lockdown, 2) determine whether the nature of mental health emergencies has changed during compared to before lockdown, 3) explore the utility of EMS data for identifying vulnerability to mental health emergencies in real-time during a pandemic. Methods: 32,401 clinical records of ambulance paramedics attending mental health emergencies in the East Midlands of the UK between March 23rd and July 31st 2020 and the same period in 2019 were analysed using binary logistic regression. Results: People of younger age, male gender and South Asian and Black ethnicity are particularly vulnerable to acute mental health conditions during lockdown. Acute cases of anxiety have increased during lockdown while suicide and intentional drug overdose have decreased. Conclusions: Self-reported data may underrepresent the true impact of lockdown on male mental health and ethnic minority groups. Emergency medical data can be used to identify vulnerable communities in the context of the extraordinary circumstances surrounding the current pandemic, as well as under more ordinary circumstances.