'When will this end? Will it end?' The impact of the March-June 2020 UK Covid-19 lockdown response on mental health: a longitudinal survey of mothers in the Born in Bradford study.

Objectives To determine clinically important change in anxiety and depression from before to during the first UK Covid-19 lockdown and factors related to this change, including ethnic differences. Design Pre-Covid and lockdown surveys nested within two longitudinal Born in Bradford cohort studies. Participants 1,860 mothers with a child aged 0-4 or 9-13, 48% Pakistani heritage Main outcome measures Odds ratios (OR) for a clinically important increase (5 points) in depression (PHQ-8) and anxiety (GAD-7) in unadjusted regression analyses, parsimonious multivariate modelling to explore ethnicity and mental ill health and lived experience of mothers captured in open text questions. Results Clinically important depression and anxiety increased from 11% to 19%, and 10% to 16% respectively from before to during the first Covid-19 lockdown. Loneliness during lockdown was most strongly associated with increases in depression (OR: 8.37, 95% CIs: 5.70-12.27) and anxiety (8.50, 5.71-12.65), followed by financial insecurity (6.23, 3.96-9.80; 6.03, 3.82-9.51). Other strongly associated variables included food and housing insecurity, a lack of physical activity and a poor partner relationship. When level of financial insecurity was taken into account, Pakistani heritage mothers were less likely than White British mothers to experience an increase in depression (0.67, 0.51-0.89) and anxiety (0.73, 0.55-0.97). Responses to open text highlighted a complex inter-play of health anxieties, mental load, loss of social support and coping strategies, and financial insecurity contributing to mental ill health. Positive aspects of lockdown were also reported, including a more relaxed pace of life. Conclusions Mental ill health has worsened with the Covid-19 lockdown, particularly in those who are lonely, economically insecure and/or of White British ethnicity. Mental health problems may have longer term consequences for public health. Strategies to mitigate adverse impacts of future lockdowns on mental health should focus on those factors we highlight as associated with worsening mental health.