The first 2 years of the COVID-19 pandemic affected the mental health of millions of Europeans, but not as strongly as many feared, with only a modest rise in mental health problems seen in a new systematic review published in The Lancet Psychiatry.
Still, access to mental health services has yet to rebound fully.
The study was conducted by researchers at University College London, who looked at evidence from 177 studies in 20 high-income European countries to assess mental health during the first 2 years of the pandemic.
There was evidence of high to moderate certainty that the prevalence of depression, generalized anxiety disorder, and non-specific mental health problems was higher during the pandemic.
Among the studies, 88 (50%) compared mental health outcomes before the pandemic with those during the pandemic, 55 (31%) measured outcomes at different timepoints over the course of the pandemic, and 34 (19%) had both a pre-pandemic and during-pandemic comparator.
"We found that the Covid-19 pandemic had a considerable effect on mental health across Europe, but overall, the impacts were not as substantial as many people had predicted early on, as we did not see a 'second pandemic' of mental health problems," lead author Nafiso Ahmed, MD, said in a press release.
"There was evidence of high to moderate certainty that the prevalence of depression, generalized anxiety disorder, and non-specific mental health problems was higher during the pandemic," the authors wrote, "with statistically significant increases ranging from 0.25% to 31%."
Low-certainty evidence suggested that eating disorders also increased by 20% to 21%. Importantly, suicidal behavior did not change significantly over the first 2 years.
Services dropped during pandemic, have yet to recover
The study shows that a wide array of mental health services were limited at the beginning of the pandemic, likely because of in-person healthcare closures.
The decreases included mental health inpatient care (adult admissions, 11% to 43% reduction; pediatric admissions, 18% to 42% reduction), mental health presentations to emergency departments, and walk-in services (adult presentations, 14% to 58%; pediatric presentations, 36% to 61%).
Increased access to services began to rise again in June 2020, but use of all these services remained below pre-pandemic levels at later timepoints in 2021, the authors said.
"Given sparse research at timepoints beyond 2020, it is unclear whether these trends continued, and they should be cautiously interpreted given long-term increases in demand for mental services already observed before the pandemic," they wrote.
