SSM featuring 2022’s top scoring abstracts … Naomi Miall

SSM featuring 2022’s top scoring abstracts … Naomi Miall!

Naomi Miall is a Research Assistant based at the University of Glasgow’s MRC/CSO Social & Public Health Sciences Unit. At 2022’s ASM in Exeter, her abstract Inequalities in mental health among children aged 5–11 before and during the COVID-19 pandemic in the UK: findings from the UK Household Longitudinal Study was one of the top 10 highest scoring. Below, she tells us about this project.

Naomi Miall MRC/CSO Social & Public Health Sciences Unit, University of Glasgow Research Assistant

Inequalities in children’s mental health before and during the COVID-19 pandemic: findings from the UK Household Longitudinal Study

One of the most shocking fall-outs of the COVID-19 pandemic period is the declines in mental health of children and young people documented by medical staff, charities, and academics. The British Medical Association report that contacts with child and adolescent mental health services have quadrupled over the past five years. One in six children aged 5-16 was experiencing a probable mental disorder in 2020, according to estimates from the Mental Health Survey for Children and Young People. This is particularly concerning because decreased wellbeing in childhood is associated with poor health in adulthood, as well as poorer education and employment outcomes.

We set out to explore how inequalities in mental health among children had changed during the pandemic. The inequalities we chose to explore included sex, ethnicity, and socio-economic factors including parental education, employment, lone parenting, household income, and area deprivation. We used data from Understanding Society, which has been annually interviewing all members of forty-thousand households since 2009 about their lives, health, and relationships.  Between 2020 and 2021, a subsample of these households was additionally surveyed every other month to understand their experiences during the COVID-19 pandemic. The survey measures the mental health of children when they are aged five and eight, by asking parents about their children’s behaviours, social relationships and emotions (the Strengths and Difficulties Score). We were therefore able to model changes in mental health inequalities among children between 2011 and 2021.

Before starting the project, I had a strong expectation that we would find inequalities had worsened during the pandemic. Inequalities were already at shocking levels before 2019. For example, children with unemployed parents were 2.7 times more likely to have high or very high mental health symptoms between 2011 and 2019 than children with at least one employed parent. I expected that lockdowns would have exacerbated these differences, with disruptions to employment and education placing greatest tolls on those in low-income families, and household confinement being most severe for those living in crowded spaces with less access to green space.

Our results showed that mental health declined across the whole population during the pandemic, however contrary to my expectations declines were more rapid in traditionally more advantaged groups. This created a ‘levelling down’ effect, where inequalities in mental health narrowed but to a worse overall level. This pattern was strongest when comparing children with unemployed to employed parents and was also apparent for inequalities related to family structure, parent education and household income.

The current outlook of child mental health is a bleak picture in the wake of COVID-19 lockdowns followed rapidly by the cost-of-living crisis. Our research shows that child mental health has been worsening over the past decade, and that there was a ‘levelling down’ of mental health inequalities during the pandemic. In other words, inequalities narrowed, but only because the mental health of more advantaged groups declined and became closer to that of less advantaged families. Interventions to improve child mental health across the population are urgently needed. These must occur alongside action to address childhood poverty and disadvantage to ensure that improvements are achieved across all families, regardless of their socio-economic characteristics.

The pre-print for this paper can be found here: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4284623

This is a special edition of our blog series that celebrates SSM members and their work. Over the next few months we will be featuring the authors of top-scoring abstracts from 2022’s ASM. To find out more visit socsocmed.org.uk/blog or email ecr.ssm@gmail.com.