OWLS [COVID-19]
Research type
Research Study
Full title
Optimising Wellbeing in Social Isolation (OWLS)
IRAS ID
284381
Contact name
Simon Gilbody
Contact email
Sponsor organisation
University of York
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
1 years, 6 months, 31 days
Research summary
Summary of Reserach
People with severe mental ill health such as schizophrenia and bipolar disorder experience some of the most profound health inequalities of any sector of society and are at greater risk of being affected by COVID-19 and the pandemic restrictions. There are multiple reasons for this; they are more likely to live in deprived circumstances and are less likely to be digitally connected and therefore may experience difficulties in maintaining social networks and accessing services which have gone online. Furthermore many people with severe mental ill health have long term physical health problems, putting them in a vulnerable group that must isolate for long periods of time. \nThis project is called the Optimizing Wellbeing during Social Isolation (OWLS) study. We will explore how people with severe mental ill health experience the current pandemic restrictions and their social consequences. In particular we will explore the ability of people with SMI to access both primary care and mental health services, whether they are digitally connected and how they utilise digital media and the internet, whether they experience feelings of social isolation and loneliness and finally if they have modified their health-related behavior to reduce the risk of COVID-19. The project is a mixed methods project involving a quantitative survey and qualitative interviews. At the center of the project is a cohort of people with severe mental ill health who have taken part in a previous survey about health related behaviours and who have consented to re-contact. We will use a sampling framework to contact a range of participants from the cohort and invite them to take part in the survey, a sub-section of whom will be invited to take part in a qualitative interview. Data from the OWLS study will be analysed and recommendations made on targeted strategies to mitigate the risk of COVID-19 and the impact of the pandemic restrictions for this vulnerable population.\n
Summary of Results
OWLS summary - review
People with severe mental ill health (SMI) experience significant health inequalities compared to people without this diagnosis. There is potential for these inequalities to become more significant as a result of the health risks and restrictions linked to the COVID-19 outbreak.
The OWLS study was set up to explore how the pandemic and its associated restrictions have affected people with SMI and suggest ways to mitigate against any widening health inequalities. 367 participants were recruited from a range of demographics within England.
Data relating to behaviours known to be harmful to health, showed that whilst some people reported smoking less during the pandemic (12%), over half of the respondents who smoke, were smoking more than before the pandemic (55%). Results from the study show that just under half the people who took part was doing less physical activity than they did prior to the COVID-19 restrictions. Of those who drink alcohol, 29% said that they were drinking more and 27% said that they were drinking less than usual.
From the data, the increase in the behaviors mentioned above was associated with being younger and self-reporting of a deterioration in physical health. The increase was not associated with gender, level of deprivation, ethnicity and self-reported deterioration in mental health.
During the pandemic, living alone and being younger were associated with being lonely among people with SMI but the same factors were also associated with increased loneliness among the general population. Feelings of social connectivity were associated with living with others.
The majority of respondents have Internet access and a device to connect with. Around half of the respondents felt that they had a good to outstanding knowledge of the Internet. There is an important minority (more than 10%) that does not own any digital device or do not have access to the Internet from home. Around a third of all participants expressed interest in learning more about how to use the Internet. Those who were more able to use the Internet were likely to be younger and have bipolar disorder rather than a psychosis-spectrum disorder. Most of the people who said they were using the Internet a lot during the pandemic, also said they felt like their mental health has declined since the beginning of the pandemic. However, it is possible that this is due to the personal characteristics of these people, like for example their diagnosis. The three biggest barriers to Internet use were people not being interested in using the Internet, finding the Internet too difficult to use and security concerns. The most common reasons for using the Internet were, accessing information/ entertainment, staying in touch with friends and buying things other than food.
The majority of people reported that they had been able to access both physical and mental health services when they needed to and a face-to-face meeting increased the likelihood that people felt that their needs had been met.
Almost a third of people who weren’t currently receiving support from mental health services thought that they would need support in the next year and of those currently receiving support about a quarter thought they would need additional support in the next year. A further quarter of those currently receiving support felt that they might need additional support in the next year.
In summary people with SMI will need additional support to prevent worsening of existing health inequalities, support will particularly be needed to help people stop smoking and take more exercise in addition to further support from mental health services. Furthermore support will need to be delivered in a way that works for the individual and not assume that everyone had access to, and can use the internet, or that appointments delivered remotely provide people with the care they need.
Recommendations for the future
Support people with SMI to enhance their digital skills and increase motivation to use the Internet. Greater support might be needed for older people with psychosis spectrum disorders. The connection between being online and worse mental health warrants greater exploration to understand why this is the case, and to make recommendations about positive use of the Internet.
Services should take into consideration individual’s needs, recognizing that needs may fluctuate and allowing patient choice in the mode of delivery and taking into account the digital divide in this population.
Plans need to be put in place for increasing funding for services and creating additional low intensity face to face services in addition to what is already available to allow people’s needs to be met as quickly and easily as possible to mitigate against greater longer term consequences, both in terms of physical and mental health.
SMI should be recognized along side other sectors of society found to be most adversely affected by the COVID- 19 restriction sand provided with targeted extra support to prevent additional ongoing adversity for one of the most vulnerable sectors of our society
REC name
North West - Liverpool Central Research Ethics Committee
REC reference
20/NW/0276
Date of REC Opinion
10 Jun 2020
REC opinion
Further Information Favourable Opinion