Coronavirus and the social impacts on Great Britain: 11 December 2020

This week, over the period 2 to 6 December, based on adults in Great Britain:

• compliance with most measures to stop the spread of the coronavirus (COVID-19) remained high, with 89% reporting always or often handwashing after returning home, 97% using a face covering, and 89% avoiding physical contact when outside their home

• around 3 in 10 (28%) adults felt that life will return to normal in six months or less, an increase from 1 in 10 (9%) on 21 to 25 October

We also look at the mental health of adults (depression and anxiety) over the period 11 to 29 November:

• In November 2020, 19% of adults experienced some form of depression, indicated by moderate to severe depressive symptoms, while 17% of adults experienced some form of anxiety.

• The proportion of adults experiencing some form of depression in the latest period is similar to earlier in the pandemic (19% in June 2020); however, these rates have almost doubled from around 1 in 10 (10%) before the pandemic (July 2019 to March 2020).

• A higher proportion of younger adults, women, disabled adults and those whose households were unable to afford an unexpected but necessary expense of £850 reported some form of depression and some form of anxiety.

• Almost half of adults (48%) reported that their well-being was being affected by the pandemic; this increased to 81% for those who had experienced some form of depression and/or some form of anxiety.

• A higher proportion of adults who had experienced some form of depression reported feeling lonely often or always (26%) compared with adults experiencing no or mild depressive symptoms (3%); a similar pattern was found for adults experiencing some form of anxiety (24% and 3% respectively).

• A lower proportion of adults experiencing some form of depression and/or some form of anxiety felt it would take six months or less for their life to return to normal (15% and 16% respectively) compared with 25% of those not experiencing depressive symptoms and/or some form of anxiety.

Statistician's comment

“Our research today shows that one in five adults in Great Britain experienced some form of depression in November. This is similar to levels reported earlier in the year, but double that reported before the pandemic. We’ve also found similar rates of anxiety in adults in Great Britain.

"It’s also interesting to see that since late October, more adults say they believe life will return to normal within six months. However a lower proportion of adults experiencing some form of anxiety and/or depression felt this was the case”.

Tim Vizard, Principal Research Officer, Office for National Statistics.

This weekly bulletin contains data and indicators from a new module being undertaken through the Office for National Statistics' (ONS') Opinions and Lifestyle Survey (OPN) to understand the impact of the coronavirus (COVID-19) pandemic on British society.

This week, we focus on the mental health of adults in Great Britain in November 2020, with comparisons during different time points throughout the coronavirus pandemic.

It looks at two of the most common mental health problems experienced by adults in Great Britain - anxiety and depression - using a set of robust questions used by GPs and health practitioners to provide a measure of anxiety and depression in adults. It should be noted that analysis in this bulletin is based on a self-reported measure (via an online or telephone survey) of adults experiencing anxiety and depression in Great Britain and does not represent a diagnosis of depression or anxiety in adults. The definition of depression and anxiety is included in Section 10: Glossary.

Estimates from November 2020 are based on three waves of the OPN, with data collection taking place from 11 to 29 November 2020. The three individual weekly datasets were pooled together to provide a sample of 12,364 adults aged 16 years and over in Great Britain.

Between July 2019 and June 2020, estimates for depression are based on the same sample of adults, responding at two different points in time. In November 2020, estimates are based on a new sample of adults. Anxiety was included in the survey for the first time in November. Information on the sampling is included in Section 11: Measuring the data.

Data on depressive symptoms and anxiety, with breakdowns by several personal characteristics, impact on life and well-being, loneliness and feelings of returning to normal, including confidence intervals for the estimates, are contained in the accompanying datasets.

Weekly update

The latest weekly statistics in this release are based on a survey of 6,029 adults aged 16 years and over in Great Britain, conducted between 2 and 6 December 2020 (inclusive). Results from this week are based on 4,151 responding adults (69% response rate).

For the latest weekly update presented in Section 3: Main indicators in Great Britain, "this week" refers to responses collected during the period 2 to 6 December 2020 and "last week" refers to responses collected during the period 25 to 29 November 2020.

Additional data on the social impacts with breakdowns by age, sex, underlying health condition, English regions and country, including confidence intervals for the estimates, are contained in the accompanying datasets.

Where to go for help

If you are affected by the topics covered in this article, the NHS provides useful information on the symptoms of depression and anxiety, and the support available. Every Mind Matters also provides helpful advice on looking after your mental health during the coronavirus pandemic.

There are several measures in place to help prevent the spread of the coronavirus (COVID-19), such as handwashing, use of face coverings, avoiding physical contact and self-isolating. These indicators are presented at a Great Britain level in Table 1.

Compliance with most measures remained high this week, with 89% (89% last week) reporting always or often handwashing after returning home, 97% (97% last week) using a face covering, and 89% (90% last week) avoiding physical contact when outside their home; 85% (88% last week) of adults reported always or often maintaining social distance when outside their support bubble this week.

Table 1: Main indicators

Download the data

This week in Great Britain, average personal well-being scores for life satisfaction (6.8), feeling that things done in life are worthwhile (7.3), and happiness (6.8) remained the same as last week, while there was a slight decrease in the anxiety score (4.1).

Figure 1: Personal well-being scores remained relatively stable compared with last week

Great Britain, March to December 2020

Notes:

1. Questions: "Overall, how satisfied are you with your life nowadays?", "Overall, to what extent do you feel that the things you do in your life are worthwhile?", "Overall, how happy did you feel yesterday?" and "Overall, how anxious did you feel yesterday?".

2. This question is answered on a scale of 0 to 10, where 0 is "not at all" and 10 is "completely".

3. Base: all adults.

Download the data

Half (50%) of adults reported that their well-being was being affected by the coronavirus (COVID-19) pandemic this week. Among those who said the coronavirus was affecting their well-being, the most common effects reported were feeling stressed or anxious (62%), feeling bored (51%) and feeling worried about the future (49%).

This week, around 3 in 10 (28%) adults felt that life will return to normal in six months or less, an increase from around 1 in 10 (9%) on 21 to 25 October 2020.

Since the summer (over the period 15 to 19 July), a higher proportion of adults reported that they think it will be more than a year before life returns to normal, compared with those who report that it will be six months or less.

In the last couple of weeks, from 25 to 29 November, a higher proportion of adults reported that they think life will return to normal in less than six months, compared with those who report that it will be more than a year.

Figure 2: There has been a steady increase in the proportion of adults feeling that it will take six months or less for life to return to normal

Great Britain, March to December 2020

Source: Office for National Statistics - Opinions and Lifestyle Survey

Notes:

1. Question: "How long do you think it will be before your life returns to normal?".

2. Base population: all adults.

3. This figure only includes those who reported that life will return to normal in six months or less, or more than a year. Other reported time periods are included in the datasets.

Download the data

Nearly 1 in 3 (31%) of adults aged 70 years and over think their life would return to normal in six months or less, compared with 26% of adults aged 30 to 49.

Men and women's perception of the future was similar - 32% of men thought life would return to normal in seven months to a year, compared with 34% of women.

Around 1 in 4 (25%) adults in the East of England and the Yorkshire and Humberside regions reported that they thought their life would return to normal in six months or less. In comparison, 33% of adults in London felt their life would return to normal within six months. However, it is important to note differences between the countries and regions of Great Britain were not statistically significant.

Nearly 4 in 10 (37%) adults who felt either comfortable or very comfortable leaving their homes reported that they expect life to return to normal in six months or less, a higher percentage than adults who felt uncomfortable or very uncomfortable (20%).

Depression and anxiety are among the most common types of mental disorders experienced by adults in Great Britain. They can affect people in different ways and can cause a wide variety of symptoms. Depressive symptoms range from lasting feelings of hopelessness, to losing interest in things one used to enjoy. Symptoms of anxiety include feelings of nervousness or being on edge, and how bothered one is about not being able to stop or control worrying.

In this bulletin, we have looked at depression and anxiety separately, using a robust set of measures looking at symptoms of depression and anxiety over the previous two weeks. It is important to note that some adults may have been experiencing both depression and anxiety at the same time, which is not covered in this release.

Rates of depression and anxiety in adults

In November 2020, 19% of adults experienced some form of depression, indicated by moderate to severe depressive symptoms, while 17% experienced some form of anxiety.

The rate of adults experiencing some form of depression in November 2020 were similar to earlier in the pandemic (19% in June 2020). However, these rates have almost doubled from around 1 in 10 (10%) before the pandemic (July 2019 to March 2020).

Analysis by the Office for National Statistics (ONS) earlier this year indicated that there were four characteristics associated with moderate to severe depressive symptoms during the pandemic: age, sex, disability and the inability to afford an unexpected expense. This section provides a summary of these characteristics again, to see if there has been any change in the depressive symptoms of adults in November 2020, when England was in a second national lockdown and additional restrictions were in place in Wales and Scotland.

We also explore anxiety by these four characteristics to provide an insight into the experiences of adults with some form of anxiety. This builds upon analysis by the ONS earlier this year looking at coronavirus and anxiety in adults, using the ONS personal well-being measures.

It should be noted that while mental health may be influenced by these characteristics, causation cannot be inferred. Information on interpreting findings in this report is included in Section 11: Measuring the data.

Age

Younger adults were more likely to experience some form of depression and some form of anxiety than older adults. Around 3 in 10 adults aged 16 to 29 years experienced some form of depression (31%), with 29% experiencing some form of anxiety in November 2020, compared with 8% and 6% respectively of adults aged 70 years and over (Figure 3).

In June 2020, a similar pattern was observed, with younger adults (aged 16 to 39 years) more likely to experience some form of depression than other adults. Rates of depression in November 2020 were higher in all age groups when compared with before the pandemic (July 2019 to March 2020).

Sex

Women were more likely to experience some form of depression and some form of anxiety than men. In November 2020, around 2 in 10 women experienced some form of depression (22%) and anxiety (21%), compared with 15% and 13% of men respectively (Figure 4).

In June 2020, a similar proportion of adults experienced some form of depression (23% of women and 15% of men), however rates during both periods in the pandemic were around two times greater than those observed before the pandemic (July 2019 to March 2020) for women (12%) and men (7%).

Disability

Disabled adults were more likely than non-disabled adults to experience some form of depression and some form of anxiety. In November 2020, around 4 in 10 (39%) disabled adults experienced some form of depression, while a third (34%) experienced some form of anxiety. This compares with just over 1 in 10 (11%) non-disabled adults (Figure 5).

In June 2020, a similar proportion of disabled adults (35%) and non-disabled adults (12%) experienced some form of depression when compared with November 2020. Rates in November were higher when compared with before the pandemic (July 2019 to March 2020), where 27% of disabled adults and 4% of non-disabled adults experienced some form of depression.

Ability to afford an unexpected expense

Adults were asked if their household could afford an unexpected but necessary expense of £850. This gives us an indication of adults who may be struggling financially. Figure 6 shows that adults who said their household was unable to afford this expense were more likely to be experiencing some form of depression and some form of anxiety, compared with other adults.

Around 3 in 10 (31%) adults who said their household was unable to afford an unexpected but necessary expense of £850 experienced some form of depression in November 2020, while just over a quarter (27%) of adults in this group experienced some form of anxiety. This compares with 11% and 12% respectively of adults whose households were able to afford such an expense.

In June 2020, a similar proportion of adults who said their household was unable to afford an unexpected but necessary expense of £850 experienced some form of depression (35%), increasing from 21% since before the pandemic (July 2019 to March 2020).

Depression and anxiety by country and region

In November 2020, rates of some form of depression in adults ranged from 17% in the South East, London and the East of England to 22% in the North East. Similar proportions were observed in Wales (21%) and Scotland (20%). No significant differences were found between the countries and regions of Great Britain.

Rates of adults experiencing some form of anxiety ranged from 16% in the South and East of England to 20% in London. Similar proportions were observed in Wales (20%) and Scotland (16%). No significant differences were found between the countries and regions of Great Britain.

We have also included analysis to understand how the coronavirus (COVID-19) pandemic has affected the life and well-being of adults experiencing some form of depression and anxiety.

Impacts on life

In November 2020, the most common concern of how the coronavirus pandemic was affecting lives was the lack of freedom and independence, with around 6 in 10 (61%) adults reporting this. A similar proportion was observed regardless of whether someone had experienced some form of depression or some form of anxiety (60%), making it the second most common concern for those experiencing anxiety or depressive symptoms.

Almost half of adults (48%) reported that their well-being was being affected, however this increased to 81% for those who had experienced some form of depression and some form of anxiety, which was the most common concern for these adults.

Similar trends were found earlier in the pandemic, where well-being was reported as one of the most common concerns by adults experiencing some form of depression (80%). More information can be found in the accompanying datasets.

Impacts on well-being

Among those that said their well-being was being affected by the coronavirus pandemic, 6 in 10 (60%) said they were feeling stressed or anxious, the most common reported feeling. This proportion increased to around 8 in 10 (82%) for those experiencing some form of depression, and nearly 9 in 10 (89%) for those experiencing some form of anxiety.

Similar trends were found earlier in the pandemic, where feeling stressed or anxious was reported as one of the most common concerns by adults who had reported their well-being was being affected and had experienced some form of depression (85%). More information can be found in the accompanying datasets.

In November 2020, 7% of adults reported feeling lonely often or always. A higher proportion of adults who had experienced some form of depression reported feeling lonely often or always (26%) compared with adults experiencing no or mild depressive symptoms (3%).

This was similar for those who had experienced some form of anxiety, with 24% reporting feeling lonely often or always, compared with 3% of those who were unlikely to have experienced some form of anxiety.

Using data collected between 11 and 29 November, we have explored how these feelings about the future compare based on reported depressive symptoms and anxiety in adults.

In November 2020, 15% of adults experiencing moderate to severe depressive symptoms felt it would be six months or less before their life returned to normal. This was the case for a higher percentage (25%) of adults with no or mild depressive symptoms.

A similar trend was observed for those experiencing some form of anxiety, with 16% of those who had experienced some form of anxiety feeling it will take six months or less for their life to return to normal, compared with 24% of adults unlikely to have experienced some form of anxiety.

Anxiety

The anxiety score used in the analysis in this report is derived using the first two items from the Generalised Anxiety Disorder (GAD-7) screener. This is an established measure that assesses the degree of an individual's anxiety over the previous two weeks.

Adults were asked the following two questions, with four response options ranging from zero (not at all) to three (nearly every day):

• Over the last two weeks, how often have you been bothered by feeling nervous, anxious or on edge?
• Over the last two weeks, how often have you been bothered by not being able to stop or control worrying?

An anxiety score was then derived by summing all responses chosen, resulting in a score ranging from 0 to 6, which has been interpreted as follows:

• 0 to 2 - Some form of anxiety unlikely
• 3 to 6 - Some form of anxiety likely

Depressive symptoms

Adults were asked a series of questions to produce a score of depressive symptoms, using the eight-item Patient Health Questionnaire (PHQ-8) depression screener. This is an established measure of depression that assesses the degree of an individual's depressive symptoms over the previous two weeks.

The depression score used in the analysis in this report is derived using eight questions from the PHQ-8. Respondents were asked the following eight questions, with four response options ranging from zero (not at all) to three (nearly every day):

• Over the last two weeks, how often have you been bothered by having little interest or pleasure in doing things?
• Over the last two weeks, how often have you been bothered by feeling down, depressed or hopeless?
• Over the last two weeks, how often have you been bothered by having trouble falling or staying asleep, or sleeping too much?
• Over the last two weeks, how often have you been bothered by feeling tired or having little energy?
• Over the last two weeks, how often have you been bothered by having a poor appetite or overeating?
• Over the last two weeks, how often have you been bothered by feeling negative about yourself or that you are a failure or have let yourself or your family down?
• Over the last two weeks, how often have you been bothered by having trouble concentrating on things, such as reading the newspaper or watching television?
• Over the last two weeks, how often have you been bothered by moving or speaking so slowly that other people could have noticed; or being so fidgety or restless that you have been moving around a lot more than usual?

The score is then derived by summing all responses chosen, resulting in a score ranging from 0 to 24, which has been interpreted as follows:

• 0 to 4 - no depression
• 5 to 9 - mild depression
• 10 to 14 - moderate depression
• 15 to 19 - moderately severe depression
• 20 or more - severe depression

According to the NHS, adults with a PHQ-8 score of 10 or more are likely to be experiencing some form of depression. Therefore, adults have been grouped into those receiving a score of 10 or more (referred to as moderate to severe depressive symptoms in this article) and those experiencing a score of zero to nine (referred to as no or mild depressive symptoms in this article).

Disability

To define disability in this publication, we refer to the Government Statistical Service (GSS) harmonised "core" definition: this identifies as "disabled" a person who has a physical or mental health condition or illness that has lasted or is expected to last 12 months or more that reduces their ability to carry out day-to-day activities.

The GSS definition is designed to reflect the definitions that appear in legal terms in the Disability Discrimination Act 1995 (DDA) and the subsequent Equality Act 2010.

The GSS harmonised questions are asked of the respondent in the survey, meaning that disability status is self-reported.

Working adults

For this survey, a person is said to be working if last week they had a paid job, either as an employee or self-employed; they did any casual work for payment; or they did any unpaid or voluntary work.

Weekly update

The Opinions and Lifestyle Survey (OPN) is a monthly omnibus survey. In response to the coronavirus (COVID-19) pandemic, we have adapted the OPN to become a weekly survey used to collect data on the impact of the coronavirus on day-to-day life in Great Britain. In the most recent wave, 6,029 individuals were sampled, with a response rate of 69% (or 4,151 individuals) for the survey conducted from 2 to 6 December 2020.

All survey results are weighted to be a nationally representative sample for Great Britain, and data are collected using an online self-completion questionnaire. Individuals who did not want to or were unable to complete the survey online had the opportunity to take part over the phone.

Where changes in results from previous weeks or differences between groups are presented in this bulletin, associated confidence intervals, which are included in the accompanying datasets, indicate their significance.

Sampling

For the period covering 2 to 6 December 2020, a sample of 6,029 households was randomly selected from those that had previously completed the Labour Market Survey (LMS). From each household, one adult was selected at random but with unequal probability. Younger and older (over 74 years) people were given higher selection probability than other people because of under-representation in the sample available for the survey.

The survey also includes a boosted sample for England, to allow more detailed analysis at a regional level and to provide analysis with more detailed demographic information. These are available in the accompanying datasets.

Weighting

The responding sample contained 4,151 individuals (69% response rate). Survey weights were applied to make estimates representative of the population.

Weights were first adjusted for non-response and attrition. Subsequently, the weights were calibrated to satisfy population distributions considering the following factors: sex by age, region, tenure, highest qualification and employment status. For age, sex and region, population totals based on projections of mid-year population estimates for November 2020 were used. The resulting weighted sample is therefore representative of the Great Britain adult population by several socio-demographic factors and geography.

Depressive symptoms and anxiety analysis

The depressive symptoms and anxiety analyses in this report are based on three time periods:

July 2019 to March 2020: Estimates covering the pre-pandemic period were based on 3,527 adults who previously completed the Opinions and Lifestyle Survey between July 2019 to March 2020. Data were weighted to be representative of adults in Great Britain based on population estimates calculated to the midpoint of this period.

June 2020: Estimates from June 2020 were based on the same sample of adults from July 2019 to March 2020, who were approached to take part in June 2020. The pooled dataset comprised two waves of data collection covering the following periods: 4 to 7 June and 11 to 14 June 2020, and included 3,527 adults. Data were weighted to be representative of adults in Great Britain based on June 2020 population estimates.

November 2020: The pooled dataset comprised three waves of data collection covering the following periods: 11 to 15 November, 18 to 22 November and 25 to 29 November 2020, and included 12,426 adults. Households were randomly selected from those that had previously completed the LMS and Labour Force Survey (LFS). Data were weighted to be representative of adults in Great Britain based on November 2020 population estimates.

Interpreting the findings in this report

When interpreting the findings in this release, it is important to note that the associations between characteristics and the presence of depressive symptoms or anxiety cannot explain causality. While the presence of a given characteristic may contribute to the development of depressive symptoms or anxiety in adults, the presence of depressive symptoms or anxiety in adults may affect the characteristic in question.

It is also important to note that there could be a variety of reasons for change in depressive symptoms before and during the pandemic, rather than this solely being a result of the coronavirus pandemic.

Weekly update

The main strengths of the Opinions and Lifestyle Survey (OPN) include:

• it allows for timely production of data and statistics that can respond quickly to changing needs
• it meets data needs: the questionnaire is developed with customer consultation, and design expertise is applied in the development stages
• robust methods are adopted for the survey's sampling and weighting strategies to limit the impact of bias
• quality assurance procedures are undertaken throughout the analysis stages to minimise the risk of error

The main limitations of the OPN include:

• analysis of estimates in Wales and Scotland are based on low sample sizes, and therefore caution should be used with these estimates
• comparisons between periods and groups must be done with caution as estimates are provided from a sample survey; as such, confidence intervals are included in the datasets to present the sampling variability, which should be taken into account when assessing differences between periods, as true differences may not exist

Depressive symptoms and anxiety analysis

The main strengths of this analysis include:

• pooling three waves of data together increases sample sizes, allowing us to explore evidence gaps and produce local level analysis for the first time
• the use of the Patient Health Questionnaire (PHQ-8) and the two-item Generalised Anxiety Disorder (GAD-7) screeners provides robust measures of the presence of depressive symptoms and generalised anxiety in the population
• robust methods are adopted for the survey's sampling and weighting strategies to limit the impact of bias
• quality assurance procedures are undertaken throughout the analysis stages to minimise the risk of error

The main limitations of this analysis include:

• the sample sizes for some groups of the population are relatively small earlier in the coronavirus (COVID-19) pandemic (June 2020) and before the pandemic (July 2019 to March 2020), particularly for younger adults, which means that confidence intervals around some estimates are larger, providing less certainty around the estimate; consequently, detailed analyses for subnational geographies and some sub-groups are not possible during these time periods

• data collected before the pandemic (July 2019 to March 2020) were achieved via a telephone interview, while data collected during the pandemic (June 2020 and November 2020) were predominantly online, with an option for telephone interview where online data collection was not possible; this means mode of data collection may have had an effect on the response given by adults to the survey questions

• some characteristics of adults in July 2019 to March 2020 were based on outcomes of adults during data collection in June 2020 because the information was not available at their first interview; it is possible that their characteristics may have been different between these two periods