576 Parental mental health and associations between living in temporary accommodation and socio-political determinants during the COVID-19 pandemic

• Published in: Archives of disease in childhood Vol. 107; no. Suppl 2; pp. A71 - A72
• Main Authors: Rosenthal, Diana Margot, Hayward, Andrew, Ucci, Marcella, Teakle, Ashlee, O’Toole, Sarah, Whitaker, Lydia, Hauari, Hanan, Hollingworth, Katie, Cameron, Claire, Schoenthaler, Antoinette, Lakhanpaul, Monica, Lewis, Celine, Heys, Michelle
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 17.08.2022; BMJ Publishing Group LTD
• Subjects: Abstracts; Adverse childhood experiences; Anxiety; Anxiety disorders; Caregivers; Children; Coronaviruses; COVID-19; Depression (Psychology); Economic Status; Family (Sociological Unit); Food security; Homeless people; Homelessness; Housing; Immigration; Mental depression; Mental health; Pandemics; Parents; Parents & parenting; Pediatrics; Public health; Socioeconomics
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2022-rcpch.117

AimsOn 23rd March 2020, the first of many COVID-19 lockdown measures were implemented in England, which affected the general population, but especially those already considered vulnerable. Homelessness is a known determinant of poor mental health. The objective was to determine whether experiencing homelessness while living in temporary accommodation (TA) is independently associated with poor parental mental health, a childhood vulnerability, and after considering measures of housing environment, food security and socio-economic status during the pandemic.MethodsA cross-sectional survey of families in the London Borough of Newham (LBN) from September-December 2020. LBN is one of the most ethnically and linguistically diverse populations in the UK with high rates of families living in TA and social deprivation. Snowball sampling was used to recruit parents/caregivers of under 5s including expectant parents, with the help of the LBN Public Health Team and their child-facing services. Living in TA was the main exposure of interest. The outcome of interest was parental mental health as measured by the self-reported Patient Health Questionnaire (PHQ-8) for depression and Generalised Anxiety Disorder (GAD-7) for anxiety.Chi-square test was used to determine differences between parents/caregivers living in TA and those who were not (non-TA). Complete case analysis and ordinal logistic regression were used to determine the odds of an increased rank of PHQ-8 and GAD-7 severity. Based on significant correlations, important socio-political determinants and childhood vulnerabilities were added to the model stepwise applying the rule of ten to determine the best fit.Results15.3% and 11.1% of TA parents/caregivers had symptoms of severe depression and moderately severe depression compared 1.1% and 4.6% of non-TA parents/caregivers, respectively. For parents/caregivers living in TA, the odds of a more severe depression rank were 3.14 times (95%CI:1.61–6.13) than for non-TA. Additional significant factors for depression were no recourse to public funds (NRPF) status [i.e., immigration control](OR 1.85, 95%CI:1.05–3.27); Very Low Food Security (OR 5.39, 95%CI:3.76–7.73); families ‘finding it very difficult’ financially (OR 1.98, 95%CI:1.16–3.38). [Figure 1].Abstract 576 Figure 1Is the adjusted odds ratio (OR) plot showing the odds of an increased rank of depression severity with living in Temporary Accommodation as the main exposure and each predictior variable given all the other variables were held constant in the modelAbstract 576 Figure 2Is the adjusted odds ratio (OR) plot showing the odds of an increased rank of anxiety severity with living in temporary accommodation as the main exposure and each predictior variable given all the other variables were held constant in the model22.9% and 20.0% of TA parents/caregivers had severe anxiety and moderate anxiety compared to 4.0% and 25.0% of non-TA parents/caregivers, respectively. For parents/caregivers living in TA, the odds of a more severe anxiety rank were 2.46 times higher (95%CI:1.27–4.75). Other significant factors for anxiety were: Very Low Food Security (OR 4.45, 95%CI:3.26–6.08); families ‘finding it very difficult’ financially (OR 1.62, 95%CI:0.96–2.73). [Figure 2]ConclusionFamilies living in TA had a greater odds of poor parental mental health outcomes, which was further compounded by factors including NRPF status, financial insecurity, food insecurity and poor housing environments. Poor parental mental health is an adverse childhood experience (ACE) directly impacting both the health and wellbeing of the parent and child throughout the life course. Targeted policies and tailored community-based mental health strategies, including the co-location of mental health and housing support within settings already accessed by TA families with under 5s, are vitally needed, since this vulnerable group is at higher risk of poorer parental mental health and a higher ACE count, which is exacerbated by the unsuitable and unsafe TA environment.