Trends in psychotropic medication across occupation types before and during the Covid-19 pandemic: a linked administrative data study.

Purpose: Using linked administrative data, this study provides the first longitudinal analysis of mental health among workers across occupational groups prior to and during the Covid-19 pandemic. Eleven years of data were analysed to examine whether the pandemic period coincided with changes in psychotropic medication for workers across broad occupational groupings.

Methods: Data from Northern Ireland (NI) Enhanced Prescribing Database (EPD) was linked with NI Longitudinal Study (NILS) to examine trends in anti-depressants, anxiolytics and hypnotics (2011-2021) among NI workers (N = 200,004) across nine major occupation groups. Quarterly prescriptions were examined prior to and during pandemic restrictions (Q1-2011 to Q4-2019; and Q1-2020 to Q4-2021, respectively). Auto-regressive integrated moving average (ARIMA) models were trained to compare 'forecasted' and 'observed' rates during the pandemic period, stratified by occupational group.

Results: Q2-2020 coincided with lower-than-expected receipt of anxiolytics and anti-depressants for several broad occupation types. Receipt of anxiolytic prescriptions among managers, directors/senior officials dropped below expected levels for the three quarters from Q3-2020 to Q1-2021. Finally, a notable increase in anti-depressants for a prolonged period was found among staff in caring/leisure and related professions, as well as higher rates of hypnotics in Q2-2021.

Conclusion: Our study provides the first longitudinal examination of variation in mental health across occupation types prior to and during the Covid-19 pandemic, using available linked administrative data. Findings suggest that occupation type was an important pandemic-related stressor and point to potential higher risk occupations that could be the focus of targeted interventions in future pandemics.