The Mental Health and Well-Being of Adults With Intellectual Disabilities During the COVID-19 Pandemic Across the UK: A Four-Wave Longitudinal Analysis.

Background: Research concerning the impact of the COVID-19 pandemic on the mental health and well-being of adults with intellectual disabilities has been cross-sectional and small scale. We examined the trajectory of mental health and well-being across the pandemic period across the UK and the factors which predicted different mental health trajectories.

Method: Adults with intellectual disabilities participated in co-designed structured interviews. Four waves of data were collected between December 2020 and late 2022. At Wave 1, 621 adults with intellectual disabilities participated, with 355 at Wave 4. Well-being, pandemic anxiety, depression, anxiety, anger and loneliness outcomes were measured. Latent class mixed modelling was used to identify subgroups and within-group trajectories.

Results: Well-being and pandemic anxiety remained relatively stable across time, but levels of anger, depression, anxiety and loneliness reduced gradually over time. Overall patterns masked trajectory subgroups, with differences in intercept and steepness of decline or increase in mental health problems. Different factors were generally influential for trajectory class membership and overall change across time for outcomes. Leaving the house for exercise or green spaces reported increasing well-being and reduced loneliness. Similarly, those working, volunteering or in education at Wave 1 were found to have increasing well-being and reduced loneliness, sadness and worry, and increasing wellbeing and reducing anger if they were working pre-pandemic.

Conclusions: Social connection and engagement in purposeful activity were vital to maintaining the mental health and well-being of people with intellectual disabilities. Factors that were found to reduce mental well-being during the pandemic should be considered in planning for future major public health challenges and in promoting better mental well-being for people with intellectual disabilities in everyday life.