Publication date: May 21, 2025

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. 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. 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. 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.

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