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.