{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T18:02:43Z","timestamp":1789581763112,"version":"build-2803163510"},"reference-count":40,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000269","name":"Economic and Social Research Council","doi-asserted-by":"publisher","award":["ES\/S012567\/1"],"award-info":[{"award-number":["ES\/S012567\/1"]}],"id":[{"id":"10.13039\/501100000269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000269","name":"Economic and Social Research Council","doi-asserted-by":"publisher","award":["UKRI861"],"award-info":[{"award-number":["UKRI861"]}],"id":[{"id":"10.13039\/501100000269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2026,7,21]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pre-COVID-19 pandemic evidence suggests that the UK\u2019s introduction of Universal Credit (UC) was associated with a deterioration in mental health. Given pandemic-related changes to the benefits system, we sought to evaluate the mental health effects of UC during the pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used nationally representative individual-level UK Longitudinal Household Panel Study data (2018\u20132021). We employed a difference-in-differences analysis with individual and time fixed effects comparing UC to legacy claimants (excluding Working Tax Credit claimants). The self-reported General Health Questionnaire (GHQ)-36 served as our main continuous outcome, while the GHQ-12 served as a supplementary caseness measure (\u22653).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Claiming UC during the COVID-19 pandemic reduced psychological distress compared with the comparison group, even after adjusting for confounders (\u22120.96 (95%\u2009CI \u22121.63 to \u22120.30)). After adding additional controls the estimates remain similar (\u22120.86 (95%\u2009CI \u22121.56 to \u22120.18)). When measured by GHQ-12 caseness, it was also associated with a reduction in the prevalence of psychological distress, but this was less certain due to wide CIs (\u22120.05 (95% CI \u22120.10 to 0.00)) and was more uncertain still after adjustment for further confounders (\u22120.04 (95% CI \u22120.10 to 0.01)). Event-study models showed that the greatest reduction in psychological distress was experienced during the first treatment year (\u22120.97 (95% CI \u22121.77 to \u22120.17)), without any significant effect 1\u2009year post-treatment (0.12 (95% CI \u22121.23 to 1.46)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings suggest that during the COVID-19 pandemic, the psychological distress of UC claimants was reduced in the short-term compared with a group of legacy claimants\u2014although with some uncertainty across alternative measures. This suggests that the pre-pandemic negative mental health effects of UC may be ameliorated by welfare reforms that aim to increase the generosity and reduce the conditionality of UC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jech-2026-225938","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:20:28Z","timestamp":1789579228000},"page":"jech-2026-225938","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Mental health effects of Universal Credit during COVID-19: a difference-in-differences analysis of UKHLS data"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9722-8153","authenticated-orcid":false,"given":"Marina Eirini","family":"Kousta","sequence":"first","affiliation":[{"name":"ESRC Centre for Society and Mental Health, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben Baumberg","family":"Geiger","sequence":"additional","affiliation":[{"name":"ESRC Centre for Society and Mental Health, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"2026091610201487000_jech-2026-225938v1.1","doi-asserted-by":"crossref","unstructured":"Waters T , Wernham T . The expiry of the universal credit uplift: impacts and policy options2021. 2026. Available: https:\/\/ifs.org.uk\/articles\/expiry-universal-credit-uplift-impacts-and-policy-options","DOI":"10.1920\/co.ifs.2024.0139"},{"key":"2026091610201487000_jech-2026-225938v1.2","doi-asserted-by":"crossref","unstructured":"Emmerson CJ , Waters T . The temporary benefit uplift: extension, permanence, or a one-off bonus?: the ifs. 2021. 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November 2021d. 2021."},{"key":"2026091610201487000_jech-2026-225938v1.7","unstructured":"Hobson F . Universal Credit: Ten Years of Changes to Benefit Claims and Payments. House of Commons Library, 2021."},{"key":"2026091610201487000_jech-2026-225938v1.8","doi-asserted-by":"publisher","DOI":"10.1332\/175982714X13875305151043"},{"key":"2026091610201487000_jech-2026-225938v1.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.113717"},{"key":"2026091610201487000_jech-2026-225938v1.10","doi-asserted-by":"crossref","first-page":"e157","DOI":"10.1016\/S2468-2667(20)30026-8","article-title":"Effects on mental health of a UK welfare reform, Universal Credit: a longitudinal controlled study","volume":"5","author":"Wickham","year":"2020","journal-title":"Lancet Public Health"},{"key":"2026091610201487000_jech-2026-225938v1.11","doi-asserted-by":"crossref","first-page":"102940","DOI":"10.1016\/j.jhealeco.2024.102940","article-title":"Universal Credit: Welfare reform and mental health","volume":"98","author":"Brewer","year":"2024","journal-title":"J Health Econ"},{"key":"2026091610201487000_jech-2026-225938v1.12","doi-asserted-by":"crossref","unstructured":"Marimpi M , Barr B , Baxter A , et al . Estimating population mental health effects of the rollout of Universal Credit in the UK using standard and novel Difference-in-Differences analysis, 2009-2019. Public Health 2025;247. doi:10.1016\/j.puhe.2025.105821","DOI":"10.1016\/j.puhe.2025.105821"},{"key":"2026091610201487000_jech-2026-225938v1.13","unstructured":"Institute for Social and Economic Research . Understanding society: Waves 1-14, 2009-2023 and harmonised bhps: Waves 1-18, 1991-2009, user guide, 09 december 2024. Colchester: University of Essex, 2024."},{"key":"2026091610201487000_jech-2026-225938v1.14","unstructured":"Kaminska O , Lynn P . Weighting and Sample Representation: Frequently Asked Questions. Colchester: Institute for Social and Economic Research, 2019."},{"key":"2026091610201487000_jech-2026-225938v1.15","unstructured":"Griffiths R . Complexities for Claimants: The Reality of the \u00a320 Weekly Uplift to Universal Credit. Bath: University of Bath, 2021."},{"key":"2026091610201487000_jech-2026-225938v1.16","unstructured":"Brewer M , Handscomb K , Resolution Foundation . This time is different \u2013 universal credit\u2019s first recession: assessing the welfare system and its effect on living standards during the coronavirus epidemic. 2020."},{"key":"2026091610201487000_jech-2026-225938v1.17","unstructured":"Edmiston D , Geiger BB , Rd V , et al . Who are the new COVID-19 cohort of benefit claimants. 2020."},{"key":"2026091610201487000_jech-2026-225938v1.18","doi-asserted-by":"publisher","DOI":"10.1080\/08039480310001418"},{"key":"2026091610201487000_jech-2026-225938v1.19","doi-asserted-by":"crossref","unstructured":"R\u00fcttenauer T , Aksoy O . When can we use two-way fixed-effects (twfe): a comparison of twfe and novel dynamic difference-in-differences estimators. 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Working Paper; 2017."},{"key":"2026091610201487000_jech-2026-225938v1.21","doi-asserted-by":"crossref","first-page":"116953","DOI":"10.1016\/j.socscimed.2024.116953","article-title":"Evaluating the influence of taxation and social security policies on psychological distress: A microsimulation study of the UK during the COVID-19 economic crisis","volume":"351","author":"Kopasker","year":"2024","journal-title":"Soc Sci Med"},{"key":"2026091610201487000_jech-2026-225938v1.22","doi-asserted-by":"crossref","first-page":"115973","DOI":"10.1016\/j.socscimed.2023.115973","article-title":"Enhanced unemployment benefits, mental health, and substance use among low-income households during the COVID-19 pandemic","volume":"328","author":"Jeong","year":"2023","journal-title":"Soc Sci Med"},{"key":"2026091610201487000_jech-2026-225938v1.23","doi-asserted-by":"crossref","DOI":"10.1016\/j.ssmph.2021.100909","article-title":"Which is most important for mental health: Money, poverty, or paid work? A fixed-effects analysis of the UK Household Longitudinal Study","volume":"15","author":"Kromydas","year":"2021","journal-title":"SSM Popul Health"},{"key":"2026091610201487000_jech-2026-225938v1.24","doi-asserted-by":"crossref","first-page":"e515","DOI":"10.1016\/S2468-2667(22)00058-5","article-title":"How do income changes impact on mental health and wellbeing for working-age adults? A systematic review and meta-analysis","volume":"7","author":"Thomson","year":"2022","journal-title":"Lancet Public Health"},{"key":"2026091610201487000_jech-2026-225938v1.25","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1017\/S0047279418000363","article-title":"What is the relationship between benefit conditionality and mental health? Evidence from the United States on TANF policies","volume":"48","author":"Davis","year":"2019","journal-title":"J Soc Pol"},{"key":"2026091610201487000_jech-2026-225938v1.26","doi-asserted-by":"crossref","first-page":"e333","DOI":"10.1016\/S2468-2667(18)30109-9","article-title":"Effects of restrictions to Income Support on health of lone mothers in the UK: a natural experiment study","volume":"3","author":"Katikireddi","year":"2018","journal-title":"Lancet Public Health"},{"key":"2026091610201487000_jech-2026-225938v1.27","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1111\/spol.12628","article-title":"Punitive welfare reform and claimant mental health: The impact of benefit sanctions on anxiety and depression","volume":"55","author":"Williams","year":"2021","journal-title":"Soc Policy Adm"},{"key":"2026091610201487000_jech-2026-225938v1.28","unstructured":"Webster D . Briefing: Benefit Sanctions Statistics; February2021a; 2021."},{"key":"2026091610201487000_jech-2026-225938v1.29","unstructured":"Webster D . Briefing: benefit sanctions statistics. February 2022. 2022."},{"key":"2026091610201487000_jech-2026-225938v1.30","unstructured":"Webster D . Briefing: benefit sanctions statistics. May 2021b. 2021."},{"key":"2026091610201487000_jech-2026-225938v1.31","unstructured":"Innes D . Spending Review: No plan to protect people in poverty. 2020."},{"key":"2026091610201487000_jech-2026-225938v1.32","doi-asserted-by":"crossref","unstructured":"Summers K , Edmiston D , Geiger BB , et al . Claiming deservingness: The durability of social security claimant discourses during the Covid-19 pandemic. Sociol Rev 2025. doi:10.1177\/00380261251336544","DOI":"10.1177\/00380261251336544"},{"key":"2026091610201487000_jech-2026-225938v1.33","unstructured":"Mackley A , Hobson F , Kennedy S . Managed migration: Completing universal credit rollout. House of Commons Library, 2024."},{"key":"2026091610201487000_jech-2026-225938v1.34","unstructured":"Thompson E , Jitendra A , Rabindrakumar S , et al . 5weekstoolong: why we need to end the wait for universal credit. 2019."},{"key":"2026091610201487000_jech-2026-225938v1.35","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.h1775","article-title":"Austerity, sanctions, and the rise of food banks in the UK","volume":"350","author":"Loopstra","year":"2015","journal-title":"BMJ"},{"key":"2026091610201487000_jech-2026-225938v1.36","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1377\/hlthaff.2020.01990","article-title":"Unmet social needs and worse mental health after expiration of COVID-19 Federal Pandemic Unemployment Compensation","volume":"40","author":"Berkowitz","year":"2021","journal-title":"Health Aff"},{"key":"2026091610201487000_jech-2026-225938v1.37","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2015.11.009"},{"key":"2026091610201487000_jech-2026-225938v1.38","doi-asserted-by":"crossref","DOI":"10.1126\/science.aay0214","article-title":"Poverty, depression, and anxiety: causal evidence and mechanisms","volume":"370","author":"Ridley","year":"2020","journal-title":"Science"},{"key":"2026091610201487000_jech-2026-225938v1.39","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/spol.12768","article-title":"Does capping social security harm health? 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