Background The COVID-19 pandemic has brought about significant behavioural changes, one of which is increased time spent at home. Although lockdowns were typically short-term and allowed people to leave their homes for exercise and essential activities, some individuals might not leave their home for prolonged periods due to, for example clinical vulnerability or shielding. This study aimed to explore longitudinal patterns of such ‘home confinement’ (defined as not leaving the house/garden) during the COVID-19 pandemic in England, and their associated predictors and mental health outcomes.

Methods Data were from the UCL COVID-19 Social Study, a large panel study of the psychological and social experiences of over 75,000 adults (aged 18+) in the UK during the COVID-19 pandemic. The analytical sample consisted of 25,390 adults in England who were followed up for 17 months (March 2020-July 2021). Data were weighted by core demographic characteristics and analysed using growth mixture models.

Results Our analyses identified three classes of growth trajectories, including one class showing a high level of persistent home confinement (the home-confined, 24.8%), one changing class with clear alignment with national containment measures (the adaptive, 32.0%), and one class with a persistently low level of confinement (the unconfined, 43.1%). A range of factors were associated with the class membership of home-confinement trajectories, such as age, gender, income, employment status, social relationships and health. The home-confined class had the highest number of depressive (diff=1.34–1.68, p<0.001) and anxiety symptoms (diff=0.84–1.05, p<0.001) at the end of the follow-up than the other two classes.

Conclusion There was substantial heterogeneity in longitudinal patterns of home confinement during the COVID-19 pandemic. In the weighted sample, nearly one in four adults maintained a high level of home confinement over the course of 17 months, even during periods when containment measures were eased or removed and when infection rates were low. People with a persistent high level of confinement had the worst mental health outcomes, calling for special attention in mental health action plans, in particular targeted interventions for at-risk groups.