People’s mental health suffered when their governments took drastic measures to control COVID-19, according to two new studies.
In one longitudinal analysis based on data from 15 countries excluding the United States, policies with higher rigor were associated with higher mean scores of stress during the first 15 months of the epidemic (standardized coefficients β = 0.014, 95% CI 0.005-0.023), Reported by Rafael Goldsmit, Ph.D., of the Brazilian School of Public Administration and Business in Rio de Janeiro, and colleagues.
People living in areas with stricter containment policies also ranked lower on scores for self-reported life assessments (β = -0.010, 95% CI -0.015 to -0.004), as indicated in The Lancet Public Health.
On top of the tightening of policies, the severity of the pandemic has also affected the mental health of the population. Countries with more deaths per 100,000 residents had higher average scores for psychological distress (β = 0.016, 95% CI 0.008–0.025) and lower life ratings (β = -0.010, 95% CI -0.017 to -0.004) .
For this analysis, Goldszmidt and his team considered the rigor of the government’s response to eight policies: school closures, workplace closures, cancellations of public events, restrictions on gatherings, public transportation closures, stay-at-home requirements, and restrictions on domestic, and international travel. Travel restrictions.
When broken down individually, some had a greater impact on mental health than others. After controlling for the severity of the epidemic, restrictions on gatherings, stay-at-home requirements, and international travel restrictions were linked with greater degrees of psychological stress and lower life ratings. School and workplace closures, public transportation shutdowns, cancellation of public events, and restrictions on domestic travel have not had a significant impact on mental health.
The authors note that women tend to be more affected than men. More specifically, women older than 30 had a stronger negative association between policy strictness and life assessment versus younger women.
Goldszmidt’s group also found that countries that implemented an eradication strategy rather than a COVID containment strategy tended to have less stringent policies, which reduced the toll on the mental health of the population. These countries also tend to see fewer deaths.
Only four countries included in the analysis have pursued a COVID elimination strategy: Australia, Japan, Singapore and South Korea. The other 11 countries – Canada, Denmark, Finland, France, Germany, Italy, the Netherlands, Norway, Spain, Sweden and the United Kingdom – have mitigation strategies.
“Governments’ responses to the COVID-19 pandemic have been widely discussed,” co-author Lara P. Aknin, PhD, from Simon Fraser University in Burnaby, British Columbia, Canada, said in a statement. “At first glance, it may appear that the countries that lifted the ban have implemented much harsher strategies than other countries due to the widely reported ban on international travel. But, in reality, people within these borders enjoyed greater freedom and generally less restrictive domestic containment measures than Citizens in relief states.”
Repeatedly, Goldsmit added, “mitigation strategies may be associated with worse mental health outcomes at least in part because containment measures such as long lockdowns and physical distancing can disrupt social bonds.”
He suggested that “strategies that aim to eliminate transmission while promoting early action and targeted rigor can reduce mortality while protecting people’s mental health in the process.” “At the same time, governments need to provide clear and consistent information on policy measures to increase the population’s confidence in the government’s handling of the pandemic.”
This longitudinal analysis collected mental health data from 15 countries between 27 April 2020 and 28 June 2021. A total of 432,642 responses from adults in the Imperial College London-YouGov Global Behavior Tracking COVID-19 Survey were included in the analysis.
Psychological distress was measured with the four-item Patient Health Questionnaire, and assessment of life was measured using the Cantrell Ladder question, which asks respondents to rate their current life situation on a scale from 0 to 10.
Looking towards Australia
In the second study simultaneously published in The Lancet Public HealthFocusing specifically on Australia, the researchers identified exactly which groups bear the brunt of these mental health effects.
Using a quasi-experimental design, Mark Wooden, MSc from the University of Melbourne, and colleagues found that lockdown was associated with a modest – but statistically significant – deterioration in the mental health of the population.
Wooden’s group compared Victorians in 2020 to those living in other parts of Australia who were not placed under lockdown.
As noted in the first study, lockdown took a significantly greater mental health toll on women than men, with women experiencing a 2.2-point decrease in their five-item mental health inventory total versus a relatively small 0.6-point reduction for men.
Women who live in apartments saw a decrease of 4.1 points, while those who live in semi-detached homes, townhouses or townhouses saw a median decrease of 4.8 points. Women who lived in separate homes saw the least impact on mental health (a decrease of 1.7 points).
Furthermore, married women with children under 15 saw a 4.4-point drop in their mental health scores during the lockdown. Interestingly enough, single mothers did not see this effect.
“This gender effect may be due to the extra workload associated with working from home while having to care for and educate their children at the same time, adding to the already existing inequalities in family and care responsibilities,” Wooden suggested in a statement.
“It may seem unexpected that this trend does not apply to single mothers,” he added. “One reason for this may be the financial support package provided by the Australian Federal Government to this group as part of its response to the economic recovery, which could have eased fears and concerns about the lockdowns.”
“Single mothers are more likely to live without a safety net and strong support system before the pandemic,” he continued. “As such, they may have found it easier to adapt to sudden changes than women in dual households.”
Wooden’s group noted that these findings are exclusive to Australians, and may not reflect the mental health implications in other countries.
Goldszmidt’s study received no funding. The woody study was funded by a grant from the National Institutes of Health.
All authors for both studies reported no disclosures.