During the almost two years of comings and goings COVID lockdownswe hear many concerns from many different corners about the mental health effects of forcing people to stay home and stay away from friends and family.
Many research projects were undertaken to try to measure the scale of the impacts on mental health.
However, the speed with which the research was generated meant that, in some cases, the quality of the research was sacrificed, with some research finding evidence of an effect on mental health, and some not.
To make sense of the very mixed findings, my colleagues and I conducted a review of all mental health studies conducted during the first year of the pandemic.
We included 33 published articles that studied a total of almost 132,000 people in various regions of the world.
We found that, overall, social restrictions doubled the odds that people would experience mental health symptoms. This means that, of those who participated in these studies, those who experienced lockdowns were twice as likely to experience mental health problems as those who did not.
This finding can be further broken down by different mental health symptoms. Social restrictions increased the odds of people experiencing symptoms of depression more than 4.5 times, the odds of experiencing stress increased nearly 1.5 times, and the odds of experiencing loneliness nearly doubled.
When we dig deeper into these results, we find that the duration and strictness of the lockdowns were affected. mental health symptoms differently. For example, strict lockdowns increased depression, while the appearance of social restrictions increased stress. Low social restrictions, where there were some restrictions but not a complete lockdown, were associated with increases in anxiety.
Additionally, mental health outcomes differed by age, with younger and middle-aged adults reporting more negative mental health symptoms than older adults.
What lessons can we draw from these findings?
The findings give us a good idea of what the scope of public health should look like in the event of future pandemics.
Anxiety was more frequent when low restrictions were introduced. This could be due to the fact that people were nervous about the precariousness of the situation and where the virus could be circulating. The introduction of such measures must be accompanied by public health messages and interventions that focus on relieving chronic fear and worry.
During periods of strict social restrictionsthe predominant mental health problem was depression, which means that mental health responses should focus on combating symptoms related to depression, such as hopelessness and loss of purpose.
The findings for stress suggest that symptoms are likely to be intensified during the early stages of social restraint application. This is probably because the start of the restrictions communicates to people an increase in the severity of the pandemic threat, and people have to work very hard to reorganize their lives if the restrictions imply the need to work from home and study at home.
During these times, it can be especially important to provide messages and interventions that help people manage their stress, such as dealing with job stress or the stress of homeschooling children. For parents, making them feel empowered in the classroom and promoting strategies that foster positive family functioning (such as more constructive communication and problem solving) could reduce parent and family stress.
Since social restrictions were found to be associated with increased loneliness, promoting digital technologies to make people feel connected is also important.
In all of these mental health problems, it is hoped that the messages that these symptoms communicate will help people to normalize and recognize the nature and severity of their symptoms. This, in turn, can prompt people to seek help for their mental health symptoms.
The quality of the research was poor.
Another important point to note from our review is that the research conducted during the first year of the pandemic was generally of poor quality.
This is because it was difficult to find good measures of social restrictions in the studies. Some studies did not detail the specific restrictions in place in various cities, or did not ask study participants to what extent they complied with the restrictions.
Additionally, some studies surveyed people’s mental health symptoms on the day social restrictions were first applied. Most people are likely to experience elevated but temporary spikes in mental health symptoms that may naturally reduce after initial shutdown announcements. This means that it is difficult to monitor the true mental health effects of social restrictions on the first day the restrictions are activated.
However, the effects of social restrictions on mental health symptoms were similar in studies where people were surveyed at one time and on more than one occasion during the restrictions. This suggests that the estimated effects appear robust, even though many studies do not have the best assessments of social constraints.
The findings of our review show that although we have some way to go in the way we conduct research on the mental health effects of COVID-19 social restrictions, the initial research highlights that these restrictions did in fact negatively affect the mental well-being of citizens.
While such restrictions may be an effective public health response to mitigate the spread of virus like COVID-19, there needs to be a coordinated response to safeguard people’s physical and mental health.
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