New Research Shows How COVID-19 Restrictions Impact Mental Health

New research shows how stricter COVID-19 mitigation regulations may have led to a collective worsening in mental health.

A team of investigators found mental health issues grew more for women and women living in households with dependent children during the lockdowns in comparison to men of all ages.

Restrictions

Nationally, countries that focused on eliminating community spread of the virus had fewer deaths and equal or better mental health trends during the pandemic than countries that focused on controlling the virus.

The investigators also found containment measures were not exactly homogenous, with some countries adopting more ambitious mitigation strategies compared to others who focused on slowing down transmission through a combination of intermittent lockdowns, workplace, business, and school closures, social distancing, face masks, and the cancellations of public gatherings and transportation.

For example, both South Korea and Japan employed early actions, including limiting international travel and testing and contact tracing programs. This resulted in less infections that paved the way for more lenient domestic containment strategies.

On the other hand, countries like France and the UK put in place less prohibitive international travel restrictions and focused on controlling the virus compared to eliminating COVID-19 through strict domestic policy measures including physical distancing and stay-at-home orders.

"Governmental responses to the COVID-19 pandemic have been widely debated,” Lara Aknin, BA, MA, PhD, Simon Fraser University said. “At first sight, it may seem that eliminator countries implemented much harsher strategies than other countries because of their widely reported international travel bans.

“But, in reality, people within these borders enjoyed more freedom and less restrictive domestic containment measures overall than citizens in mitigator countries.”

The Impact

In this study, investigators assessed how the variation of policy restrictions impacted mental health, combining daily policy stringency data with mental health data from samples in 15 countries.

The countries were grouped as either eliminators such as Australia, Japan, Singapore, and South Korea or mitigators such as Canada, Denmark, Finland, France, Germany, Italy, Netherlands, Norway, Spain, Sweden, and the UK.

There was an overall stronger link between severe containment policies and lower life evaluation in the mitigator countries compared to the eliminator countries.

The most damaging polices for the mental health of inhabitants was restrictions on gatherings and stay-at-home orders, which led to a loss in social connection, greater psychological distress, and lower life evaluations.

However, school, workplace, public event and transportation closures and restrictions on domestic travel were not associated with declining mental health and the number of consecutive days under high or low levels of pandemic restrictions had no impact on mental health outcomes.

Stricter policies were associated with lower opinions of the government’s handling of the pandemic.

As the pandemic waned on, lower deaths likely resulted in a decline in the negative association between the restrictions and future mental health.

The Mental Health of Females During Lockdown

In a second study, investigators found mental health impacts were not felt equally across different demographic groups. Using data from 20,000 individuals in Australia, the investigators found lockdown had a significant but relatively small, adverse mental health effect.

The investigators found females were more likely to suffer from decreased mental health than males, particularly those between 20-29 years of age. However, there were no significant effects for adolescents of either gender or for males between 20-29 years of age.

Males older than 55 years did see an improvement in mental health during lockdown.

“While the effects of lockdowns on overall population mental health were small, there were substantial and clinically relevant impacts for some groups,” Study author Prof Mark Wooden of the University of Melbourne said. “Women, especially those living in couple families with dependent children, have been hit hardest and were more likely than men in any age group to see a decline in their mental health.

“This gendered effect may be due to the additional workload associated with working from home while having to care for and educate their children at the same time, heightening already existing inequalities in household and caring responsibilities.”