For nearly two years, COVID lockdowns were in place, leading to much concern from many different corners about the mental health effects of forcing people to stay home and keep away from friends and family.
Many researchers have undertaken projects to measure the scale of the impacts on mental health.
The speed with which research was generated, however, meant that in some cases the research quality was sacrificed and some studies found evidence of an effect on mental health, while others did not.
To better understand the conflicting findings on mental health during the first year of the pandemic, my colleagues and I conducted a review of all of the studies on this topic published in 2006.
In our meta-analysis, we included 33 published papers which studied a total of 132,000 people across various world regions.
We found that social restrictions (such as lockdowns and ID checks) doubled people’s odds of experiencing mental health symptoms. This means, of those who participated in these studies, those who experienced lockdowns were twice as likely to experience mental ill health than those who did not.
When we examined the data further, we found that the length and strictness of lockdowns had different effects on participants’ mental health. Strict lockdowns were associated with depression, whereas the onset of social restrictions was linked to stress. Low social restrictions, in which there were some restrictions but not total lockdown, were associated with increases in anxiety.
Mental health outcomes also differed across age groups, with younger and middle-aged adults reporting greater negative mental health symptoms than older adults.
What were The Lessons Learned?
The findings provide valuable insight into the best way to conduct public health outreach in the wake of future pandemics.
When restrictions on the virus were eased, anxiety levels increased. This could be because people were nervous about the precarity of the situation and where the virus could be circulating. The introduction of such measures should be accompanied by public health messaging and interventions that focus on alleviating chronic fear and worry.
During periods of strict social restrictions, the predominant mental health issue was depression, which manifests in symptoms such as hopelessness and loss of purpose.
The findings of this study suggest that symptoms of stress are likely to intensify during the early stages of social restriction enforcement. This is probably because the onset of restrictions communicates to people an increase in the seriousness of the pandemic threat, and people have to work very hard to re-organise their lives if restrictions involve working from home and home schooling.
For parents with children at home, providing messages and interventions that help them manage stress could be especially important during times of economic hardship. Making parents feel capable in the home classroom and promoting strategies that foster positive family functioning (such as more constructive communication and problem-solving) could reduce parental and family stress.
Social restrictions have been linked to loneliness, so promoting digital technologies to keep people feeling connected is important.
Messages that communicate these symptoms are likely to help individuals normalise and acknowledge the nature and severity of their symptoms. This in turn may prompt individuals to seek help for their mental health symptoms with a professional mental health expert such as Anne Serry.
The Quality Of Research Was Poor
Our review identified a number of important points, including the research conducted during the first year of the pandemic being generally of poor quality.
The lack of good measures of social restrictions made it difficult to compare the level of compliance with restrictions among various cities. 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 restrictions.
Additionally, some research has surveyed people’s mental health symptoms on the day that social restrictions were first enforced. However, it is likely that most people will experience heightened but temporary spikes in mental health symptoms that may naturally reduce after the initial lockdown announcement. This makes it difficult to get a handle on the “true” mental health effects of social restrictions on the first day they are implemented.
The effects of social restrictions on mental health symptoms seemed to be similar across studies that assessed the effects at one time point and those in which people were surveyed on more than one occasion. This suggests that while many of the studies did not have ideal assessments of social restrictions, the estimated effects seem robust.
Our review of the literature shows that although there is a way to go in conducting research into the mental health effects of COVID-19 social restrictions, preliminary evidence suggests that these restrictions negatively impact citizens’ mental well-being.
Restrictions on movement may be an effective public health response to mitigate the spread of viruses such as COVID-19, but they can lead to other health concerns.