The mental health impact of COVID-19 restrictions


Author: Elisabet Rodriguez Alzueta, Postdoctoral Researcher, SRI Biosciences, Center for Health Sciences


How did pandemic isolation and pandemic-related changes affect individuals around the globe?

For nearly nine months, the physical toll of the COVID-19 pandemic has been tracked, analyzed and then communicated to millions of people around the world. In most countries, updates on infection, hospitalization and death rates have become a regular part of daily life.

But how has the pandemic impacted the mental health of people around the world? And what can be done about it?

Shortly after quarantines and confinements began in March 2020, I was speaking with several scientific colleagues and we all expressed a similar and growing concern: that the world was confronting not only a physical health emergency, but an unprecedented global mental health threat as well. Our worries were based not only on common sense and our own scientific learnings, but also on research conducted among individuals confined during preceding outbreaks, such as SARS and MERS.

As mental health researchers, we felt a keen responsibility to understand the threat faced by the general public globally, so that medical professionals and governments around the world could better help their populations manage COVID-19-associated mental health challenges. In record time, we worked together to design an online survey that would quantify the psychological cost of COVID-19 pandemic restriction measures on people in many countries.

The survey, which we translated into multiple languages, covered several different spheres of life and health. We were especially interested in psychological and sleep measures, because we hypothesized that these might be most severely affected by COVID-19 pandemic restrictions.

Between April and May 2020, 6,882 adults from 59 countries participated in the survey. Their responses, which our multi-country, cross-organization research team summarized and recently published online in the Journal of Clinical Psychology, provide one of the most comprehensive pictures to date of the global psychological burden caused by pandemic isolation. They also highlight demographic risk factors that may contribute to pandemic-related mental health issues:

  • Survey results suggest that a significant proportion of the global adult population has experienced depression and/or anxiety symptoms as a result of the pandemic. Specifically, 24% of survey respondents reported moderate to severe symptoms of depression, and 19.5% reported moderate to severe symptoms of anxiety.
  • Over and above individuals’ demographic characteristics, quarantine status and COVID-19 infection status, the strongest predictor of higher depression and anxiety symptoms was COVID-19 related life changes, such as transitioning to working from home, being unable to pay bills, and having verbal arguments or conflict with other adult(s) at home.
  • Women and non-binary/trans gender individuals reported a higher prevalence of depression and anxiety symptoms as compared to men.
  • Other demographic factors that were associated with higher levels of depression and anxiety include being younger, not being partnered and living in a high-income country.
  • Having dependent children at home, working, and living in lower income countries reduced the likelihood that individuals would experience depression and anxiety.

Some of our findings could have been predicted by previous research and/or mental health practice, but some were not expected. As an example, we were surprised by the fact that the level of quarantine or social restrictions issued by governments at the time of our survey was not a notable predictor of depression and anxiety symptoms. This finding suggests that the depression and anxiety symptoms reported in this research were not directly accounted for by government restrictions, but more likely the consequences of these restrictions and of the pandemic as a whole on study participants’ lives.

The findings from our global survey provide direction for government programs and policies that can help reduce the psychological burden of pandemic-related impacts. These include integrating mental health services into pandemic preparedness plans, expanding our ability to provide mental health counseling and services remotely via videoconferencing and telephone, and providing practical guidance for quarantine-related transitions such as working from home. I’m thankful that — as a researcher in SRI’s Center for Health Sciences — I had the ability and capacity to explore this timely and important topic. The findings contribute to SRI’s expansive research and expertise in human health, and simultaneously help to address a critical and potentially growing global health need.

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