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2020 was the year that the world came to a halt. While virus infections are not uncommon, COVID-19 is the only one, thus far, that brought in huge challenges with its speed of infection, serious effects, and high mortality rates. In the beginning, many world leaders brushed it off as another influenza outbreak; however, it took an unprecedented stranglehold on the world, which led many countries to scramble to implement drastic social restrictions measures and lockdowns. To date, there are 750 million cases and 6.83 million deaths (WHO Coronavirus (COVID-19), n.d.) and counting. Even after battling with the virus (for three years) and with vaccines, the world still sees an average of 120,000 new cases each day. This is not over.
Impact of COVID-19
The COVID-19 pandemic has had a profound and far-reaching impact on the general population. At the height of the pandemic, the spikes in cases and deaths devastated people’s sense of security and well-being. Those who lost a loved one to the virus may experience significant emotional trauma.
To stem the spread of the virus, governments worldwide sought quick and drastic measures to limit human movement. They imposed social restrictions such as physical distancing, constraints on social gatherings, and lockdowns. In some countries like South Africa, even the army was called in to enforce social restrictions.
As a result of the mandated lockdowns and social restrictions, thousands of people worldwide lost their jobs, leaving them feeling uncertain about their future. With high uncertainty and unpredictability, fear and anxiety were induced amongst the general population. The pandemic has impacted more than the physiology of the general population; it has taken a toll on social and psychological well-being.
Although the measures did well to slow down the virus’s spread, they came with social, economic, and psychological consequences. As early as March 2020, the World Health Organization recognized a global increase in fear, stress, and anxiety due to the pandemic (Mental Health and Psychosocial Considerations During the COVID-19 Outbreak, 2020). Early studies in other countries also indicated a high prevalence of adjustment disorder symptoms, depression, anxiety, insomnia, and post-traumatic stress disorder (Jiang et al., 2022).
Impact on Public Mental Health
As people stayed home, they could not go about their daily routines, work or socialize. Besides feelings of isolation and anxiety, some people lost their sense of purpose. Exacerbated by the fact that they could not communicate and interact with their loved ones as before, people experienced significant loneliness. Many turned to alcohol and other substance abuse to cope with their sadness and anxiety. (Jiang et al., 2022).
While governments focus their resources on containing the biomedical effects of the virus, mental health took a backseat. However, mental health and socioeconomic consequences could be more profound and last longer than the physiological effects of the infection (Nguse & Wassenaar, 2021).
Mental Health Situation in Victoria, Australia
Take Victoria, Australia, as an example. Even though the country had a low transmission and prevalence rate, the government imposed some of the strictest restrictions, such as closed borders, social distancing, stay-at-home orders, travel, and exercise time restrictions, compared to other countries. The narrative study by Jiang et al. found that the general mental health of Victorians was negatively affected by COVID-19 restrictions in 2020. There was an increase in clinical depression and anxiety, an increase in alcohol and substance use, and a significant increase in the use of digital mental health services. Their results nearly doubled those from other states with less strict regulations, demonstrating the detrimental effects of social isolation and stringent restrictions on mental health. They also found increased anxiety, depression, and sleep and appetite problems in children and teens throughout the pandemic, reflecting how vulnerable they are to the effects of containment measures. (2022)
Mental Health Situation in South Africa
Similarly, in South Africa, where mental health is peripheral to the healthcare industry, researchers theorized that due to culture and biopsychosocial factors unique to South Africa, COVID-19 might lead to mental health presentations such as post-traumatic stress disorder, mood disorders, anxiety disorders, phobias, and obsessive-compulsive disorders. Similarly, a study conducted by the Human Sciences Research Council found that 33% of South Africans were feeling depressed, 45% were feeling fearful, and 29% were experiencing loneliness during the first lockdown period. The research by Nguse & Wassenaar also found that those who had experienced childhood trauma and other adversities were more likely to experience depressive symptoms brought on by the perceived risk of getting COVID-19.
Such depressive symptoms and perceptions are not uncommon in the world. The study by Heinen et al. showed that participants in Oxfordshire and Buckinghamshire, United Kingdom, who reported depression, anxiety, loneliness, low quality of life, and panic attacks, have higher scores on the health anxiety inventory (2021)
Health anxiety, also known as hypochondriasis or illness anxiety, is characterized by a heightened fear of developing a severe illness, which frequently results from an incorrect appraisal of psychological or physical symptoms. (WHO, 2016). The cognitive behavioral model of health anxiety also shows that negative beliefs can exacerbate anxiety and affect how one feels about their capacity to deal with the perceived threat.
Heinen et al. also identified predictors of health anxiety as being female, having pre-existing physical or mental conditions, and having poor tolerance for uncertainty. Other factors such as demography, lifestyle, changes in financial situation or employment, ethnicity, or having a close relative or friend with COVID-19 did not predict health anxiety. (2021)
Doing Better For the Future
As governments curbed the spread of the virus and focused on biomedical remedies, they overlooked the onslaught of mental health problems. Nguse & Wassenaar calls for the government to expand strategies to include plans offered by other disciplines, like Psychology, to ensure that the mental health of South Africans is considered in the development of strategies and policies (2021).
COVID-19 may be amplifying existing gaps within the system. Pillay & Kramers-Olen noted how social restrictions worsened situations in poorer communities with smaller housing, causing them to face more mental health effects from unemployment and substance withdrawal. Even carrying out the most basic task of handwashing and physical distancing is difficult for a population without access to clean water and soap. These families were worse off than before, with little or no financial reserves. As such, public health strategies should consider existing cultural and developmental context and social justice (2021).
Similar to the findings in South Africa, Jiang et al. also observed more adverse mental health effects in Victorians from low socioeconomic backgrounds, those who are unemployed due to the pandemic, people with disabilities, and people with previous mental health diagnoses. The authors highlight the value of alternative service delivery methods, such as digital mental health services, to cope with the increasing demand for mental health access during and after Victoria’s severe COVID-19 pandemic suppression efforts.
All the research points to the importance of further studies and the development of policies and strategies that address poor mental health in the population, focusing on vulnerable groups within the population. Since this is not over, it might be something we can do better.
WHO Coronavirus (COVID-19) Dashboard. (n.d.). With Vaccination Data. https://covid19.who.int/
Pillay, A. L., & Kramers-Olen, A. L. (2021). COVID-19, psychosocial issues, politics, and public mental health care. South African Journal of Psychology, 51(2), 293–303. https://doi.org/10.1177/00812463211015750
Nguse, S., & Wassenaar, D. (2021). Mental health and COVID-19 in South Africa. South African Journal of Psychology, 51(2), 304–313. https://doi.org/10.1177/00812463211001543
Jiang, J., Akhlaghi, H., Haywood, D., Morrissey, B., & Parnis, S. (2022). Mental health consequences of COVID-19 suppression strategies in Victoria, Australia: a narrative review. Journal of International Medical Research, 50(11), 030006052211344. https://doi.org/10.1177/03000605221134466
Heinen, A., Varghese, S., Krayem, A., & Molodynski, A. (2021). Understanding health anxiety in the COVID-19 pandemic. International Journal of Social Psychiatry, 68(8), 1756–1763. https://doi.org/10.1177/00207640211057794