Mental Health and Well-Being during the First Year of - PowerPoint Presentation

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Mental Health and Well-Being during the First Year of

COVID-19

Dr. Lara Aknin

The Lancet’s COVID-19 Mental Health Task Force

Daily life (pre-COVID)

Daily life (during COVID)

COVID-19 upended the lives of manyChange in daily life due to fear of contracting the virus and public health measures implemented to slow spread What are the mental health consequences of living through a pandemic? How can we respond?

Mental Health Task ForcePURPOSE: To summarize findings, delineate high-priority open questions, and offer recommendations to support mental health during the current pandemic Why focus on mental health? Critical, consequential, and under-supported facet of mental health

Impacts ~1/3 of working age population and only 1/20 receive access to evidence-based treatment (Clark et al., 2018)Impacts on personal, economics, and societal functioning

Key detailsEvidence-based summary of rapidly emerging literaturePrioritizes high quality data (e.g., large or weighted nationally rep. samples, pre-registered, use of validated scales)”Earn their ink”

LimitationsFirst year only - pandemic is dynamic and unfoldingMost data from WEIRD nations (Henrich et al., 2010)

Key constructs4 key constructs with sufficient evidencePsychological distress – anxiety, depression, generalized distress

Self-harm – including suicideSubjective Well-Being (SWB) – positive/negative emotions, life satLoneliness – as well as social connection

Guiding questions and Overview of

How did mental health and related constructs change during the first year of COVID-19?Look at the data in several waysChanges from pre-pandemic to during pandemic

Factors that predict greater risk/protection during onset and early months

During pandemic, which activities correlated with better/worse mental health

How can we support mental health during this time and beyond?

Changes in Mental Health from before to during the pandemicTwo complimentary types of evidenceRepeated cross-sectional surveys

Longitudinal surveysEach approach has -/+Consistent patterns  more convincing conclusions

Psychological distressRepeated cross-sectional US: 3x increase in depression (Ettman et al., 2020); 4x more people report severe

psyc distress (McGinty et al., 2020)UK: higher anxiety (Fujiwara et al., 2020)Norway: 3x more people surpassing depression cut off (Ebrahimi et al., 2021)LongitudinalUKHLS increase in avg distress and % surpassing cutoff in Apr 2020 (Pierce et al., 2020)Overtime, psyc

distress may have declined (

Fancourt

et al., 2020; Robinson et al., 2020). US recovery to pre-pandemic by June 2020 (Daly & Robinson, 2020)

Clear and consistent evidence that psychological distress increased during early months of pandemic and that most (but not all) facets returned to pre-pandemic levels by mid-2020

Self-harmRepeated cross-sectional MixedThoughts of self-harm and suicide increased in UK (Iob

et al., 2020) but No increase in Norway (Knudsen et al., 2021)Longitudinal14 mil UK patient records suggest self harm reduced, but may result from fewer visits (Carr et al., 2020)Fewer searches of suicide in Western Europe and US (Brodeur et al., 2021)Real-time govt data reveal no increase in suicide rates in 21 countries (Pirkis et al., 2021)

Some mixed evidence but most data show no increase in suicide over the first several months of the COVID-19 pandemic.

Subjective well-beingRepeated cross-sectional More negative emotionsMixed evidence on reduced positive emotions (GWP no change; UK and US decline)

Life satisfaction remains relatively unchanged in GWP but reductions in Canada, US, UKLongitudinalFew studies, but suggest resilienceFrance (Recchi et al., 2020) shows increase in emotional well-being German Socio-Economic Panel (Liebig, 2020) no change in life satisfaction

The data show a clear increase in negative emotions, and mixed evidence for positive emotions. Most large data sets show little or no change in life satisfaction.

LonelinessRepeated cross-sectional Significant increase but not as substantial as expectedUS ~2-3% higher in national sample in Apr 2020 than 2 years prior (McGinty et al., 2020)

LongitudinalUS: national sample no mean-level increase loneliness reported from Jan – Apr 2020, significant increase in perceive social support (Luchetti et al., 2020)US + UK adults, students in Canada: little to no change in social connection (Folk et al., 2020)Norway: loneliness did not change or declined (Hansen et al., 2021)

Notable resilience in loneliness and social connection. Small significant increase or no increase at all.

What factors that predict greater risk or protection during onset and early months?Mean-levels overlook who has been impacted the mostLongitudinal data sets from before pandemic provide insight into whether various factors (e.g., age, gender) predicted change in mental health

New risk or protective factors?

Psychological distressPredictors of psyc distress under COVID-19 (Banks & Xu, 2020; Pierce et al., 2020):female, minority or marginalized racial group, urban area, lowest income quintile, unemployed or inactive, living without a partner, having pre-existing health risk

many factors predicted greater psychological distress before COVID-19New profiles of risk: females, in younger age categories (18-24; 25-34), having children <5yr at home Also, employed or retired – surprising

Clear and consistent evidence that psychological distress increased during early months of pandemic and that most (but not all) facets returned to pre-pandemic levels by mid-2020

Self-harmLittle informationFrom Japan consider age, gender, and occupation status (Ueda et al., 2020)Greatest increase among younger (<40 yrs

) femalesHigher among students and homemakersMixed evidence but

What experiences and behaviours are associated with greater or lower mental health during COVID?Personal experience with or proximity to illness

Worrying of personal illness, health of others, caring for others Economic hardshiponeself or familyTime useGardening, exercising, reading, listening to music (+)Following COVID-19 news (-)Child care, home schooling, and chores (-)

SummaryConverging evidence for increase in psyc distress in early months, especially among female, young, and have children under 5yo at homeSeveral sources suggest a return to baseline on most measures by mid-2020Little evidence for increase in suicides in 20+ countries

Little change in life satisfaction, but increase in neg emotionsSmall or little change in lonelinessRisk: proximity, financial strain, child/household care, covid newsProtection: exercise, nature, read

RecommendationsSupport immediate, large-scale research into the nature, treatment, and long-term consequences of COVID-19 on mental health.

Screen and monitor mental health among COVID-19 survivors, close relations, and those with greater exposure risk or burden of care.Prioritize safe access to childcare and elementary schooling. Invest in mental health care so that someone with mental illness has equal access to evidence-based treatment as someone who has physical illness.

Tailor mental health resources. Include online and in-person follow-up.

Supplement existing mental health care with well-being promotion.

Facilitate access to mental health care and well-being promotion alongside social care.

Reflections on human resilienceSome findings resonate with work on adaptationLiteratures on psychological immune system, immune neglect, hedonic adaptation, hardinessCOVID-19 may be toughest test yetglobal, all-encompassing, unknown ending, strains many common forms of social support, waves

Temporary substitution?

THANK YOU!Thanks to the task force members for their insight and contribution!Liz Dunn, Sonja Lyubomirsky, John Helliwell, Richard Layard, Jan Emmanuel De Neve, Ashley Whillans, Shekhar Saxena, Jamil

Zaki, Sara Jones, Daisy Fancourt, Tyler VanderWeele, Elkhonon Goldberg, Elie Karam, Emily Thronton, Andrew Rzepa, Ozge

Caman

, and

Yanis

Ben Amour

Pre-print available here:

https://psyarxiv.com/zw93g/

email:

lara_aknin@sfu.ca