The COVID-19 pandemic is taking a heavy mental health toll even on people who are not directly impacted by the disease, shows a new study in Frontiers in Psychiatry.

In a first-of-its-kind Australian mental health survey, researchers found that people in countries with low rates of infection and fatalities—like Australia at the onset of the pandemic—still experience twice as much depression and anxiety. These outcomes are largely related to financial stress and disruptions to people’s social lives.

“We already know from past pandemic research that the people who are most affected, such as those who become ill and/or are hospitalized and their carers, experience more severe impacts. However, the impacts of COVID-19 on the broader population in relatively less affected countries are also likely to be substantial,” says lead author Dr. Amy Dawel of the Australian National University in Canberra, Australia.

“Our data show that the by-products of COVID-19 are affecting populations broadly—notwithstanding how great the physical illness impact is—and the concern is that countries with strong restrictions, who appear to circumvent the worst of COVID-19, may overlook the indirect impacts of the pandemic.”

To capture a snapshot of the population’s mental health just after the first COVID-19 restrictions went into effect, Dr. Dawel and her collaborators surveyed nearly 1300 Australian adults in March 2020. At this time, authorities had recently closed international borders, bars and restaurants, and limited social gatherings. The participants included a representative distribution of the population, with equal numbers of men and women and participants across all age groups over the age of 18 from every Australian state and territory.

In order to prevent any potential bias, the survey was designed so that participants would not know the aims of the study. Instead the researchers incorporated the survey into market research panels, without any mention of COVID-19 or mental health during study recruitment.

Since the survey occurred in the early stages of the pandemic, only 36 participants reported having received a COVID-19 diagnosis or having had a close contact who had been diagnosed. There were also relatively few people who had been tested, had self-isolated or who had known anyone who had any of these experiences.

Surprisingly, these cases of COVID-19 contact showed no link to mental health impacts. In contrast, financial distress and disruptions to work and social activities were significantly associated with symptoms of depression and anxiety, as well as lower psychological wellbeing. However, working from home wasn’t associated with any negative effects.

Higher rates of mental health symptoms were also found among people who were younger, identified themselves as female or who reported having a pre-existing mental health condition.

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