Mental well-being in the post-COVID era

The impact of COVID-19 on the mental health of people has been significant. The onset of common mental illnesses such as anxiety disorders and depression were previously anticipated by the research community (Hyland et al., 2020; Kanter & Manbeck, 2020; Shevlin et al., 2020). Self-isolation, social distancing measures have been linked, in the past, to the onset of depression and anxiety (Santini et al., 2020), paranoia and hallucinations (Michalska da Rocha, Rhodes, Vasilopoulou, & Hutton, 2017). Factors such as loss of employment, financial difficulties can prompt poor mental health (Hyland et al., 2020). Although isolation as such cannot trigger the onset of depression but the perception of contracting the virus and perceiving the symptomology of COVID-19 infection can be a major trigger (Jaspal et al., 2020). Individuals with a history of mental illness or have been diagnosed with a mental health disorder are more vulnerable to develop further illnesses (Freeman et al., 2011). Lifestyle risk factors such as nutrition, exercise, preventative health behaviours as well as carer-dependent activities (Hayes et al., 2017) may all be disturbed during global pandemics such as COVID-19. This not only increases their risk of contracting the disease but also reduces their life expectancy substantially (Onwumere, 2021). The impact of socio-economic factors such as loss of employment, financial difficulties, personal tragedies during the pandemic can further exacerbate the vulnerabilities of people to mental illness.

In order to look beyond the pandemic and better prepare for the future, it is important to monitor and recognise the psychological and social vulnerabilities of people. One approach to do this is to look at the perceptions of people on the pandemic and the coping strategies they adopted during the entire course of the pandemic.

Perceptions and coping strategies:

People’s perceptions of the impact of the pandemic in their lives is multi-dimensional and can have both positive and negative results. Perceptions can be influenced by a variety of factors such as demographics, social support systems, financial and employment circumstances, carer responsibilities, history of mental illness, technology use and personality traits (Homes et al., 2020; Kiraly et al., 2020; Pareek et al., 2020; Brooks et al., 2020; Chen et al., 2020, Wang et al., 2020). Studying all these factors can help understand the most vulnerable populations that are risk during the pandemic. A large study (379,875 participants) was conducted in the UK to understand the different variables linked to the mental well-being of people during COVID-19. It was found that age was the most prominent characteristic variable that showed impact from the pandemic (Hampshire et al., 2021). Older people demonstrated profound increase in anxiety during the course of the pandemic. Younger people, on the other hand, were already found to have high levels of depression and anxiety prior to the pandemic. Age along with other factors such as employment, social systems, home environment can have a direct impact on the mental well-being of people across the age spectrum (Hampshire et al., 2021)

People’s perceptions and responses to stress depend on their ability to cope with stress. A UK study that investigated the different coping strategies adopted by people during the first 21 weeks of the pandemic (Fluharty et al., 2021), in the UK shed some insights into the strategies people adopted during the course of the pandemic. Numerous coping methods have been adopted by people during the course of the pandemic some of which included as self-destruction, denial, substance abuse, active coping, behavioural changes etc (Fluharty et al., 2021).

Participants who adopted socially supportive systems, problem focused, avoidance of stressors methods to handle stress appeared to have high mental health symptoms at the beginning of the pandemic. But symptoms gradually decreased over time, particularly women who chose socially supporting strategies for coping (Fluharty et al., 2021). Avoiding the stress or being in denial provides relief in the short-term but can be detrimental in the long term (Skinner et al., 2003). This is because avoidance or denial fails to identify the core stressor and therefore does not address it. Identifying the source of the psychological stressors will help determine the type of social or medical resources the individual may require to handle the stress (Fluharty et al., 2021). Participants who adopted problem-focused coping strategies (which means those who actively seek solutions to the problem) or who approach the situation with emotions (acceptance and positive mindset), which is referred to as emotion-focused coping, were found to have higher levels of depression or anxiety symptoms at the beginning of the pandemic (Fluharty et al., 2021). But there is also evidence of how the symptoms have improved over time as well as the numerous adaptation strategies that people implemented during isolation and lockdowns (Porter and DeMarco, 2019). Socially supported coping strategies are effective and has been found to help build resilience to stress (Ozbay et al., 2007). This is because the multi-faceted nature of such a system (friends, emotional support etc), can help cope with psychological distress. This has been observed amongst general population in China (Yu et al., 2020).

The gender gap in symptoms of anxiety and depression was also found to be greater at the beginning of the pandemic with prevalence higher amongst women (Fancourt et al., 2020). In the case of adults with severe mental illnesses, carers are mostly female (Hayes et al., 2015) who have also reported high levels of anxiety and depression due to higher levels of social isolation when compared to general population (Onwumere, 2021). There are also other groups of people who are likely to be more vulnerable to mental illnesses and therefore vulnerable to COVID-19. Black, Asian and other minority ethnic (BAME) groups have recorded more COVID-19 deaths (Intensive Care National Audit Research Centre, 2020). Therefore, expanding and building on the research and understanding of the intersectionality of all these psychosocial and social factors is important to prepare for the future.

Conclusion

The impact of the COVID-19 pandemic on all aspects of human life has been profoundly felt across the world. While the world still reels from its impact, it is important to reflect back on the strategies that the human population adopted to overcome the pandemic. Mental health is important at every stage of life, irrespective of the age, race and ethnicity of people around the world. Numerous studies have shown the negative impact of the pandemic on mental health of people. Although increased levels of anxiety and depression can be due to a range of psychosocial and socio-economic factors, this pandemic has shown that socially supportive coping strategies are the most effective to improve the mental well-being of people. More research in this area will shed light into how the coping strategies changed over time and how other factors such as personality traits, demographic characteristics and vaccine perceptions helped improve the mental wellbeing of people.

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