Was the Mental Health Crisis from the Pandemic Minimal?

CW: This article discusses topics of mental illness which could be distressing to some readers.

A recent BMJ Review suggests that the mental health crisis caused by the COVID-19 pandemic had a minimal impact. Well, I beg to differ.

The review

The BMJ Review analysed 137 studies across Europe and Asia, 77% of those studies being from high-income countries and 20% being from upper middle-class countries. According to BMJ, no changes were found among this group for general mental health or anxiety, but depression symptoms worsened minimally. In 3 of BMJ’s studies, with data from March to April 2020 and late 2020, symptoms were unchanged from pre-COVID-19 levels, or increased initially and then returned to pre-COVID-19 levels. However, this is not an accurate portrayal of society as a whole. What about the working-class and lower-class?

Poor people would disagree

According to the MDPI, during the COVID-19 crisis, 45% of African adults suffered from depression, 37% suffered from anxiety, and 28% suffered from insomnia. The study suggested that more African adults suffered from depression during the pandemic than adult populations in other countries or regions. This is because Africa is considered a lower-income continent, with limited medical facilities and resources such as advanced healthcare facilities, intensive care units, sanitary items, clean water, and vaccine penetration. This also explains why it has been particularly vulnerable to the spread of COVID-19. PLOS ONE found that in the United States, the daily inflow of COVID-19 cases was associated with worse mental health, and the size of this effect declined in 2021 and 2022 as vaccination rates rose. This shows the impact COVID-19 had on countries outside of Europe and Asia. Compare this to South America, which - according to Cambridge University Press - had a higher prevalence of mental health symptoms during the pandemic than Central America - 35% suffering with anxiety, depression, or insomnia - particularly in healthcare workers anbMJh d students.

In the UK, there has been a rise in energy costs since the beginning of 2020, with people struggling to afford to pay their rent, or mortgage, as well as other household bills. Not to mention, key workers were working more or longer hours, and others were earning only 80% of their usual wage on furlough. Key workers were unlikely to manage a work/social life balance, and were likely to suffer from stress due to coming into contact with lots of people, anxiety over the lack of personal protective equipment, guilt over the possibility of spreading the virus, and anger over the lack of support for key workers. Those who were on furlough or unemployed throughout the pandemic suffered due to not having enough financial or welfare support, leading to anxiety over money concerns.

So would young people

The BBC’s report of the BMJ review and an NHS study stated that 18% of 7-16 year olds and 25.7% of 17-19 year olds in England had a probable mental disorder in 2022, compared to 12.1% and 10.1% in 2017. This shows that mental health issues in young people has increased drastically since around the time of the pandemic. NHS figures show that the number of children in contact with mental health services rose by nearly 30% between 2020-21 and 2021-22, to nearly a million.

Mind reports that, in 2021, about a third of adults and young people said their mental health had become much worse since March 2020. Did the BMJ review take that into consideration? 30% of adults and 34% of young people said that their mental health got worse during the pandemic, with only 59% of young people saying that they will enjoy school, college, or university more once restrictions ease, but 21% not even thinking they will enjoy it then.

The facts

The NHS recommends 5 Steps To Mental Well-being for people trying to manage their mental health. This consists of connecting with other people, being physically active, learning new skills, giving to others, and mindfulness. This helps people feel like they belong, like they are worthy, like they are supported, that they have a sense of purpose. But how could people connect with others when there was restrictions on meeting in person? What access to exercise did people have if they were living in small houses, or crowded households, in urban areas - and what time did they have to exercise if they were key workers? Is it possible to feel present in the moment when you are anxious about a virus, when you’re feeling claustrophobic, or hopeless, or unprepared for changes?

According to Mind, people also suffered from lack of socialisation due to shielding, lack of natural light because of the restrictions, lack of stimulation, mask anxiety, sensory overload, and social phobia once restrictions were lifted.

The BMJ review might be able to say that mental health was hardly impacted by the pandemic in upper-class countries, but the young people around the world with a lack of education and socialisation in their developmental years, and the working-class people with insufficient financial and welfare support were impacted by the pandemic, and this needs to be acknowledged.

You can read more about the impact of COVID-19 on mental health here.