Mental Health in a Global Pandemic: Lessons Learned From Psychological Science

Nearly 2 years into the COVID-19 pandemic, an emerging body of literature is revealing the pandemic’s mental health impact on children, adolescents, and adults, including those who had previously been diagnosed with a mental illness. Four psychological scientists presented initial findings on these impacts, along with their future implications, in a December 9 webinar produced by the APS Global Collaboration on COVID-19. The panel was moderated by Allison Harvey, a specialist in clinical science at the University of California, Berkeley. 

The APS Global Collaboration on COVID-19 convenes psychological scientists and other behavioral science experts to assess how the field has contributed to combating the COVID-19 pandemic and to identify gaps in understanding that should be addressed through new research. Learn more about the initiative, and view a recording of the December 9 webinar, at psychologicalscience.org/covid-initiative. 

The collaboration’s next webinar, Psychology Meets Biology in COVID-19: What We Know and Why It Matters for Public Health, will take place January 21. 

Context matters—and timing is critical 

“We cannot make global generalizations about how mental health impacts individuals or even certain subgroups of individuals; we need to carefully look at nuanced context,” according to June Gruber, a clinical psychologist who researches affective disturbances at the University of Colorado Boulder. Gruber illustrated how higher levels of COVID risk (i.e., exposure) can increase depression symptoms, whereas lower risk levels actually appear to decrease depression. She also cited a study by Eiko Fried (Leiden University) and colleagues showing how events such as university closures can modulate the levels of anxiety and depression that university students experience during the pandemic.  

The power of resilience has emerged as another lesson from COVID. Citing a study by George Bonanno (Columbia University) and colleagues, Gruber noted that most people showed resilience trajectories in anxiety and depression symptoms (i.e., showed no increase of symptoms) during the initial months of COVID-19. However, researchers must also study the longer-term or chronic impacts. For instance, a year after COVID was first detected, increased depression affected individuals with high as well as low COVID risk, and life satisfaction decreased for all participants.  

Socioeconomic and racial disparities 

“We are all in the same storm, but we are in different ships trying to navigate the storm,” said Derek M. Novacek, a postdoctoral fellow researching mental illness at the University of California, Los Angeles, who shared research evaluating racial differences in the psychosocial response to COVID-19 in veterans with psychosis or who had experienced recent homelessness. Systemic racism has contributed to an overrepresentation of Black Americans among homeless individuals and homeless veterans, as well as among individuals diagnosed with psychosis. Novacek and colleagues studied whether these and other racial disparities in the pandemic could lead to different psychosocial outcomes for Black veterans compared with White veterans.  

Interestingly, Novacek and colleagues found that social support—specifically, higher family integration among Black veterans, compared with White veterans—led to better social integration overall and somewhat protected them against depression and psychological distress during the pandemic. Moreover, community integration and functioning did not change much across the pandemic. Novacek also noted that veterans are more likely to have access to case management, psychotherapy, psychiatric care, and housing assistance, among other privileges, that might help to mitigate potential racial disparities within the general population. 

Age and gender differences 

For many researchers, the shelter-in-place orders issued during the pandemic provided an opportunity to study loneliness. Christopher R. Beam, a clinical psychologist and researcher specializing in lifespan development at the University of Southern California, and colleagues are examining newly published studies for age and gender differences in anxiety, depression, and loneliness during COVID-19. In his presentation, Beam showed some preliminary data from this global review of countries including the United States, China, Brazil, Germany, India, Russia, and Australia, along with populations including community samples, students, educators, healthcare workers, and others.  

During the pandemic, older adults did not appear to report more loneliness than younger adults, with the exception of older adults in Brazil and China, Beam said. Older adults also did not report more symptoms of anxiety or depression than younger adults. These findings suggest that older adults might have been more resilient during the pandemic. In a gender comparison, women appeared to report more loneliness, anxiety, and depression than men during the pandemic. “We think it’s time to put in place some During the pandemic, older adults did not appear to report more loneliness than younger adults, with the exception of older adults in Brazil and China, Beam said. Older adults also did not report more symptoms of anxiety or depression than younger adults. These findings suggest that older adults might have been more resilient during the pandemic. In a gender comparison, women appeared to report more loneliness, anxiety, and depression than men during the pandemic. “We think it’s time to put in place some active coping strategies that can make people’s lives a bit more rewarding . . . rather than more passive coping strategies such as drinking and substance use,” Beam said. He suggested “coping strategies that tackle day-to-day activities, and general activities that people tended to enjoy prior to the pandemic” for helping to tackle loneliness and social isolation. 

Couples’ distress, homeschooling, and substance use  

Gender differences also emerged in studies of romantic couples during pandemic-related lockdowns. Sherry Stewart, a clinical psychologist who researches substance use at Dalhousie University, presented research she and her team have conducted on romantic conflict, homeschooling, and substance use. 

The more conflict a couple reported, the more motivated they appeared to be to use alcohol for coping. However, the more women drank to cope, the more their partners also drank. However, as men drank more to cope, their partners were less likely to exhibit drinking behavior. This indicates that women might modulate their drinking behavior in response to their partners’ distress.  

Stewart and colleagues also found differences between couples who did or did not have to homeschool their children during the pandemic, depending on whether their schools canceled in-person classes. Homeschooling parents reported less optimism, higher role strain, and higher use of cannabis and alcohol to cope. The more hours an individual spent homeschooling, the higher their reported anxiety and depression symptoms as well as COVID-related traumatic and socioeconomic stress. In addition, the parents’ partners’ drinking frequency and quantity tended to increase. The same was true for mothers specifically: The more hours mothers spent homeschooling, the more frequently they and their partners drank. However, the more hours fathers spent homeschooling, the less frequently mothers drank. These findings suggest that “a more equitable division of homeschooling labor may have protective effects on alcohol use for women,” Stewart said.   

Overall, Stewart’s findings suggest the need to carefully weigh the costs and benefits of school closures and to plan educational supports that will help with homeschooling tasks and psychological supports to help parents’ coping mechanisms. Considering relationship effects, not just individual outcomes, also appears to be fundamental, and researchers and practitioners could design couple-level interventions to address couples’ distress during this and future pandemics.

View a recording of this webinar, including references to much of the research cited.

Get the latest updates on the APS Global Collaboration on COVID-19 

Register for the next webinar on January 21, 2022, @ 12:00-2:30 PM ET 

Psychology Meets Biology in COVID-19: What We Know and Why It Matters for Public Health