A new study by academics at UNSW Business School, UNSW Science, and Asia University finds the mental health of young adults aged 18 to 34 is the most affected by restrictions associated with COVID-19.
Published in Translational Psychiatry, the study of 6475 participants shows 50 per cent of young adults surveyed in the US report feeling moderate mental distress. This is above the average prevalence of 37 per cent, and well above the less than 25 per cent of people over 65, who demonstrate feeling mental distress as a result of COVID-19.
The lead author, Dr Elvira Sojli, an Associate Professor of Finance and Scientia Fellow Alumni in the School of Banking and Finance at UNSW Business School, says this is a surprising result for the researchers.
“The long-term effects and death rate of COVID-19 is highest among those over 60,” she says. “Also, evidence from previous pandemics, such as MERS and SARS, shows higher rates of mental distress among older adults.”
Dr Sojli co-authors the study alongside Associate Professor Wing Wah Tham of UNSW Business School, Scientia Professor Richard Bryant of UNSW Science, and the late Professor Michael McAleer of Asia University (Taiwan). She suggests several reasons why the younger cohorts show higher levels of mental distress in the study.
“Younger people rely more on mobility for social interaction, travel, and leisure activities, and the loss of these activities adversely impacts on mental health,” she says.
Pounding hearts and nausea: How do the researchers track mental distress?
The study examines the effects of restrictions using data from the US probability-based survey, Covid-19 Household Impact Survey. This survey was conducted by the National Opinion Research Center (NORC) at the University of Chicago in April, May, and June 2020.
The survey asked participants about their individual mental distress during the lockdown period, for example how often in the past week they experienced symptoms such as feeling ‘hopeless about the future’ or ‘lonely’ or ‘physical reactions such as sweating, trouble breathing, or a pounding heart when thinking about your experience with the coronavirus pandemic’.
The UNSW authors then use these responses to create a Psychological Distress Scale, with higher scores indicating higher mental distress. This is then compared with self-reported previous mental health diagnoses.
The Covid-19 Household Impact Survey also included questions around whether respondents had personal plans affected by the restrictions, about their current employment, likely future job prospects, and their physical health.
“While the data is representative of the US population, it gives us insights that are generally applicable to other groups of people,” says Dr Sojli.
‘Poor physical health’ another likely contributing factor to distress
The findings from the UNSW study show that, as well as young adults exhibiting higher levels of mental distress as a cohort, other correlations include better physical health with lower levels of mental distress, with an individual with poor physical health being five times more likely to feel moderate mental distress.
Older men are also more likely than older women to exhibit moderate mental distress, (though there was seemingly no effect for young adults), and white, non-Hispanic young adults are more likely to demonstrate moderate mental distress, compared to respondents who were Asian.
Could the argument be made for the younger generation being more mental health literate, and therefore more aware of their symptoms? Dr Sojli says this is not the case, based on the data collected.
"Respondents were asked about prior mental health issues,” she says. “There didn’t seem to be big differences across age groups on that, indicating that older people are not shy about mental health issues.”
What lessons are there for Australia from the study?
While the research uses data from the US, the researchers say there are several learnings here for Australia.
"The lessons are very clear,” says Dr Sojli. “The US did not have as strict a lockdown, compared to Victoria, and in NSW in recent months, and we still saw a large impact on the mental health of younger people in the US. The learnings we get from this data can certainly be applied to other countries outside of the US, like Australia.
“The Australian federal and state governments need to think harder about how to deliver mental health support. Age-group specific policies and preventative actions are necessary and need to be drawn up.”
There is also a lack of COVID-19 related mental health data being collected in Australia, with the level of comprehension and representation shown in the COVID-19 Household Impact Survey. Indeed, studies in countries such as Germany are collecting information on COVID-19 and mental health.
"The Australian census collection was a missed opportunity on this front,” says Dr Sojli. “There ought to have been a few questions on mental health in the census, to allow for an understanding of the situation in the country.”
The authors say as well as underlining the need for differentiated and targeted mental health responses to the mental health effects of COVID-19 by age groups, the study demonstrates the need for preventative actions that reduce specific mental health burdens during the pandemic, such as impacts of social restrictions or job stress on younger people.
“There is also the need to switch from individual-based approaches to population-wide screening aimed specifically at identifying people with elevated levels of risk,” says Dr Sojli. “And our results highlight that it is imperative to focus initially on the younger age cohorts.”