MELBOURNE: Victorians reported a decline in mental health, an increase in psychological distress and a reluctance to engage with health professionals during the state’s recent winter lockdown, according to a new report from Monash University.
The report lays bare the negative health consequences faced by Victorians as they progressed through one of the world’s longest and most restrictive COVID-19-related lockdowns.
The insights from the study, jointly funded by Monash University and icare Foundation, could help overseas governments plan and provide health and social services to mitigate these impacts, as many northern countries enter winter with rampant case numbers.
Professor Alex Collie and colleagues from the University’s School of Public Health and Preventive Medicine, started their study in March, as Australia entered a national lockdown. They enrolled 2,600 working-age Australians across all states and territories, who completed a survey tracking employment and mental and physical health status. Participants completed the survey again one and three months later, allowing researchers to see changes to the same people over time.
During the third survey period, the state of Victoria experienced a second wave of infections, and went into one of the longest and most restrictive lockdowns in the world, whilst their interstate counterparts gradually returned to near-normal life. At its most restrictive, Melbourne residents were subject to stringent work-from-home orders, a curfew, a five-kilometre travel radius, limits on time spent outside, and school and business closures.
Prior to the lockdown, the health of Victorians was equivalent to other Australians on most study measures. This changed significantly during the lockdown, when participants from Victoria reported:
a worsening of mental health
increases in psychological distress
low levels of engagement in paid work
reduced in-person social interaction
In addition, Victorians reported that they were more likely to:
have avoided seeking medical treatment
be working from home (if they were working)
have spoken with a friend or family member about their mental health
make behavioural changes to manage mental health problems
have had a COVID-19 test
Thirty seven percent of Victorians reported they avoided seeking medical treatment during the winter lockdown, compared to 25 per cent of those in the rest of Australia.
Forty five percent of Victorians who avoided healthcare cited fear of coming into contact with others as the reason, whereas this was reported by only 29 per cent of those outside Victoria. Study participants from Victoria were also more likely to report that healthcare professionals asked them not to come for a consultation or treatment.
Professor Collie says: “The study shows that lockdowns have significant impacts on health, and on things that affect our health such as our social interactions and work.”
“We also observed a drop in engagement with healthcare. The lockdown created a really difficult situation of increased mental health needs in the community coupled with people avoiding seeking care,” Professor Collie said.
“It shows how important it is for healthcare professionals and governments to build trust and encourage engagement, and public campaigns with this message could be incredibly important for countries entering lockdowns now.”
The lockdown also impacted the way Victorians engaged with others. Fifty-four percent of Victorians said they had not spent time with anyone outside their household in the past week compared with 17 per cent of other Australians. Victorians were more likely to have spoken to someone on the telephone or via the internet on a daily basis, highlighting the importance of social connections during a time of physical distancing and lockdown scenarios.
Victorians also showed changes in help seeking behaviours, particularly around mental health. They were more likely to report distracting themselves by keeping active or learning a new skill, and to have participated in an online forum, and less likely to have taken no actions for their mental health.
Professor Collie says the high rate of action to improve mental health is encouraging, and points to additional social supports that could be worthwhile.
“The fact that around 85 – 90 per cent of people undertook activities to look after their mental health reveals a wide community acknowledgement of the importance of mental health. Guiding people in making good choices could be an effective campaign for those managing lockdowns.”
No differences were seen between Victorians and other Australians on levels of financial stress, ability to access funds in an emergency or employment, despite more Victorians reporting that they were not engaged in paid work. One explanation for this is that Government financial stimulus were supporting the financial and employment situations of Victorians during the winter lockdown.
Professor Collie says: “Our findings suggest that Job Keeper and the Coronavirus Supplement were keeping Victorians attached to their employers and helping unemployed people out of poverty. But this also means we should be very careful about withdrawing these payments given the continued high rates of unemployment and mental health problems in our community.”
“In summary, lockdown measures must be coupled with additional community-wide supports and services that address the determinants of health. We need to support community and social networks, support people financially, keep them engaged with their workplaces, and find ways of ensuring people seek care when it’s needed.”
Future reports from the study will examine changes in health and work among other states in Australia, including New South Wales, and will look more closely into issues such as working from home and returning to the workplace.