Mental health may be significantly impacted by COVID-19-related social distancing and isolation

By Sally Robertson, B.Sc.Apr 16 2020

A study conducted by a team of psychologists and social scientists has revealed that the social distancing and isolation measures introduced in the UK as a result of COVID-19 may already be having significant negative impacts on people's mental health and well-being.

The study found that a large proportion of the public may be experiencing depression, anxiety, and a sense of social, economic, and personal loss as a result of adhering to the new measures.

The authors say their findings suggest that a rapid response is needed to address these mental health impacts, and timely support is essential for those prone to depression, anxiety, or suicidal thoughts.

The study also highlights that adherence to social distancing and isolation is likely to eventually wane, especially where people are uncertain of how long they will need to adhere and whether they can cope in the long-term.

Furthermore, "social distancing and isolation 'exit strategies' must account for the fact that, although some individuals will voluntarily or habitually continue to socially distance, others will seek high levels of social engagement as soon as possible," writes the team.

Public perceptions and experiences of social distancing and social isolation during the COVID-19 pandemic: A UK-based focus group study. Image Credit: TZIDO SUN / Shutterstock

There has been no qualitative research into the public's experience of the measures

The authors say that although research on the effects of previous pandemics is available and research into the mental health impacts of social distancing and isolation is ongoing, no qualitative research into the public's experience of the measures and how this relates to adherence has yet been published.

Now, psychologist Kimberly Dienes from the University of Manchester and colleagues have reported on online discussions held with 27 UK residents (aged 18 or older) between March 28^th and April 4^th 2020 (five to 12 days since lockdown began on March 23rd).

Participants were divided into five focus groups comprising between five and eight people who joined video or audio discussions for 60 to 90 minutes.

Four main themes emerged from the analysis and are described in a pre-print version of the paper, which is available in medRxiv while the study undergoes peer review.

Social and psychological impacts

The main theme in terms of social and psychological impact was loss, which was subdivided into loss of social interaction, loss of income and loss of structure and routine

One participant described the loss of social interaction after just one week of lockdown as already having "taken its toll on mental health," with another participant describing how it leaves people feeling "alienated" and some participants likening it to being in "prison."

Some participants said losing their income had made them feel "quite depressed" and that  the loss of structure and routine had left them feeling "overwhelmed."

Criticisms of government communication

Most participants felt government guidance had been unclear and distrusted the "politicizing" of the pandemic and the "mixed messages" from the media. Participants described the constant media focus on COVID-19 while being isolated at home, as "claustrophobic in both a physical and an emotional sense." They also said the ambiguity of terms such as "essential" and "emergency" supplies and services made it difficult to follow advice.

Adherence and non-adherence of self and others

All participants described being highly adherent to the measures. Still, many described observing non-adherence in others, which was viewed as being due to a lack of social consciousness among "inconsiderate" or "arrogant" individuals. Non-adherence was also attributed to a lack of understanding and the police not being able to enforce adherence due to the previously mentioned ambiguity of terms such as "essential."

Uncertainty over future social reintegration

Participants said the biggest problem is not knowing "when it's going to end" and the associated feeling of "powerlessness." Some said there was a limit to how long they and others could adhere and that they would prefer to be given a specific date, even if that date is a long way off in the future. Some felt that once the measures are relaxed or removed, they would immediately go back to living life "completely as normal," whereas others felt they would continue to be anxious and cautious about health and that people might continue to socially distance from each other.

Study implications

"This study suggests that the social distancing and isolation associated with COVID-19 policy is having substantial negative impacts on the mental health and well-being of the UK public within a short time of policy implementation," writes the team. "Policymakers and the public health community must discuss measures to respond to the likely wave of mental ill-health, which is expected to follow, and which is tentatively suggested by our early qualitative evidence."

The researchers say it is important to consider that the initial adherence to social distancing and isolation is likely to eventually wane and that the lockdown "exit strategy" needs need to account for the fact that, while some people will voluntarily continue to socially distance, "others will seek immediately to re-integrate fully beyond what they are permitted to."

Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.