As the pandemic dragged on through 2020 and 2021, I read the news with empathy for my Melbournian neighbours who endured 262 days of lockdown. “I don’t know how they are doing it,” I said repeatedly. “It’s got to be tough on their mental health.”

So exactly how tough was lockdown on mental health? And who was most impacted?

This has been a hot topic of research over the last two years. Most studies were limited however, because they simply provided a snapshot in time of an individual’s mental health. And what we really want to know is how much lockdown has changed mental health.

Professor Peter Butterworth, population mental health expert, and colleagues* have answered this question by taking advantage of an ongoing annual survey of over 20,000 Australians. 

“Our study was unique because we used data from the HILDA** household survey, which has been following the same Australian families since 2001,” says Butterworth.

“The annual survey went into the field in the second half of 2020, just as Victoria’s second lockdown began. Our analysis compared the mental health of people in Victoria who were experiencing lockdown, with other Australians who had emerged from lockdown and their lives were relatively normal.”

“Most critically, prior to 2020 there was little difference in the mental health of people in Victoria and those in the rest of Australia. So this analysis provides a unique insight into the causal effects of lockdown on mental health.”

So who was impacted the most? My gut feeling – from personal experience and conversations with friends – is women who were home-schooling children. And this turned out to be true, with the most severe impacts felt by women in couples with dependents.

“It's quite a dramatic difference when you look at women compared to men, or when you compare women with dependent children to other women,” says Butterworth.

“The expectations were that you would continue to work from home with the same level of productivity you had before. Other research however, has confirmed women were largely responsible for home-schooling, other caring, and household tasks: all within the same 24 hours. I think it's not necessarily surprising that this type of role overload was associated with quite a dramatic effect on mental health and well-being.”

The study also found that women living in units and townhouses faced a similar magnitude of impact.

“The effect of housing may well be tied to the opportunity for some form of escape or release. Without having access to your own outdoor space, the capacity to move beyond the confines of your home were much more constrained.”

Butterworth refers to the impact on these women’s mental health as being ‘clinically relevant.’

“What we see is a substantial difference in mental health beyond the sort of change you would expect to see from day-to-day fluctuations. This change in mental health is similar to what we would associate with becoming unemployed or other adverse major life events,” says Butterworth.

While women, coupled women with dependent children, and those living in apartments were impacted the most, it’s not to say the effect of lockdown on other groups should be ignored.

“We aren’t saying that men’s mental health didn’t suffer, because it did in many cases. However, on average, the decline was not of the same magnitude that is was for women.”

“Also, keep in mind that this study was specifically focused on the effect of lockdown. So people with poor mental health prior to the pandemic continued to have the poor mental health, and to some extent their mental health did worsen during lockdown. On average, however, there wasn't a dramatic, additional worsening due to the lockdown.”

The results of this study might not be surprising, but they are hugely important. The ability to quantify the impact of lockdown on mental health provides a platform for informed policy decisions.

“While lockdowns were effective in terms of preventing and controlling the spread of coronavirus, understanding the adverse consequences, including the mental health effects, is important,” says Butterworth.

“Should we be in a situation where this type of policy response is on the table again, being aware of who was most disadvantaged by the lockdowns and the circumstances in which this occurred is important. Being aware upfront of the gendered nature of the mental health effects of lockdowns suggests exploring ways to more equitably share home-schooling and childcare responsibilities, or that employers need to be more mindful of the competing demands on their staff working from home, and put other protections in place.”

Further policy adaptations should also recognise the role of environmental factors, such as housing and access to outdoor space during lockdowns.

Meanwhile, Australians are breathing a collective sigh of relief as lockdowns appear to be a thing of the past – and this research supports my own home-schooling / lockdown malaise of 2020!

By Liz Drummond

* Effect of lockdown on mental health in Australia: evidence from a natural experiment analysing a longitudinal probability sample survey, is published in Lancet Public Health, and is a collaborative project between researchers from the Australian National University, University of Sydney, and University of Melbourne.

**The Household, Income and Labour Dynamics in Australia (HILDA) survey is a household-based panel study that collects information about economic and personal well-being, labour market dynamics and family life. It follows the lives of >20,000 Australian each year since 2001.