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Policy stringency and mental health during the Covid-19 pandemic: a longitudinal analysis of data from 15 countries

Lara Aknin, Bernardo Andretti, Jan-Emmanuel De Neve, Elizabeth W Dunn, Daisy Fancourt, Elkhonon Goldberg, Rafael Goldszmidt, John Helliwell, Sarah P Jones, Ozge Karadag, Elie Karam, Richard Layard, Anna Petherick, Shekhar Saxena, Ashley Whillans and Jamil Zaki


To date, public health policies implemented during the COVID-19 pandemic have been evaluated on the basis of their ability to reduce transmission and minimise economic harm. We aimed to assess the association between COVID-19 policy restrictions and mental health during the COVID-19 pandemic. Methods: In this longitudinal analysis, we combined daily policy stringency data from the Oxford COVID-19 Government Response Tracker with psychological distress scores and life evaluations captured in the Imperial College London-YouGov COVID-19 Behaviour Tracker Global Survey in fortnightly cross-sections from samples of 15 countries between April 27, 2020, and June 28, 2021. The mental health questions provided a sample size of 432 642 valid responses, with an average of 14 918 responses every 2 weeks. To investigate how policy stringency was associated with mental health, we considered two potential mediators: observed physical distancing and perceptions of the government's handling of the pandemic. Countries were grouped on the basis of their response to the COVID-19 pandemic as those pursuing an elimination strategy (countries that aimed to eliminate community transmission of SARS-CoV-2 within their borders) or those pursuing a mitigation strategy (countries that aimed to control SARS-CoV-2 transmission). Using a combined dataset of country-level and individual-level data, we estimated linear regression models with country-fixed effects (ie, dummy variables representing the countries in our sample) and with individual and contextual covariates. Additionally, we analysed data from a sample of Nordic countries, to compare Sweden (that pursued a mitigation strategy) to other Nordic countries (that adopted a near-elimination strategy).


21 April 2021


The Lancet Public Health 7(5) , pp.e417 - e426, 2021


DOI: 10.1016/S2468-2667(22)00060-3

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(22)00060-3/fulltext

This Journal article is published under the centre's Community Wellbeing programme.