COVID-19 has taken a relatively limited toll on the mental health of most people around the globe, according to a paper published today in The BMJ by a McGill University-led research team involving collaborators from McMaster University, the University of Toronto, and other institutions.

The team reviewed data from 137 studies in various languages involving 134 cohorts of people from around the world. Most of the studies were from high or middle-income countries, about 75% of participants were adults, and 25% were children and adolescents between the ages of 10 and 19.

To their surprise, the researchers found that despite the dramatic stories to the contrary, where changes in mental health symptoms were identified compared to before the pandemic, these changes were minimal for the most part. This held true whether the studies covered the mental health of the population as a whole or that of specific groups (e.g., people of particular ages, sex or gender, or with pre-existing medical or mental health conditions).

Mental health during the pandemic: Need for a more nuanced understanding

"Mental health in COVID-19 is much more nuanced than people have made it out to be," says Brett Thombs, the senior author, a Canada Research Chair and professor in the Department of Psychiatry at McGill University and senior researcher at the Lady Davis Institute of the Jewish General Hospital.

"Claims that the mental health of most people has deteriorated significantly during the pandemic have been based primarily on individual studies that are 'snapshots' of a particular situation, in a particular place, at a particular time. They typically don't involve any long-term comparison with what had existed before or came after."

A story of resilience

By doing an overview of studies from around the world with data about the mental health of various populations, both prior to the pandemic and during COVID-19, the researchers found that there was little change in the mental health of most of the populations studied.

"This is by far the most comprehensive study on COVID-19 mental health in the world, and it shows that, in general, people have been much more resilient than many have assumed," says Ying Sun, the first author on the paper and a research coordinator from the Lady Davis Institute.

The pandemic's disproportionate effect on women

Some women experienced a worsening of symptoms–whether of anxiety, depression or general mental health. This could be due to their multiple family responsibilities, working in health care or elder care, or in some cases, family violence.

"This is concerning and suggests that some women, as well as some people in other groups, have experienced changes for the worse in their mental health and will need ongoing access to mental health support," said Danielle Rice, an Assistant Professor at McMaster University and St. Joseph's Hospital in Hamilton, Ontario. "The Canadian federal and provincial governments along with governments elsewhere in the world have worked to increase access to mental health services during the pandemic, and should ensure that these services continue to be available."

Moving forward

"Our findings underline the importance of doing rigorous science–otherwise, our expectations and assumptions, together with poor-quality studies and anecdotes–can become self-fulfilling prophecies," says Thombs.

The McGill University and Lady Davis Institute team is continuing to update their findings as research accumulates to look at mental health across different time periods in the pandemic. They are also looking at what governments and health agencies can do to ensure that researchers have access to better-quality and more timely mental health data going forward so that our health systems can gather information that will allow them to target mental health resources to people who need them most.

Some effects:

• Among studies of the general population, no changes were found for general mental health or anxiety symptoms.
• Depression symptoms worsened by minimal to small amounts for older adults, university students, and people who self-identified as belonging to a sexual or gender minority group, but not for other groups.
• For parents, general mental health and anxiety symptoms were seen to worsen, although these results were based on only a small number of studies and participants.
• The findings are consistent with the largest study on suicide during the pandemic, which included monthly data from official government sources on suicide occurrences from 21 countries between 1 January 2019 or earlier to 31 July 2020 and found no evidence of a statistically significant increase in any country or region; statistically significant decreases did, however, occur in 12 countries or regions.