Czeisler ME, Wiley JF, Facer-Childs ER, et al. - Due to its direct (i.e, SARS-CoV-2 infection, potentially due to neuronal or astrocytic infection, microvascular, or inflammatory mechanisms) and indirect (ie, social and economic impacts of COVID-19 prevention measures) effects, the coronavirus disease 2019 (COVID-19) pandemic has been linked with mental health consequences. Researchers herein performed evaluation of mental health in the absence of substantial direct pandemic mental health consequences by performing investigation of mental health in a region with one of the longest lockdowns and lowest COVID-19 prevalence globally (Victoria, Australia). Victorian residents aged ≥ 18 years were administered surveys for the COVID-19 Outbreak Public Evaluation (COPE) Initiative. Among 1,157 assessed Victorians, one-third described anxiety or depressive disorder symptoms, one-fifth described suicidal ideation, and one-tenth described having seriously considered suicide in the prior 30 days. Increased prevalence of adverse mental health symptoms was observed among young adults, unpaid caregivers, people with disabilities, and people with diagnosed psychiatric or sleep conditions. No change in the prevalence estimates of symptoms of burnout, anxiety, and depressive disorder was noted. Overall findings suggest that during prolonged lockdown, adverse mental health symptoms were persistently common despite low SARS-CoV-2 prevalence highlighting the urgent necessity for mental health support services.