Czeisler ME, Wiley JF, Facer-Childs ER, et al. - The correlation of the COVID-19 pandemic has been observed with mental health consequences due to direct (ie, 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) mechanisms. Researchers herein performed evaluation of mental health in the absence of direct pandemic mental health consequences by investigating 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 during 15-24 September 2020 for The COVID-19 Outbreak Public Evaluation (COPE) Initiative. One-third of 1,157 Victorians reported anxiety or depressive disorder symptoms in September-2020, one-fifth reported suicidal ideation, and one-tenth reported having seriously considered suicide within 30 days. Increased prevalence of adverse mental health symptoms was observed among young adults, unpaid caregivers, those with disabilities, and those with pre existing psychiatric or sleep conditions. No change in prevalence of symptoms of burnout, anxiety, and depressive disorder was observed between April-2020 and September-2020. In view of persistent common experiences of adverse mental health symptoms despite low SARS-CoV-2 prevalence during prolonged lockdown, they emphasize the urgent necessity for mental health support services.