Speed Summary: Lancet COVID-19 Commission Report on the Mental Health Consequences of the Pandemic

A new collaborative international report from the medical journal The Lancet summarises a year’s data from around the world on the psychological and neurological effects of the pandemic, with some interesting implications for digital wellbeing.

Debates over digital wellbeing and digital harms have been sidelined by the pandemic.

As the quip goes, the war over screentime is over; screens won.

Digital screens, along with the connected technology that lies behind them, have kept lives and livelihoods alive, connected and active through the pandemic. If digital technology is like any other technology – either a benefit or a hazard – then digital technology has racked up a huge number of benefit points during the pandemic by acting as a ‘great enabler’.

In a very real sense, digital technology has shown itself to be humane technology, enabling human work, school, and play to continue through lockdowns. We may have been socially distanced, but we’ve been digitally connected. Our three basic psychological needs for autonomy, competence and relatedness have been satisfied – in part – by digital technology. In short, digital technology has enabled humans to adapt, evolve and show resilience in the face of adversity. In this context, the grievance-culture fuelled side of the pre-pandemic digital wellbeing lobby looks a little obsolete in a post-corona world. Rather than restricting digital access to vulnerable communities, we need to democratise and universalise digital access, so all can benefit.

My view is that we need to reset ‘digital wellbeing’ for a post-corona world, and stop focusing on digital ill-being, and start focusing on how digital technology can positively promote human wellbeing – our ability to experience pleasure and purpose in life. It’s here that the new Lancet report “A Review and Response to the Early Mental Health and Neurological Consequences
of the COVID-19 Pandemic” is instructive (pre-print via COVID-minds). The report summarises data from 36 studies from around the world, involving some 950,000 participants, and shows that the stress of the pandemic is having a widespread negative impact on people’s mental health and wellbeing. In short, the report shows that more people need more mental health and wellbeing support in the aftermath of the pandemic, and this support could be delivered digitally.

“A clear and consistent body of evidence suggests that mental health has declined during COVID-19, and some early but informative data suggest that self-harming behaviours have increased in some places but not others. Evidence regarding the impact of COVID-19 on well-being is mixed. Some facets of well-being show clear evidence of decline (e.g., positive emotions), but others (e.g., life satisfaction, social connection or loneliness) show signs of resilience“.

The Lancet COVID-19 Commission Mental Health Task Force

In the face of this widespread deterioration in mental health and wellbeing due to the pandemic, the report recommends population-wide roll outs of easy, low-cost evidence-based positive psychology interventions, which could be delivered digitally. Such interventions include mindfulness, gratitude, practicing kindness or generosity, and self-compassion or imagining one’s best possible self. These interventions may be particularly useful because, unlike professional mental health care, they are brief, accessible, convenient, self-administered and non-stigmatizing.

Of course, many wellbeing apps already exist that use these techniques, but a specific post-pandemic roll out to at-risk populations would help. The report notes that younger individuals, females, and those with children under the age of 5 years show the largest increase in mental distress. Those who have suffered infection themselves, or are close to those who have been infected, or are struggling with financial uncertainty or strain introduced by COVID-19 are also particularly likely to need support.

Parallel research, published just today also in The Lancet found that people who have been infected with COVID-19 themselves are particularly at risk of mental health issues. Specifically, an analysis of 236,379 patient records (mostly from the US) found that 34% patients experienced mental health and neurological conditions within the six months of infection. This was higher (46%) for patients who had severe disease requiring intensive care. The most common conditions were anxiety (17%) and mood disorders (symptoms of depression) 14%, whilst 5% suffered from insomnia. Overall, the study found a 44% greater risk of neurological and mental health diagnoses after Covid-19 than after flu.

Between the two Lancet reports, it is clear people’s mental health and wellbeing has been undermined by a pandemic that has infected millions of people and altered the lives of nearly every human on the planet.

Some headline statistics highlighted in the report include

• A comparison of two nationally representative surveys in the US conducted before and early during the COVID-19 shows a three-fold increase in depression symptoms
• Early in the pandemic 13.6% of American adults indicated symptoms consistent with severe psychological distress, which is four times greater than was observed 2018 (3.9%)
• In the UK the prevalence of clinically significant mental health distress rose from 18.9% in 2018-2019 to 27.3% in late April 2020 during lockdown
• During the initial outbreak period 18% of UK adults had thoughts about suicide or self-harm and 5% have engaged in self-harm or deliberate hurting over the past week. To put this in context, 5.4% of the adult population typically report having had suicidal thoughts in the past year
• In Japan, suicide rates initially declined by 20% during the early months of the pandemic, but then increased by nearly 30% compared to the relevant monthly average from 2017-2019
• Across 34 countries, the Gallup World Poll from recorded small but statistically significant increases in the frequency of negative emotions (rising from 24% to 26%) and decreases in the frequency of positive emotions (from 77% to 74%) in 2020, compared to 2017-2019 levels
• Life satisfaction in Canada dropped in 2029 by 1.38 points on a zero to ten response scale, from 8.09 in 2018
• A longitudinal sentiment analysis of 17,865 active users of Weibo, China’s most popular social media platform, spanning a two-week period from January 13 to 26, 2020 (with the COVID-19 outbreak declared mid-way on January 20) reveal a small but significant increase in negative emotion, depression, and indignation alongside decreases in positive emotion, including happiness and life satisfaction

The report does note that there are also surprising areas of apparent resilience, especially when it comes to wellbeing in terms of life satisfaction (no reported decrease) or loneliness (no reported increase) – although aggregate averages may hide significant variation in certain populations. More recent research is painting a less rosy picture. For example, life satisfaction dropped 2% in the UK in 2020, whilst loneliness has increased, particularly for young people (16-24 years old) who were five times more likely to have felt lonely in the past week, compared to the 65-74 year old group. Overall, the emerging data paints a picture of a world that needs more wellbeing support.

So is it time to flip the digital wellbeing debate away from digital ill-being, digital grievances and the agenda of those selling digital detox plans and retreats? Instead, let’s create a more positive vision for digital wellbeing that is about harnessing the promise of digital technology to promote human wellbeing and positive mental health.