Melbourne Institute of Applied Economic and Social Research - Research Publications
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ItemEffect of lockdown on mental health in Australia: evidence from a natural experiment analysing a longitudinal probability sample survey(ELSEVIER SCI LTD, 2022-05)BACKGROUND: Many studies have examined population mental health during the COVID-19 pandemic but have been unable to isolate the direct effect of lockdowns. The aim of this study was to examine changes in the mental health of Australians aged 15 years and older during the COVID-19 pandemic using a quasi-experimental design to disentangle the lockdown effect. METHODS: We analysed data from ten annual waves (2011-20) of the longitudinal Household, Income and Labour Dynamics in Australia (HILDA) Survey to identify changes in the mental health of respondents from the pre-COVID-19 period (2011-19) to the COVID-19 period (2020). Difference-in-differences models were used to compare these changes between respondents in the state of Victoria who were exposed to lockdown at the time of the 2020 interviews (treatment group) and respondents living elsewhere in Australia (who were living relatively free of restrictions; control group). The models included state, year (survey wave), and person-specific fixed effects. Mental health was assessed using the five-item Mental Health Inventory (MHI-5), which was included in the self-complete questionnaire administered during the survey. FINDINGS: The analysis sample comprised 151 583 observations obtained from 20 839 individuals from 2011 to 2020. The treatment group included 3568 individuals with a total of 37 578 observations (34 010 in the pre-COVID-19 and 3568 in the COVID-19 period), and the control group included 17 271 individuals with 114 005 observations (102 867 in the pre-COVID-19 and 11 138 in the COVID-19 period). Mean MHI-5 scores did not differ between the treatment group (72·9 points [95% CI 72·8-73·2]) and control group (73·2 points [73·1-73·3]) in the pre-COVID-19 period. In the COVID-19 period, decreased mean scores were seen in both the treatment group (69·6 points [69·0-70·2]) and control group (70·8 points [70·5-71·2]). Difference-in-differences estimation showed a small but statistically significant effect of lockdown on MHI-5 scores, with greater decline for residents of Victoria in 2020 than for those in the rest of Australia (difference -1·4 points [95% CI -1·7 to -1·2]). Stratified analyses showed that this lockdown effect was larger for females (-2·2 points [-2·6 to -1·7]) than for males (-0·6 [-0·8 to -0·5]), and even larger for women in couples with children younger than 15 years (-4·4 points [-5·0 to -3·8]), and for females who lived in flats or apartments (-4·1 points [-5·4 to -2·8]) or semi-detached houses, terraced houses, or townhouses (-4·8 points [-6·4 to -3·2]). INTERPRETATION: The imposition of lockdowns was associated with a modest negative change in overall population mental health. The results suggest that the mental health effects of lockdowns differ by population subgroups and for some might have exaggerated existing inequalities in mental health. Although lockdowns have been an important public health tool in suppressing community transmission of COVID-19, more research is needed into the potential psychosocial impacts of such interventions to inform their future use. FUNDING: US National Institutes of Health.
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ItemRecurring pain, mental health problems and sick leave in Australia(Elsevier BV, 2021-12)A substantial proportion of Australians report recurring pain and mental health problems, but their separate and joint contributions to sick leave use has not been examined. This study examines the interaction of pain and mental health problems with sick leave usage and the extent to which unobservable time-invariant factors contribute to these conditions and the propensity to take sick leave. Longitudinal data on self-reported paid sick leave days, pain, mental health problems and multiple covariates, and spanning the period 2005 to 2019, were derived from the Household, Income, and Labour Dynamics in Australia Survey. The analysis included 3404 and 3448 employed women and men, respectively, with paid sick leave entitlements, with an average of 6 observations each. Negative binomial regression models were used to investigate the association while adjusting for multiple covariates. After multiple adjustments, recurring pain was linked to 1.7 additional sick leave days per year among women and 2.3 among men, whereas the corresponding figures for recurring mental health problems were 1.5 and 0.7, respectively. Time-constant between-individual heterogeneity slightly attenuated these estimates, suggesting that unobserved characteristics contribute to both symptoms and a higher propensity to take sick leave. Pain and mental health problems – single-occasion but particularly recurring – are both important contributors to sick leave days in Australia. However, their effects do not appear to interact with one another. Thus, to help the employees continue working, mental health problems and pain have to be tackled early on, aiming to reduce any stigma related to them. Moreover, modification in working conditions could be useful in finding better matches between employees and their jobs, provided that the employer is aware of the mental health problems and pain of their employees.
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ItemTrends in the Prevalence of Psychological Distress Over Time: Comparing Results From Longitudinal and Repeated Cross-Sectional Surveys(Frontiers Media, 2020-11-26)Background: While there is discussion of increasing rates of mental disorders, epidemiological research finds little evidence of change over time. This research generally compares cross-sectional surveys conducted at different times. Declining response rates to representative surveys may mask increases in mental disorders and psychological distress. Methods: Analysis of data from two large nationally representative surveys: repeated cross-sectional data from the Australian National Health Survey (NHS) series (2001–2017), and longitudinal data (2007–2017) from the Household, Income and Labor Dynamics in Australia (HILDA) Survey. Data from each source was used to generate weighted national estimates of the prevalence of very high psychological distress using the Kessler Psychological Distress scale (K10). Results: Estimates of the prevalence of very high psychological distress from the NHS were stable between 2001 and 2014, with a modest increase in 2017. In contrast, the HILDA Survey data demonstrated an increasing trend over time, with the prevalence of very high distress rising from 4.8% in 2007 to 7.4% in 2017. This increase was present for both men and women, and was evident for younger and middle aged adults but not those aged 65 years or older. Sensitivity analyses showed that this increase was notable in the upper end of the K10 distribution. Conclusions: Using household panel data breaks the nexus between declining survey participation rates and time, and suggests the prevalence of very high psychological distress is increasing. The study identifies potential challenges in estimating trends in population mental health using repeated cross-sectional survey data.