COVID-19, Isolation, and Improving Mental Health through Digital Connectedness
No.2024-8(June) YaleInclusionEconomics YaleEconomicGrowthCenter pborileicfy KeyPoints •Globally,stringentcontrolswereimplementedtomitigatetherapidspreadofthecoronavirusdisease(COVID-19)–andmentalhealthdeteriorated.Mobile phonesprovidedanimportantgatewaytoconnectionandinformationduringthisperiodofisolation. •Insomelow-andmiddle-incomecountries(LMICs),womenhavelimitedaccesstomobilephonesandInternet.Toensurewomencanbenefitfromthebenefitsofdigitaltechnologyduringcrisesandotherwise,countriesmustaddressthesedisparities,ensuringlackofmoney,knowledgegaps,andrestrictivesocialnormsdonotdisproportionatelypreventwomenfromonlineconnectivity. •Avarietyofpolicylevershavebeenemployedtoaddressrestrictivegendernormsaroundphoneuse.ResearchinIndiabytheInclusionEconomicsnetworkshowsthatofferingwomenbrief,small-groupdigitalliteracytrainingincreasestheirmobilephoneusebeyondprovisionofphonesalone,withgainsevidentseveralyearslater. •Womenwhotookpartinmobilephonetrainingreportlowerlevelsofdepressionandanxietyandembracemoreliberalbeliefsabout appropriatemobilephoneandinternetuse.Training-inducedimpactsonmentalhealthtookplacethroughtheCOVID-19pandemic,suggesting digitalconnectionmaybeprotectiveofmentalhealthincircumstanceswhenin-personinteractionsarecurtailed. ©2024AsianDevelopmentBankInstitute ISSN2411-6734 DOI:https://doi.org/10.56506/SIGV5974 ThisworkislicensedunderaCreativeCommonsAttribution-NonCommercial-ShareAlike4.0InternationalLicense. COVID-19,Isolation,andImprovingMentalHealththroughDigitalConnectedness ErikJorgensen,SeniorResearchandPolicyManager,InclusionEconomicsatYaleUniversity CharityTroyer-Moore,ScientificDirector,InclusionEconomicsatYaleUniversityAdenaSpingarn,CommunicationsConsultant,InclusionEconomicsatYaleUniversity 1.TheMentalHealthTollofthePandemic Globally,theCOVID-19pandemichadamassiveimpactonhealthandhumancapital.Datashowthatapproximately14.9millionliveswerelostin2020and2021alone(WHO2022),andmanymorewereinfected.Butevenascountriesaroundtheworldputinplacemeasurestomitigatethespreadofinfection,adifferenthealthconcernemerged.Isolation,socialdistancing,grief,incomeshocks,andotherCOVID-19-relatedtraumacontributedtowhatsomehavetermedthe‘silentpandemic’–thementalhealthtollsoftheCOVID-19pandemic,manifestedthroughincreasedfeelingsofanxiety,depression,insomnia,andrelatedissues.ZhangandChen(2021)showedthattheseimpactswerenotfeltequallyacrosstheglobe:SouthAsiaandLatinAmerica,forexample,hadsomeofthehighestprevalenceofmentalhealthproblems.Ameta-analysisof35studiesinSouthAsiafoundprevalenceratesofdepressionandanxietyof41%and34%,respectively(Hossainetal.2021).InIndia,Singh,Bajpai,andKaswan(2021)alsofoundhighlevelsofinsomniaanddistress(27%and43%,respectively).Theseratesareparticularlyhighcomparedtoanalysesthatfoundlowerratesofdepression(16%)andanxiety(22%)inSoutheastAsia(Pappaetal.2022).WithinIndia,someevidencesuggeststhatcontainmentmeasuresduringthepandemicresultedinadeclineinmentalhealthforwomen,especiallythosewithdaughtersorlivinginfemale-headedhouseholds(Bauetal.2022),manyofwhomalreadyfacedmobilityrestrictionsandmorelimitedsocialnetworksduetopervasivegendernorms(Jayachandran2021;Fieldetal.2016).Forexample,evenpriortothepandemic,nationalsurveydatashowthat60%ofwomenfromIndiawerenotallowedtotravelalonetoplacessuchasthemarketorhealthclinic(IIPSandICF2017)whileAndrewetal.(2020)foundthattheaveragemotherinruralOrissaonlyhadoneconnectionwithwhomshecouldtalkaboutpersonalissues. 2.PolicyAvenuestoAddresstheTollofthePandemic Toalleviatesomeoftheimmediateeconomicburdensofthepandemic,manycountriesmademajorinvestmentsinsocialprotectionsystems,increasingspendingby270%betweenDecember2020andMay2021(UNDESA2021).Socialprotection,andpovertyalleviationprogramsmoregenerally,havebeenshowntobenefit thementalhealthofvulnerablemembersofsociety.Ridleyetal.(2020)showhowcashtransfersreducedtheincidenceofsuicideinIndonesiaandimprovedmentalhealthinKenyaforatleast3yearsaftertransfersended.Meanwhile,inIndia,graduationprograms,whichseektobreakpovertytrapsthroughamultifacetedinterventionaddressingmultipledimensionsofpoverty,wereshowntohavelong-lastingeffectsonreducingmentaldistress.However,theseprogramsareextremelyresource-intensive,makingthemdifficulttoimplementatscale. Somelow-incomecountrieshaveattemptedtoaddressmentalhealthcrisesdirectlybyemployinglast-mile,informalmentalhealthworkers,suchasZimbabwe’sFriendshipBenchprogram.Whilepreliminaryevidenceshowsthattheseinterventionsholdpromise(Chibandaetal.2016),theyhaveyettobescaledwidely,andmanycountrieshavestruggledtoaddresstheriseinmentalhealthdisordersinthewakeoftheCOVID-19shock—achallengedue,inpart,toinsufficientfinancingandserviceavailabilityformentalhealthcare.AllcountriesinSouthAsia,forexample,spentbelowtheglobalmedianof2%ofgovernmenthealthbudgetsonmentalhealth(MiaandGriffiths2022).Giventhelowlevelofpublicinvestmentinmentalhealthcarefinancingduringandafterthepandemic,governmentswouldbenefitfromothertoolstoimprovementalhealth.Inthispolicybrief,welookatacasestudythatshowshowmentalhealthissuescanbeaddr
