Background The COVID-19 pandemic triggered vast governmental lockdowns. The impact of these lockdowns on mental health is inadequately understood. On the one hand such drastic changes in daily routines could be detrimental to mental health. On the other hand, it might not be experienced negatively, especially because the entire population was affected. Methods The aim of this study was to determine mental health outcomes during pandemic induced lockdowns and to examine known predictors of mental health outcomes. We therefore surveyed n = 9,565 people from 78 countries and 18 languages. Outcomes assessed were stress, depression, affect, and wellbeing. Predictors included country, sociodemographic factors, lockdown characteristics, social factors, and psychological factors. Results Results indicated that on average about 10% of the sample was languishing from low levels of mental health and about 50% had only moderate mental health. Importantly, three consistent predictors of mental health emerged: social support, education level, and psychologically flexible (vs. rigid) responding. Poorer outcomes were most strongly predicted by a worsening of finances and not having access to basic supplies. Conclusions These results suggest that on whole, respondents were moderately mentally healthy at the time of a population-wide lockdown. The highest level of mental health difficulties were found in approximately 10% of the population. Findings suggest that public health initiatives should target people without social support and those whose finances worsen as a result of the lockdown. Interventions that promote psychological flexibility may mitigate the impact of the pandemic.

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As the novel coronavirus disease 2019 (COVID-19) pandemic continues, engaging the public in adherence to precautionary measures for preventing COVID-19 spread or infection becomes difficult. The present study aims to extend our understanding of how illness perceptions, coping, and self-efficacy affect adherence to precautionary measures among the public. An online survey was administered between April and June 2020 to a sample of 514 Hong Kong citizens. Variables considered were illness perceptions toward COVID-19, problem-solving, avoidance-based coping, self-efficacy, as well as adherence to precautionary measures including physical distancing, limiting unnecessary travelling, and washing hands regularly with soap and water. Adjusted structural equation model showed that illness perceptions toward COVID-19 had significant direct effect on their adherence to precautionary measures (unstandardized β = 0.50, [95% CI, 0.28, 0.80], p = 0.001), and indirect effects through avoidance-based coping (β = −0.10 [95% CI, −0.26, −0.01], p = 0.016) and self-efficacy (β = −0.10, [95% CI, −0.18, −0.01], p = 0.025). These results imply that apart from emphasizing the health hazards of a novel infectious disease, an effective public health intervention and crisis communication should address avoidance-based coping and self-efficacy of the public in adherence to precautionary measures for COVID-19.

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