Capability impacts of the Covid-19 lockdown in association with mental well-being, social connections and existing vulnerabilities: an Austrian survey study

Simon, J.; Helter, T. M.; White, R. G.; van der Boor, C.; Laszewska, A.

Background: Impacts of the Covid-19 pandemic and its public health measures go beyond physical and mental health and incorporate wider well-being impacts in terms of what people are free to do or be. We explored these capability impacts of the Covid-19 lockdown in association with people's mental well-being, social support and existing vulnerabilities in Austria. Methods: Adult Austrian residents (n=560) provided responses to a cross-sectional online survey about their experiences during Covid-19 lockdown (15 March-15 April 2020). Instruments measuring capabilities (OxCAP-MH), depression and anxiety (HADS), social support (MSPSS) and mental well-being (WHO-5) were used in association with six pre-defined vulnerabilities using multivariable linear regression. Results: 31% of the participants reported low mental well-being and only 30% of those with a history of mental health treatment received treatment during lockdown. Past mental health treatment had a significant negative effect across all outcome measures with an associated capability well-being score reduction of -6.54 (95%CI: -9.26,-3.82). Direct Covid-19 experience and being "at risk" due to age and/or physical health conditions were also associated with significant capability deprivations. When adjusted for vulnerabilities, significant capability reductions were observed in association with increased levels of depression (-1.79) and anxiety (-1.50), and significantly higher capability levels (+3.77) were associated with higher levels of social support. Compared to the cohort average, individual capability impacts varied between -9% for those reporting past mental health treatment and +5% for those reporting one score higher on the social support scale. Conclusions: Our study is the first to assess the capability limiting aspects of a lockdown in association with specific vulnerabilities. The negative impacts of the Covid-19 lockdown were strongest for people with a history of mental health treatment. In future public health policies, special attention should be also paid to improving social support levels to increase public resilience.