The Impact of COVID-19 Lockdown Announcements on Mental Health: Quasi-Natural Experiment in Lombardy, Italy

Background: Evidence showed that mental health problems have risen markedly during COVID-19. It is unclear if part of the mental sufferings relates to the climate of uncertainty and confusion originated by rough communication by health officials and politicians. Here we test the impact of unanticipated policy announcements of lockdown policies on mental health of the older population. Methods: We used a representative telephone-based survey of 4,400 people aged 65 years or older in Italy's Lombardy region to compare information on self-reported symptoms of anxiety, depression, and poor-quality sleep of subjects interviewed on the days of policy announcement with that of subjects interviewed on other days. We used regression models adjusting for potential socio-demographic confounders as well study design with inverse probability weighting. Results: On days when policy makers announced to extend the lockdown, mental health deteriorated on average by 5.5 percentage points [95% CI: 1.1 to 9.8] for self-reported anxiety symptoms and 5.1 percentage points [95% CI: 2.7 to 7.4] for self-reported depressive symptoms. The effect of announcement to shorten the lockdown is more moderate but statistically significant. These associations were short term in duration; after just one day, self-reported mental health and sleep quality return to levels better than pre-announcement until a new policy change. Conclusions: Our research shows that lockdown policy announcements are associated with short term worsening in mental distress, highlighting the importance of appropriate communication strategies and political determinations in crisis times.