Special Report – Mental health impact could be “pervasive and prolonged”

When the pandemic passes and everything goes back to ‘normal’, mental damage will remain, experts warn.

MB January 2021 Special Report | The COVID-19 year


A large Internet survey with over 52,000 responses from 36 regions of China, including Macau and Hong Kong, reported that, overall, 35 per cent of respondents were experiencing COVID-19 related psychological distress.

Although this impressive number deserves some reservations from the scholars with whom Macau Business spoke (*), the truth is that it cannot be ignored that the pandemic situation has not only left economic consequences, for instance, but that there are also impacts to mental health.

“There is no doubt that the social and psychological consequences of pandemic go far beyond economic issues,” states Jianhua Xu, head of the Department of Sociology at the University of Macau. 

“Due to the pandemic, many people suffer from mental health problems at different levels. These may be caused by quarantine, by the fear of losing jobs, by social distance, and by travel restrictions (particularly those for whom regular cross-board travelling was part of their daily lives),” an adjunct professor at the Centre for Macau Studies also said.

Another characteristic that experts have identified from the existing literature regarding the psychology of pandemics: “It appears that the mental impact of the pandemic usually tends to be more widespread and long-lasting than its direct physical effects because the latter may only inflict those infected, whereas the former can affect the public in general and on a global level,” explains Juliet Chan, postdoctoral associate, Department of Psychology, University of Macau. “The occurrence of these mental impacts may occur in waves and not necessarily synchronized with the outbreaks of the pandemic.”

Juliet Chan is involved in several studies that aim to understand the scale of the pandemic’s impact on mental health.

A first-published study indicated, among other findings, “Some of the precautionary measures against the pandemic, such as social distancing and working from home, may have triggered some lifestyle-changing stressors, including increased family conflicts, friendship deterioration, and weight gain, and these emerging stressors are found to be associated with a higher level of mental distress.”

Another study “discovered that there are twice as many people who reported dysfunctional COVID-19 thinking patterns than those who reported dysfunctional COVID-19 anxiety,” Juliet Chen confided to Macau Business.

Even so, and it is important to highlight this fact, these studies are precocious and do not allow definitive conclusions to be drawn. “We have to wait for the data from our ongoing longitudinal studies to make more conclusive claims. A prudent recommendation at this moment from our existing data is that the pandemic has created new stressors and challenges to people’s mental health, directly and indirectly, and we cannot rule out the possibility that this effect would be pervasive and prolonged. People can [suffer] under both direct and indirect mental impacts under the pandemic and even in a post-pandemic era,” Ms Chen added.

(* The study in question, a nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations, was carried out between January and February last year, at a very early stage of the pandemic. The English version is only two pages and does not provide data by region. Macau Business contacted one of the 6 authors, all from Shanghai, but did not receive answers to the questions raised.)

“There are twice as many people who reported dysfunctional COVID-19 thinking patterns than those who reported dysfunctional COVID-19 anxiety” – Juliet Chen


“Stigma and discrimination”

“Pandemic has caused various stigma and discrimination to many populations,” states Jianhua Xu, department head in the Department of Sociology at the University of Macau. Together with a group of students, Professor Xu just finished a paper entitled Stigma, discrimination and hate crimes in Chinese-speaking world amid COVID-19 pandemic.

Professor Xu shared with Macau Business readers the first findings of the research: “the COVID-19 pandemic has given rise to stigma, discrimination and even hate crimes against various populations in the Chinese language speaking world.”

“We found that at the early stage of the pandemic, stigma was inflicted by the non-Hubei Chinese population onto Wuhan and Hubei residents, by some Hong Kong and Taiwan residents onto mainland Chinese, and by some Westerners onto overseas Chinese. With the number of cases outside China surpassing that in China, stigmatisation was imposed by the Chinese onto Africans in China,” reads the paper. “We further explore how various factors, such as the fear of the disease, food and mask culture, political ideology and racism, affected the stigmatisation of different victim groups.”

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