Clinical, Financial and Social Impacts of COVID-19 and Their Associations with Mental Health for Mothers and Children Experiencing Adversity in Australia (preprint)

ABSTRACT

Background Australia has maintained low rates of SARS-COV-2 (COVID-19) infection, due to geographic location and strict public health restrictions. However, the financial and social impacts of these restrictions can negatively affect parents’ and children’s mental health. Families who were already experiencing adversity before the COVID-19 pandemic are likely to be disproportionately affected. In an existing cohort of mothers recruited for their experience of adversity, this study examined 1) families’ experiences of the COVID-19 pandemic and public health restrictions in terms of clinical exposure, changes to financial circumstances, financial hardship, family stress, and family resilience (termed ‘COVID-19 impacts’); and 2) associations between these COVID-19 impacts and maternal and child mental health.Methods Participants were mothers recruited during pregnancy (2013-14) across two Australian states (Victoria and Tasmania) for the ‘right@home’ trial. A COVID-19 survey was opportunistically conducted from May-December 2020, when children were 5.9–7.2 years old. Mothers reported COVID-19 impacts (drawn from the Coronavirus Health and Impact Survey (CRISIS), Australian Temperament Project, and Household, Income and Labour Dynamics in Australia Survey); their own mental health (Depression, Anxiety, Stress Scales short-form) and their child’s mental health (CRISIS subscale). Associations between COVID-19 impacts and mental health were examined using regression models controlling for pre-COVID-19 characteristics.Results 319/406 (79%) mothers completed the COVID-19 survey. Only one reported having had COVID-19. In contrast, self-quarantine (20%), financial changes (job/income loss (27%)) and family stress (e.g., difficulty managing children’s at-home learning (40%)) were high. Many mothers also reported family resilience (e.g., family found good ways of coping (49%)). COVID-19 impacts associated with poorer mental health (all standardised coefficients) included self-quarantine (mother β = 0.48, child β = 0.47), financial hardship or change (mother β = 0.27, child β = 0.37) and family stress (mother β = 0.49, child β = 0.73). Family resilience was associated with better mental health (mother β=-0.39, child β=-0.47).Conclusions The financial and social impacts of Australia’s public health restrictions have substantially affected families experiencing adversity, and their mental health. Unless these impacts are addressed, the inequities arising from adversity are likely to be exacerbated. To recover from COVID-19, policy investment should include income support and universal access to family health services.