Institutional trust, mental distress increase in New Zealand following COVID-19 lockdown
Individuals were more likely to report institutional trust, as well as increased psychological distress, after the COVID-19 pandemic than before, according to a survey study conducted in New Zealand and published in American Psychologist.
“At the start of the pandemic, things moved very quickly in New Zealand, as they did around the world," Chris Sibley, PhD, of University of Auckland, and Fiona Kate Barlow, PhD, of University of Queensland, told Healio Psychiatry. "We thought it was important to provide rapid-turnaround, high-quality data on how New Zealanders were holding up under lockdown, their levels of mental health and also their levels of trust in police, politicians and satisfaction with government. We have never seen anything like this before, and so data on how people would react were very limited. Our results showed that, in New Zealand, under the conditions of a strong and cohesive national response, people were more likely to lean on and trust their politicians, scientists, police and communities and ultimately more likely to comply with the lockdown and health guidelines.”
Sibley, Barlow and colleagues sought to determine the immediate effects of a nationwide lockdown as a pandemic response. They analyzed 20-year longitudinal survey data on social attitudes, personality and health outcomes of approximately 60,000 New Zealand citizens who were included in the New Zealand Attitudes and Values Study. The latest data for that study were being collected when the country initiated its lockdown. In the 18 days following lockdown, 1,003 participants had responded to the survey.
Sibley, Barlow and colleagues examined institutional trust and attitudes toward the nation and government, as well as health and well-being, and applied propensity score matching to approximate the conditions of a randomized controlled experiment. They compared responses after the pandemic to those from the same number of individuals who responded before the pandemic, controlling for similar demographic and lifestyle variables, including age, gender, ethnicity, mental health diagnosis and smoking behavior.
Results showed those in the post-lockdown group reported higher trust in science, politicians and police, as well as higher levels of patriotism. The post-lockdown group also reported “slightly higher levels of psychological distress,” Sibley said in the release. Among the pre-lockdown group, 77.1% of participants reported no distress, 16.2% reported moderate distress and 6.6% reported serious distress. Among the post-lockdown group, 73.5% reported no distress, 21.1% reported moderate distress and 5.8% reported serious distress.
"Internationally, we hope that our results from New Zealand will help contribute, along with results reported by other researchers in other countries, to inform a plan for what to do in the event of the next global crisis," Sibley and Barlow told Healio Psychiatry. "For example, we should anticipate that well-being will deteriorate, and we should build mechanisms to provide support for those most affected.”
Perspective
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This study by Sibley and colleagues provides a thoughtful analysis of various factors before and during the COVID-19 pandemic. Although the study was not designed to specifically evaluate the effects of the pandemic, COVID-19 provided a sort of “natural experiment.”
As a U.S. physician, I cannot help but think of how individuals in the U.S. would respond to this survey. At baseline, U.S. citizens compared with citizens of New Zealand reported lower satisfaction and confidence in the national government (31% vs. 64%), police (79% vs. 83%), judicial system (53% vs. 64%), education system (64% vs. 71%) and health care (76% vs. 83%), according to a Gallup World Poll and OECD Fact Sheet. The Pew Research Center reported that public trust in the U.S. government is near historic lows. It is not a leap to imagine that these baseline characteristics would affect a U.S. version of this survey.
The crux of this study may lie in one word: Trust. Trust in the institutions (eg, government, public health, military) that we depend on in challenging times. Trust that our government will seek the counsel of experts to create a plan. Trust that, despite a crisis, there is a path forward.
It is understandable that people in a lockdown would report higher levels of psychological distress. The authors report that the levels of psychological distress were “slightly higher” than before the pandemic. This magnitude is important to note. Contrast this with two surveys conducted by the U.S. Census Bureau and Mental Health America of individuals in the U.S. that show dramatic increases in symptoms of depression and anxiety during the pandemic. It is plausible that the trust demonstrated in the New Zealand study toward science, politicians and police was not present in the U.S. during the pandemic. Since psychological distress may represent a symptom of mistrust and lack of confidence in institutions, we can therefore explain the rise in symptoms of depression and anxiety in the U.S.
During the pandemic, various U.S. news outlets praised New Zealand’s response to COVID-19. The Atlantic published a story titled, “New Zealand’s Prime Minister May Be the Most Effective Leader on the Planet.” In contrast, the U.S. response has been fraught with political battles, misinformation and even protests. Now, amid massive nationwide protests of police violence and racism following the deaths of Ahmaud Arbery, George Floyd, Breonna Taylor and others, the U.S. landscape appears even more different than the one found in New Zealand.
In a time of crisis, we look for inspiration and stability to guide us forward. This study provides evidence that institutions in New Zealand have earned the trust and support of its citizens, which, as the authors suggest, “buffer the effects of stress and help people cope with challenges at both a psychological and physical level.” As this pandemic unfolds, it will be important to expand on this data and continue studying the effects of COVID-19 on individual mental health, physical health and the health of a country. From that, we can use our resources to guide an effective and equitable response. We cannot change the past, but we can learn from history and chart a new course forward.
References:
OECD. Government at a glance 2019: New Zealand. http://www.oecd.org/gov/govataglance.htm. Accessed June 10, 2020.
OECD. Government at a glance 2019: United States. http://www.oecd.org/gov/govataglance.htm. Accessed June 10, 2020.
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