This Too Shall Pass: Measuring the Effect of COVID-19 Lockdowns on Mental Health, Healthcare & Substance Use

Abstract

The COVID-19 pandemic led to unprecedented public health restrictions. Using difference-in-differences and event study analysis, I evaluate the impacts of lockdown orders at the state and metropolitan area level using Google Trends and the Household Pulse Survey. I find that the first wave of lockdown impositions in early 2020 has insignificant effects on anxiety, depression, reported counseling usage, and interest in substance misuse treatment, but that interest in therapy, drinking, and smoking decline. Lifting the first lockdown reduces anxiety and depression and increases interest in therapy and substance misuse treatment. Subsequent re-lockdowns significantly increase reported anxiety and depression. I argue that many of these effects may be because lockdowns decrease social activity, which may contribute to worse mental health and less interest in some kinds of substance use. At the same time, lockdowns may also deter people from seeking out mental healthcare and substance misuse treatment, suggesting that the transition of these services to telehealth delivery may not have been entirely successful. These results begin to offer a fuller picture of the long-term implications of lockdown policies on mental health.