Intention to seek mental health services during the 2022 Shanghai COVID-19 city-wide lockdown (Preprint)

Abstract

Background: The implementation of COVID-19 lockdown measures had immediate and delayed psychological effects. From March 27 to June 1, 2022, the Shanghai government enforced a city-wide lockdown that affected 25 million residents. During this period, mental health services were predominantly provided through digital platforms. However, limited knowledge exists regarding the general population's intention to use mental health services during this time.

Objective: This study aimed to assess the intention of Shanghai residents to use mental health services during the 2022 Shanghai lockdown and identify factors associated with the intention to utilize mobile mental health services.

Methods: An online survey was distributed from April 29 to June 1, 2022, using a purposive sampling approach across 16 districts in Shanghai. Eligible participants were adults over 18 years of age who were physically present in Shanghai during the lockdown. Multivariable logistic regression was used to estimate the associations between demographic factors, lockdown-related stressors and experiences, physical and mental health status, and study outcomes –mobile mental health service use intention (mobile applications and/or WeChat Mini Programs).

Results: The analytical sample comprised 3230 respondents, among whom 29.7% (weighted percentage, 1030) screened positive for depression and/or anxiety based on the nine-item Patient Health Questionnaire or the seven-item Generalized Anxiety Disorder Scale. Less than one fourth of the respondents (24.4%, 914) expressed an intention to use any form of mental health services, with mobile mental health service being the most considered option (19.3%, 728). Only 10.9% (440) used digital mental health services during the lockdown. Factors associated with increased odds of mobile mental health service use intention included being female, being employed, being a permeant resident, experiencing COVID-related stressors (such as loss of income, food insecurity, and traumatic experiences), and having social and financial support. Individuals with moderate or severe anxiety, as well as those with comorbid anxiety and depression, demonstrated a higher intention to use mobile mental health services. However, individuals with depression alone did not exhibit a significantly higher intention compared to those without common mental disorders.

Conclusions: Despite a high prevalence of common mental disorders among Shanghai residents, less than one-fourth of the study respondents expressed an intention to use any form of mental health services during the lockdown. Mobile applications and/or WeChat Mini Programs were the most considered mental health service formats. The study provided insights for developing more person-centered mobile mental health services to meet the diverse needs of different populations.

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