Mental health during and after protests, riots and revolutions: A systematic review

Abstract

Objectives: Protests, riots and revolutions have long been a part of human history and are increasing globally, yet their impact on mental health remains largely unknown. We therefore systematically reviewed studies on collective actions and mental health. Method: We searched PubMed, Web of Science, PsycINFO and CINAHL Plus for published studies from their inception until 1 January 2018. Study quality was rated using the Newcastle–Ottawa Scale. Results: We identified 52 studies ( n = 57,487 participants) from 20 countries/regions. The prevalence of post-traumatic stress disorder ranged from 4% to 41% in riot-affected areas. Following a major protest, the prevalence of probable major depression increased by 7%, regardless of personal involvement in the protests, suggestive of community spillover effects. Risk factors for poorer mental health included female sex, lower socioeconomic status, exposure to violence, interpersonal conflicts, frequent social media use and lower resilience and social support. Nevertheless, two studies suggested that collective actions may reduce depression and suicide, possibly due to a collective cathartic experience and greater social cohesion within subpopulations. Conclusion: We present the first systematic review of collective actions and mental health, showing compelling evidence that protests even when nonviolent can be associated with adverse mental health outcomes. Health care professionals therefore need to be vigilant to the mental and psychological sequelae of protests, riots and revolutions. Further research on this emerging sociopolitical determinant of mental health is warranted.

Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic

“…Findings from a 2014 review 3 on trauma and mental health suggest that depression increases during and after traumatic events; our study adds to this literature. A 2020 study by Ni et al 8 analyzed depression symptoms before and after political unrest in Hong Kong using the same measure of depression symptoms we deployed in this study. They reported national depression symptoms prevalence before the unrest to be 6.5% (compared with 8.5% in our pre–COVID-19 US sample) and 11.2% in 2019 during unrest (compared with 27.8% in our during–COVID-19 sample).…”

“…Data from Hong Kong show greater levels of depression, anxiety, and psychological distress during the 2019 Hong Kong civil protests. 8 , 9 …”

Financial hardship and health risk behavior during COVID-19 in a large US national sample of women

“…These events will have implications for the health of populations for years to come. In addition to the physical health burden from COVID-19, mental health problems and stress are and will continue to be substantially elevated during and after the pandemic, as suggested by emerging studies ( Brooks et al, 2020 ; Cao et al, 2020 ; Czeisler et al, 2020 ; Ettman, Abdalla, et al, 2020 ; Lai et al, 2020 ; Liu et al, 2020 ; Wang et al, 2020 ), data from prior pandemics ( Hawryluck et al, 2004 ; Jalloh et al, 2018 ; Ko et al, 2006 ), and other types of widespread mass traumatic events ( Galea et al, 2002 ; Goldmann & Galea, 2014 ; Ni et al, 2020 ; Silver et al, 2002 ).…”

Vicarious trauma, social media and recovery in Hong Kong

“…An individual may seek and receive high quality mental health support but additional attention must be directed towards the reforming of community. As noted by Ni et al, (2020), even though social unrest is a part of human history, limited research has been conducted into the effects on community-level mental health. Our early findings suggest that the rapid provision of counselling services that reflect linguistic and cultural diversity, opportunities to talk about the significance of events with others familiar with the setting, as well as using social media channels to rebuild a sense of community offer ways forward.…”