Abstract
OBJECTIVE: The COVID-19 pandemic and associated restrictive measures affected the mental health and well-being of individuals globally. We assessed non-modifiable and modifiable factors associated with the change in well-being and mental health from before to during the COVID-19 pandemic in South Africa. METHODS: A cross-sectional online survey was conducted from 26 April, 2020, to 22 April, 2021. Paired samples t-tests were conducted to assess change in well-being (measured on The World Health Organization-Five Well-Being Index (WHO-5)) and mental health (a validated composite psychopathology p-score). Sociodemographic, environmental, clinical, and behavioural factors associated with change in outcomes were examined. RESULTS: The sample comprised of 1866 adults (M age = 44.26 ± 17.36 years, female = 78.9%). Results indicated a significant decrease in well-being (p < 0.001) and increase in p-score (p < 0.001) from before to during the pandemic. Having a prior mental health condition was associated with a worsening well-being score, while being female was associated with a worsening p-score. Being of Black African descent was associated with improved p-score and higher socio-economic status (SES) was associated with improved well-being. Factors associated with worsening of both well-being and the p-score included adulthood adversity, financial loss since COVID-19, and placing greater importance on direct contact/interactions and substance use as coping strategies. Higher education level and endorsing studying/learning something new as a very important coping strategy were associated with improved well-being and p-score. CONCLUSION: Findings inform the need for targeted interventions to reduce and prevent adverse well-being and mental health outcomes during a pandemic, especially among vulnerable groups.