Under COVID-era stay-at-home orders, household conflicts had direct link to poor mental health

A study by the UCLA FSPH Center for Health Policy Research found that adults in California who had financial or child care difficulties due to COVID-19 in 2020 experienced an increase in household conflict during the statewide stay-at-home orders.

The research also found that among adults with serious or moderate psychological distress, those who experienced an increase in household conflict during 2020 were also likelier to have their everyday lives negatively impacted, particularly their social life and personal relationships.

The findings are based on data from the 2020 California Health Interview Survey.

When the stay-at-home orders forced businesses, child care centers and schools to close or operate online only, millions of Californians lost critical sources of income or were forced to stay home to care for their children. The new study reports that state residents who faced those types of economic hardships were more likely to report that they experienced an increase in interpersonal conflict in the home — including yelling at or engaging physically with another member of the household.

Overall, 12% of adults in the survey reported experiencing serious psychological distress and 11% reported moderate psychological distress during 2020. But the incidence of serious distress was much greater — 60% — among those who said they experienced an increase in physical confrontations.

“If untreated or undertreated,” according to the report, “ongoing mental health issues can often interfere with or limit a person’s ability to function in their day-to-day life.”

The study found that adults with serious psychological distress or moderate psychological distress who experienced an increase in physical conflicts during stay-at-home orders experienced a higher risk of severe impairment to their social lives and personal relationships. Among all adults with serious or moderate psychological distress, 42% said their social lives were adversely affected and 34% said their personal relationships were adversely affected. But among respondents with serious or moderate psychological distress who also experienced an increase in physical conflicts, those figures were significantly higher: 93% said their social lives were hurt and 93% said their personal relationships suffered.

Therefore, the findings suggest, state policymakers must continue to address the mental health impact of the pandemic, including by removing barriers to mental health care, said Imelda Padilla-Frausto​, lead author of the study, a research scientist at the center, and a UCLA Fielding alum.

“Mental health recovery from the pandemic begins when equitable policies are made to address the social and economic crises of the pandemic,” Padilla-Frausto said, adding that that the pandemic’s effects on mental health and on people’s social lives and personal relationships will be felt for years to come.

The authors also found that 39% of adults who had difficulty finding or affording child care during the stay-at-home orders reported an increase in snapping or yelling, while 23% of adults who had difficulty paying their bills or affording groceries, school tuition and other basic expenses, and 20% of adults who could not pay for their rent or mortgage said the same. Among adults who did not face similar financial or child care difficulties, just 12% reported that they experienced more interpersonal conflict in the home.

“We know that the COVID-19 pandemic had a tremendous impact on mental health over the last three years,” Padilla-Frausto said. “However, this study takes a deeper dive into how increases in household conflict during the pandemic stay-at-home orders were more pronounced among adults who had difficulties with childcare or had financial stressors, and how they were associated with poor mental health and severe impairment in daily life.

“In addition to ensuring access to care and addressing the social and economic crises left in the wake of the pandemic, strengthening family and community relationships can be an important buffer during times of crisis as well as during times of healing and recovery.”

The authors write that equitable social, political and economic changes are needed to help Californians who were financially disadvantaged by the pandemic — and especially for marginalized communities who were already experiencing financial strain before COVID-19 emerged.​

By Vanessa Villafuerte for UCLA FSPH Center for Health Policy Research