In Part 1 of our COVID-19 and well-being study published on 4 March 2021, we found that more than half of surveyed respondents reported experiencing worsened mental well-being over the past year. Women and people under 35 years old were the most impacted by negative mental health within this period, a finding in line with global studies. Part 1 also showed a clear relationship between physical and mental well-being; those who reported worsened mental well-being over the past year were more likely to also report worsened physical well-being.

In this Part 2 of the research series, we explore the impact of the ‘new normal’ living conditions on mental health. In particular, we found that the number of people you live with and the frequency of working from home have a significant effect on a person’s mental health.

Note: Respondents’ mental health or well-being was measured against their responses to the DASS-21 questionnaire. For more details on how the DASS-21 questionnaire was applied, as well as the study’s overall methodology, please refer to Part 1.

Living Alone and Mental Well-being

Overall, respondents living alone experienced worse mental well-being compared to those who live with others (Figure 1). A high proportion, 78%, of those who live alone reported levels of depression compared to 52%-60% of those who live with others. In terms of severity, 38% of those living alone reported severe and extremely severe depression compared to a lower 23%-28% of those living with others.

The pattern is similar for stress; 60% of those living alone self-reported varying levels of stress compared to 32%-46% of those who live with others. In terms of severity, 28% of respondents living alone experienced severe and extremely severe stress compared to 13%-20% of those living with others.

Notably, this pattern is slightly different for anxiety. In terms of overall incidence, respondents who live alone do not appear to show significantly higher levels of anxiety compared to respondents who live with others. In terms of severity, however, respondents who live alone do show higher levels of severe and extremely severe anxiety at 44%, compared to 24%-33% of those who live with others.

Figure 1: Number of People in Household and Mental Well-being

These findings are consistent with global studies that have found correlations between living alone and psychological distress. The American Psychological Association (APA) attributes this to social isolation, which has been found to have very real health implications such as the increased risk of heart disease and amplified depression.

It is important to note that living alone does not necessarily mean one would experience loneliness or social isolation, but it may present greater mental health risks for certain groups. In sociologist Eric Klinenberg’s study of social isolation and the impact on public health, he found that demographic groups such as men, the elderly, and low-income communities who live alone are more at risk of feeling isolation or loneliness.

Work from Home Frequency and Well-being

When the Movement Control Order (MCO) started last year, the government reported that 33.5% of Malaysian workers began working from home. This change in working mode for many Malaysians has evidently had an effect on workers’ mental well-being (Figure 2). Respondents to our study who work from home every day reported higher depression and stress scores compared to those who work less days from home or who do not work from home at all.

64% of respondents who work from home every day reported levels of depression compared to 53%-55% of those who work from home less frequently or not at all. In terms of severity, 30% of respondents who work from home daily reported severe and extremely severe depression compared to 20%-26% of respondents who work from home less frequently or not at all.

The pattern is similar for stress where 50% of those who work from home every day reported levels of stress compared to 35%-38% of respondents who work from home less frequently or not at all. In terms of severity, however, the differences in severe stress levels between respondents who work from home daily compared to those who work from home less frequently are less marked.

The differences in incidences of anxiety, between those who work from home daily compared to those who work from home less frequently or not at all, is marginal. As with the findings on living alone and anxiety outlined above, similarly here, anxiety is potentially driven more by factors other than working from home arrangements.

Figure 2: Work From Home Frequency and Mental Well-Being

What are the challenges of working from home every day? Singaporean psychologist Jeanette Lim shared that during the COVID-19 pandemic, there was an observable trend of mental health issues stemming from overworking and isolation as a result of working from home. Although working from home may be preferred by some workers, the mental health effects of working from home will need to be a key consideration as companies and the government weigh on policies allowing for flexible working arrangements post-pandemic.

Policy Considerations

The findings above point to the effects of social isolation on Malaysians’ mental health over the past year, as represented by the depression and stress levels of those living alone and those working from home on a daily basis. While other factors also contribute to one’s mental health, the importance of social interaction in daily life may be under-estimated relative to more visible factors, like employment or income changes.

In recent years, mental health in general has been widely discussed by the government, mental health NGOs and public figures. However, in order to address the particular mental health effects of the past year under COVID-19, there should be more awareness amongst policymakers and the general public around specific and unseen risks such as social isolation. Initiatives such as public campaigns could inform the public on ways to deal with social isolation, such as reminding individuals who live alone to keep in touch with their loved ones or to seek social interactions in their communities, while abiding to pandemic-related SOPs.

Public health campaigns should also extend to companies to educate them on the challenges of working from home daily. While companies could endorse flexible working arrangements, further support should be given, for example by instituting policies or practices that support regular checks and maintenance of employee well-being.

Apart from public and corporate awareness on social isolation, there should also be more physical spaces that promote being outside and enable safe social interactions. In an editorial published last year, we discussed a rethinking of urban spaces to accommodate for mental well-being, particularly pro-social spaces such as neighbourhood futsal courts that improve the physical lifestyles and relationships in the communities they are built in.

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In the final and third part of our study, we will present our findings on how COVID-19’s impact on the financial and employment situations of many Malaysians has affected their mental well-being.

If you are experiencing emotional or mental health difficulties, get support and help on these hotlines: Mercy Malaysia and the Ministry of Health Crisis Preparedness and Response Centre’s psychosocial support hotline at 03-29359935. Ministry of Women and Family Development’s Talian Kasih hotline at 15999 or WhatsApp 019-2615999.