Long-term trajectories of mental health in Australia through COVID-19: Assessing distress and quality of life in priority populations

Purpose The COVID-19 pandemic significantly impacted mental health, particularly in individuals with pre-existing conditions and in younger people. However, long-term mental health trajectories beyond the acute phase remain unclear. This study examined distress levels and quality of life (QoL) in individuals with mental and/or physical health conditions, and across different age groups between 2020 and 2024. Methods Using data from the COLLATE project – a series of online mental health surveys of the Australian public – we conducted general linear models to assess demographic parameters and risk factors associated with distress and QoL in 2,134 participants. Major Findings Mental and physical health conditions were associated with higher distress and lower QoL throughout 2020 to 2024. Having both conditions had a compounding effect on QoL but not distress, which was primarily influenced by mental health conditions. Younger people reported higher distress across this period. Overall, QoL was lower in 2024 than 2020. Conclusion Poorer mental health in those with mental and physical health conditions, and younger age groups, persisted from 2020 to 2024. This is concerning considering extensive literature demonstrating disproportionately greater impacts of COVID-19 on the mental health of priority populations and highlights groups that may require ongoing psychosocial support.