'A lot of small things make a difference'. Mental health and strategies of coping during the COVID-19 pandemic.

ABSTRACT

INTRODUCTION: The social and economic consequences of COVID-19 have the potential to affect individuals and populations through different pathways (e.g., bereavement, loss of social interaction). OBJECTIVE: This study adopted a solicited diary method to understand how mental health was affected during England's first lockdown. We also considered the experiences of diary keeping during a pandemic from the perspective of public participants. METHODS: Fifteen adults older than 18 years of age were recruited from northwest England. Diarists completed semistructured online diaries for 8 weeks, which was combined with weekly calls. A focus group captured participants' experiences of diary keeping. FINDINGS: Four key factors influenced mental health, which fluctuated over time and in relation to diarists' situations. These concerned navigating virus risk, loss of social connections and control and constrictions of the domestic space. Diarists also enacted a range of strategies to cope with the pandemic. This included support from social networks, engagement with natural environments, establishing normality, finding meaning and taking affirmative action. CONCLUSION: Use of diary methods provided insights into the lived experiences of the early months of a global pandemic. As well as contributing evidence on its mental health effects, diarists' accounts illuminated considerable resourcefulness and strategies of coping with positive effects for well-being. While diary keeping can also have therapeutic benefits during adversity, ethical and practical issues need to be considered, which include the emotional nature of diary keeping. PUBLIC CONTRIBUTION Members of the public were involved in interpretation of data as well as critiquing the overall diary method used in the study.