The mental health of working women after the COVID-19 pandemic: an assessment of the effect of the rise in sexual harassment during the pandemic on the mental health of Pakistani women using DASS-21

INTRODUCTION: The mental health of South Asian women has been observed to be in regression lately, with sexual harassment as one of the major factors accounting for mental health deterioration, especially for women who leave their homes frequently for work and study. The COVID-19 pandemic not only augmented the mental health distress of the general female population but the rise in sexual violence against women is being consistently reported around the globe. Based on this background, we adopted a two-pronged strategy to assess whether working women and students aged 18–55 experienced a rise in sexual harassment in the 18 months after lifting the COVID-19 lockdowns. Secondly, using the well-validated psychometric test, DASS-21, we evaluated the psychiatric outcome of this change on the mental health of those women. STUDY DESIGN: The study was designed as a quantitative, cross-sectional survey-based research. METHODOLOGY: A total of 303 women participated in this study. Personal interviews through a specifically designed questionnaire and psychometric test DASS-21 were administered to assess the mental health state of working women and female students, aged between 18 and 55 years old. The mean age of the participants was 37 ± 2.8. The study population was further categorized into two main groups of limited and frequent interactions based on varying levels of the frequency of leaving home and interacting with male strangers in their daily routine. Data were analyzed and the correlation between limited/frequent interaction and DASS-21 total scores and sub-scores of depression, anxiety and stress, and other sociodemographic variables were investigated using the Chi-square test, whereas psychosocial predictors of mental distress were evaluated using multiple linear regression analysis after matching limited and frequent interaction groups using a 1:1 propensity score-matched pair method for sociodemographic covariates. RESULTS: Overall, approximately 50% of our study population experienced changes in the behavior of male strangers that could be categorized as harassment in their daily life interactions, whereas 33.66% of participants experienced relatively more sexual harassment post-pandemic than before it. This observation was significantly correlated with the frequency of male interaction (χ2 = 5.71, p < 0.01). Overall, 34% of our study population scored >60 on the DASS21-total score, whereas 29.04% scored >21 on the depression scale. Alarmingly, >40% of the women in the frequent interaction group scored in the extremely severe range of anxiety and depression. Moreover, in the regression analysis, out of all the factors analyzed, the extent of everyday interaction with male strangers, an increase in fear of sexual crimes, and a self-perceived increase in mental distress during the 18 months post-pandemic were found to be highly statistically significant predictors of mental distress not only for total DASS 21 but also for the sub-scales of depression, anxiety, and stress. CONCLUSION: In Pakistan, women experienced a rise in sexual harassment cases post–COVID–19. An increase in sexual harassment was found to be a predictor of negative mental health in the form of depression, anxiety, and stress.