Title : Economic hardship and mental health outcomes among families affected by the 2022 Sri Lankan economic crisis

The 2022 Sri Lankan economic crisis resulted in severe financial hardship, which disproportionately affected low-income households and ethnic minority communities. This led to increased mental health problems, like depression and anxiety, exacerbated by culturally embedded stigma toward help-seeking behavior and a healthcare system with few mental health experts. The Social Determinants of Health (SDH) framework shows how financial strain and poor healthcare cause harm to mental well-being, while the Conservation of Resources (COR) theory explains how loss of resources (material and financial), precipitates psychological distress. Little is known about how such families cope or find support during this crisis, making this study vital for planning effective solutions.

A survey of 141 Sri Lankan adults, mostly young (53.9% aged 25–34) and from diverse groups (36.4% Indian Tamil), was conducted using community-based purposive and snowball sampling strategies. Tools like the PHQ-9 for depression and GAD-7 for anxiety measured mental health. The survey instrument assessed financial strain, coping behaviors, and sources of perceived support. Statistical tests (Chi-square, p < .05) examined bivariate associations between mental health, coping, and support.

Majority of the participants met criteria for severe depression (87.9%) and severe anxiety (88.7%), respectively. Financial problems, like job or income loss (88.1%) and high costs (86.7%), were major issues. Coping included prayer (55.2%) and exercise (55.2%), but also avoidance-oriented coping like ignoring problems (54.3%) and substance use (42.4%). Peer networks (59.5%) digital support platforms (53.8%) helped the most, while government-provided assistance was often perceived as unhelpful (7.6%). Depression was strongly tied to support from friends (χ² = 202.023, p < .001) and family (χ² = 160.637, p < .001). Anxiety was linked to talking with others (χ² = 152.597, p < .001) and spiritual practices (χ² = 127.416, p < .001).

The crisis caused a major mental health emergency which was mitigated by peer support and healthy coping but worsened by systemic deficiencies in government and healthcare infrastructure. Solutions should include financial aid, community mental health programs, and online support, which are tailored to diverse groups. Longitudinal prospective studies are needed to create fair, effective plans.

Keywords: Sri Lanka, economic crisis, mental health, depression, anxiety.

Dr. Sainudeen Marikkar Mohamed Shakeek Haksathul Nazreen is a medical doctor who graduated from Russia and has worked as both a clinician and medical researcher in Sri Lanka. She holds a Master of Public Health (MPH) from the United Kingdom and is a Member of the Royal Society for Public Health. She serves as Vice President of the Master of Public Health programme and as a Trustee of the Sheffield Occupational Health Advisory Service (SOHAS). Dr. Nazreen also holds diplomas in Special Needs Education and Psychology from Sri Lanka. Her interests include public health, health promotion, research, and advancing population health through evidence-based practice and community engagement.