Adults' and Older Adults' Mental Health During COVID-19 in Hong Kong: An Ecological Analysis of Family Resilience

Introduction: Based on an ecological model of resilience, this study aimed to identify common and differential ecological risk and protective factors influencing the psychological health of general adult population (aged 18-60) and older adults (older than 60) in Hong Kong during the COVID-19 pandemic. Method: A population-based random telephone survey was conducted in 2020, and 877 respondents in Hong Kong (308 older adults, i.e., older than 60; 569 adults, i.e., aged 18-60) were interviewed. Multiple group structural equation modeling was used to examine the proposed model. Results: Chinese older adults in Hong Kong reported significantly lower levels of psychological distress than adults, and no difference in levels of family functioning was evident between the two groups. Community resources and family functioning served as important protectors for both groups. Parent-child conflicts were a significant mediator between COVID-19 stressors and psychological distress for adults only, while a decreasing level of outdoor family leisure served as a significant mediator for older adults only. Discussion: The findings highlighted the importance of providing family- and community-based mental health services for Chinese people facing a public health crisis such as COVID-19 in Hong Kong. Mental health services designed for adult and older adult family members should emphasize different components.