Research identifying adults’ mental health during the coronavirus disease 2019 (COVID-19) pandemic relies solely on demographic predictors without examining adults’ health condition as a potential predictor. This study aims to examine individuals’ perception of health conditions and test availability as potential predictors of mental health—insomnia, anxiety, depression, and distress—during the COVID-19 pandemic. An online survey of 669 adults in Malaysia was conducted during 2–8 May 2020, six weeks after the Movement Control Order (MCO) was issued. We found adults’ perception of health conditions had curvilinear relationships (horizontally reversed J-shaped) with insomnia, anxiety, depression, and distress. Perceived test availability for COVID-19 also had curvilinear relationships (horizontally reversed J-shaped) with anxiety and depression. Younger adults reported worse mental health, but people from various religions and ethnic groups did not differ significantly in reported mental health. The results indicated that adults with worse health conditions had more mental health problems, and the worse degree deepened for unhealthy people. Perceived test availability negatively predicted anxiety and depression, especially for adults perceiving COVID-19 test unavailability. The significant predictions of perceived health condition and perceived COVID-19 test availability suggest a new direction for the literature to identify the psychiatric risk factors directly from health-related variables during a pandemic.

Background: Research identifying adults’ mental health during the COVID-19 pandemic relies solely on demographic predictors without examining adults’ health status during the COVID-19 pandemic as a potential predictor. Methods: An online survey of 669 adults in Malaysia was conducted during May 2–8, 2020, six weeks after a Movement Control Order (MCO) was issued. Findings: Adults’ health condition had curvilinear relationships (horizontally reversed J-shaped) with insomnia, anxiety, depression and distress. Reported test availability for COVID-19 (from “strongly disagree” to “strongly agree”) also had curvilinear relationships (horizontally reversed J-shaped) with anxiety and depression. Younger adults reported worse mental health, but people from various religions and ethnic groups did not differ significantly in reported mental health. Interpretation: Adults with worse health conditions had more mental health problems, especially adults at the lower end of the health spectrum. Test availability negatively predicted anxiety and depression, especially for adults experiencing poor COVID-19 test availability. The significant predictions of health condition and COVID-19 test availability suggest a new direction for the literature to identify psychiatric risk factors directly from health related variables during a pandemic. Funding: Tsinghua University-INDITEX Sustainable Development Fund (Project No. TISD201904).

This study predicts handwashing behavior during the Covid-19 pandemic. An analysis of 674 adults in Malaysia identifies their time spent on social media per day as a key predictor of handwashing. The association between time spent on social media and handwashing substantially depends on gender and the number of children in the same household. Additional predictors include age and health condition. This study helps identify specific target groups for health communication on hand hygiene via people’s use of social media, which can be a key channel for health communication campaigns during a pandemic.