Review of 'Reflections, Resilience, and Recovery: A qualitative study of the COVID-19 impact on an international general population’s mental health and priorities for support'

Dear Editors,

Thank you for the opportunity to review ‘Reflections, resilience, and recovery: A qualitative study of the COVID-19 impact on an international general population’s mental health and priorities for support’. 

In this article the authors thematically analysed qualitative responses from a large-scale survey to explore why some mental health stayed stable and others fluctuated in the context of the COVID-19 pandemic.  This is an important study.  As the authors state, there have been several large-scale surveys etc but there is a need to have more descriptive studies. 

I have some comments below – I hope the authors and editors find them helpful in any revisions.

Presentation of analysis/ findings

• There was quite a quantitative ‘feel’ to what is a qualitative study.  For example, the attention to the proportional overlap of codes/ combinations of codes.  This is not necessarily something I would recommend changing.  I think, in some sense, it meant that the authors laid out the analytic steps well and it was easy to see their chain of reasoning – something that can potentially be glossed over.  In terms of presentation of results, I think it potentially could be useful to place pages 13 -18 (the description of coding and grouping of themes under method/ analysis.  This section feels quite descriptive and the codes are not so much finding as step towards identifying themes. (I wonder given the nature of the study (qualitative) is it necessary to test hypotheses – doesn’t quite seem to fit with the design.
• Group Differences: The treatment of group differences was rather short, and I was expecting some more descriptive analysis rather than the T tests.  Given the information on employment/ income/ country etc I expected some more analysis here.  I also think it might have been a more useful or insightful way to discuss the unexpected theme (see comment below).
• Unexpected theme – were the ruminations an unexpected theme or an unexpected way of responding?  I think this might be more usefully integrated into an expanded section on group differences. Overall, given the questions, I think the findings are not unexpected (in general).

Conclusion:

I think the conclusion could be strengthened in some way with recommendations for future studies. One of the identified gaps was the number of quantitative studies which do not explore reasons/ solutions in terms for stability and change in mental in the context of the pandemic.  Given the author’s study where next from a research perspective?