COVID-19 lockdowns were first used in China and later worldwide by national and state governments.[179] Most workplaces, schools, and public places were closed. Lockdowns closed most mental health centers. Patients who already had mental health disorders may have worsened symptoms.[180] Fiji edit In September 2021, mental health organizations and an advisor to the government urged the government to address suicide prevention, although suicides in 2020 were lower than in 2019, as they warned that Fiji was beginning to suffer from a "mental health epidemic."[181] Italy edit Italy was the first country to enter a nationwide lockdown. According to a questionnaire, 21% of participants reported moderate to extremely high depression, while 19% reported moderate to extremely high anxiety.[182] Moreover, about 41% reported poor sleep before the lockdown, increasing to 52% during the lockdown. A cross-sectional study of 1,826 Italian adults confirmed the lockdown's impact on sleep quality, which was especially prevalent among females, those less educated, and those who experienced financial problems.[183] India edit Alcohol bans during the pandemic reportedly led to suicides in India.[184] Pakistan edit Pakistan is a low-income country and generally has poor mental health and does not prioritize mental health, so the pandemic increased these effects on the population. Pakistan thrives on community living, and the pandemic cut relationships off and increased feelings of distress and Mehr sehen