Shadows in the Air: Mental health vulnerabilities under PM10 and PM2.5, before and after COVID-19

Air pollution is an increasing public health concern, with evidence indicating that poor air quality adversely affects health through various pathways. However, its impact on mental health remains underexplored despite indications of pollutant-induced distress. This study examines the causal relationship between air pollution and mental health disorders-such as depression, sleep disorders, ADHD, and OCD-in South Korea. Assessing this relationship is challenging due to the simultaneous occurrence of economic growth, rising stress, and worsening air quality. Additionally, mental health issues have risen despite declining pollution levels post-COVID-19, further complicating the analysis. To address these challenges, we use wind speed and direction as instrumental variables. Our results show significant adverse effects of air pollution on mental health, particularly before 2020. Although the impact diminishes post-pandemic with improved air quality, certain demographic groups remain vulnerable. This study underscores the need for policies safeguarding mental health in at-risk groups, regardless of declining average pollution levels, and contributes to the literature by highlighting effects on less-studied disorders such as ADHD and OCD.