Young people, women, Black and Latino Americans, and those without a bachelor’s degree were far more likely to display symptoms of depression or anxiety.
More than one-third of Americans are showing signs of clinical anxiety or depression during the coronavirus pandemic, according to a new survey from the U.S. Census Bureau.
The online Household Pulse Survey, which has been conducted on a weekly basis since April 23, asked questions normally used to screen patients for mental health problems. It found that 31% showed symptoms of generalized anxiety disorder and 26% showed signs of major depressive disorder during the week of June 4. Overall, 36% of respondents showed symptoms of one or both disorders.
Those numbers represent an alarming increase over pre-pandemic levels: Only 10.9% of Americans showed symptoms of anxiety disorder and/or depressive disorder in the first half of 2019, according to initial data from CDC’s January-June 2019 National Health Interview Survey (NHIS). The NHIS report also showed that only 8% of Americans showed symptoms of anxiety disorder from January through June of 2019, while roughly 7% showed symptoms of depressive disorder.
The Census Bureau’s findings reveal just how much Americans are struggling after months of isolation, fears of contracting the coronavirus, and mounting economic uncertainty. They also indicate that the nation’s mental health woes, which were already an issue before the coronavirus, have exploded into a full-fledged crisis affecting Americans of all ages, races, genders, and across all 50 states.
While people of all stripes are suffering, the survey found that vulnerable Americans were far more likely to show symptoms. Young Americans, who already experienced higher rates of mental health issues, are once again experiencing distress at higher rates. In the June 4-9 survey, which polled more than 83,000 respondents, nearly half (49%) of Americans between the ages of 18-29 exhibited symptoms of anxiety or depression.
These young people include students who may now have to defer, forego, or drop out of college because they can’t afford it; those who are graduating into the worst economic situation since the Great Depression; and workers who were just starting to get their bearings after entering the job market following the 2008 financial collapse.
Well over one-third of individuals between the ages of 30-59 also reported symptoms, but only 27% of those between the ages 60-69 and 19% of respondents ages 70 or older showed symptoms, highlighting the generational differences in how people are experiencing the crisis.
Women, Black and Latino Americans, and those without a bachelor’s degree were also far more likely to display symptoms of depression or anxiety. These findings aren’t entirely unexpected: After all, those groups have been the most affected by the pandemic. Black and Latino Americans have died of COVID-19 at higher rates than their white peers, and along with women and the less-educated, have been more likely to lose their jobs and find themselves struggling to pay their bills. Poor Americans, who are also more likely to have lost their jobs and have been plunged into hunger, are also disproportionately struggling with mental health issues.
Dawn Brown, director of community engagement at the National Alliance of Mental Illness (NAMI), wasn’t surprised by this disparity. “I think the stressors of COVID-19 are affecting those marginalized communities more than people who are affluent and can work from home,” Brown said.
Lower-income people also often live in overcrowded homes, she noted, which increases the likelihood of spreading the disease to loved ones. “Those are societal and economic factors that can create an environment with a lot more stress and anxiety when faced with a pandemic,” she said.
The Census Bureau’s findings are the most wide-ranging look at the pandemic’s mental health consequences, but they echo a growing body of research showing just how widespread the toll is.
“[The findings] don’t surprise me at all,” Brown said. “They’re very consistent with what we’re collecting in terms of the mental health impact of the COVID-19 crisis.”
NAMI, which began tracking data of the pandemic’s impact in early March, has seen a dramatic increase in overall call volume to its helpline this year compared to the same time in 2019, Brown said. It’s not just an increase in calls, either. There’s been a notable shift in the people who are calling and the issues they’re calling to discuss.
“The majority of the calls are different now. They are mentioning anxiety and depression far more common than in the past, and it’s usually related to COVID-19,” Brown said. “A lot of our callers don’t have a diagnosis of a mental illness, but they are experiencing symptoms of depression and anxiety, so it’s actually creating symptoms in people otherwise not affected by mental health conditions.”
Paul Gionfriddo, president and CEO of Mental Health America, said his group has seen a similar surge of people in duress reaching out, and like Brown, noted that this was driven by entirely new populations that are now experiencing mental health issues.
“We have been offering online mental health screening free of charge and anonymously since 2014,” Gionfriddo said. “During the month of May, more than 5,000 people per day took a screening. The results we have seen are consistent with what the Census found in its Pulse Survey. But here’s the difference—while the severity of mental health problems is just as bad as it has always been, what is different is the sheer volume of people being newly affected by serious mental health concerns.”
“While the severity of mental health problems is just as bad as it has always been, what is different is the sheer volume of people being newly affected by serious mental health concerns.”
Other research has also documented the mental health toll of the pandemic. A May survey by the American Foundation for Suicide Prevention found people are experiencing anxiety and sadness more often than before the pandemic.
The long-term consequences of the rise in mental health issues could be devastating, experts noted. They warn that without intervention and policy solutions, the U.S. could see an increase in suicides, substance abuse, and overdose deaths.
Gionfriddo called on legislators to address the issue before crises occur.
“They should do two simple things. First, public officials should issue a call to action to make mental health screening as common as blood pressure screening—something that was already recommended by the U.S. Preventive Services Task Force for everyone over the age of 11, even before the pandemic hit,” Gionfriddo said. Second, he continued, lawmakers should invest billions of dollars to rebuild the mental healthcare system.
The system has long been underfunded and insurance companies have often discriminated against mental health services, which has made it incredibly difficult for patients to access affordable care.
“The mental health provider networks are really inadequate. It’s really hard for people to find a provider, let alone a provider that takes your insurance and is in network,” Jennifer Snow, acting National Director of Advocacy and Public Policy for NAMI told COURIER last year. “We really see that for many people with mental illness, actually accessing the care they have is extraordinarily problematic.”
As part of the CARES Act, Congress allocated $425 million for substance abuse and mental health services, but that’s a drop in the bucket compared to what’s needed, according to Gionfriddo.
“At a minimum, tens of thousands to hundreds of thousands more people have experienced serious mental health concerns as a result of the pandemic,” he said. “If as a result we experience just a 10 to 20% increase in demand for behavioral health services … that would cost our healthcare delivery system $25 to $50 billion.”
Complicating the issue further is that there remains something of a stigma around mental illness in the United States, and many people suffer in silence. Gionfriddo and Brown both urged anyone struggling with their mental health to reach out for help.
“Everyone is worried. Don’t guess about whether your worry is transitioning to depression, anxiety, PTSD, or more. Take a screen. Get some answers,” Gionfriddo said. “And then—if you need it—reach out and get help. That will make a huge difference in your life.”
Both shared several resources that are available to people experiencing mental health issues. They include:
- The National Suicide Prevention Lifeline. If you or someone you know is in crisis—whether they are considering suicide or not—please call the toll-free Lifeline at 800-273-TALK (8255) to speak with a trained crisis counselor 24/7.
- The NAMI HelpLine—1 (800) 950-NAMI (6264)—which can be reached Monday through Friday, 10 a.m.–6 p.m., ET.
- The Crisis Text Line, which connects you with a trained crisis counselor who can provide free, 24/7 crisis support via text message. Text HOME to 741-741 to seek help.
- Mental Health America’s free online mental health screenings that can help people determine if they’re experiencing symptoms of depression, anxiety, or other mental health conditions.
- 7Cups, a low-cost, on-demand emotional health service and online therapy provider.
Gionfriddo urged anyone who is struggling to reach out to help. “Even when it is hard to find a clinician to help, it is not hard to find these online resources, and we and others will help,” he said.
The Census Bureau plans to conduct its survey every week for three months, and Brown expects that an increasing number of people will continue to exhibit symptoms of anxiety and depression.
“While we’re already pretty deep into the pandemic, we have a long way to go and it’s reasonable to assume that there will be an increase in mental health concerns as people begin to realize this is not a short-term situation, as it begins to affect their their savings, and potentially their retirement or their college education,” she said. “There’s just going to be a lot of serious issues.”