Trends in mental health symptoms, service use, and unmet need for services among US adults through the first 8 months of the COVID-19 pandemic

• Published in: Translational behavioral medicine Vol. 12; no. 2; pp. 273 - 283
• Main Authors: Coley, Rebekah Levine, Baum, Christopher F
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 16.02.2022
• Subjects: Adult; Analysis; COVID-19; Cross-Sectional Studies; Epidemics; Evaluation; Female; Humans; Mental Health; Mortality; Pandemics; Prevalence studies (Epidemiology); Psychological aspects; SARS-CoV-2; Statistics; Surveys; United States; United States; COVID-19; Depression; Anxiety; Disparities; Mental health treatment
• ISSN: 1869-6716; 1613-9860
• DOI: 10.1093/tbm/ibab133

Abstract The COVID-19 pandemic has led to rising morbidity, mortality, and social and economic disruption, likely impairing mental health. The purpose of this study was to track trends in mental health symptoms, use of services, and unmet need for services among US adults, and to delineate variation across demographic strata. Data were drawn from the 2020 US Household Pulse Survey from repeated cross-sectional online surveys collected between April 23 and November 23, 2020 from 1,302,455 US adults, weighted to represent the US population. Survey respondents self-reported their symptoms of anxiety and depression, use of medication and counseling services, and unmet need for services. Reports of probable anxiety and depression rose significantly through the study period, to prevalence rates of 37% and 29%, respectively, by November, 2020, rates more than four times higher than early 2019 US norms. Use of prescription medication, counseling services, and unmet need for mental health services also rose significantly. Prevalence rates of probable mental health disorders were highest among young, less educated, single parent, female, Black and multi-racial respondents, with some vacillation in such disparities over cohorts. Young, female, and moderately educated respondents also reported higher unmet needs for services. Disparities in estimates of mental health disorders and mental health treatment indicate a striking disequilibrium between the potential need for and the use of mental health services during the COVID-19 pandemic. Rising mental health challenges are being borne largely by young, less advantaged people of color and women, with the potential for expanded interruptions to optimal functioning and societal recovery from COVID-19. The myriad stressors imposed by the COVID-19 pandemic have impaired mental health and wellbeing. Although evidence from early in the pandemic revealed elevated rates of mental health conditions, research has not documented whether psychological disorders have continued to rise as the pandemic has persisted. In this research, we assess data from over 1.3 million US adults who participated in cross-sectional surveys between April and November, 2020 to track trends in mental health disorder symptoms and services. Our results show that reports of anxiety and depression rose significantly from April to November, 2020 to rates more than four-times higher than in 2019. We also found evidence of growing unmet need for mental health services. Rising mental health challenges are being borne largely by young, less advantaged people of color and women. Growing disparities in mental health disorders and treatment raise concerns for psychological, social, and economic recovery from COVID-19. Rebekah Levine Coley, Ph.D. Lay Summary The myriad stressors imposed by the COVID-19 pandemic have impaired mental health and wellbeing. Although evidence from early in the pandemic revealed elevated rates of mental health conditions, research has not documented whether psychological disorders have continued to rise as the pandemic has persisted. In this research, we assess data from over 1.3 million US adults who participated in cross-sectional surveys between April and November, 2020 to track trends in mental health disorder symptoms and services. Our results show that reports of anxiety and depression rose significantly from April to November, 2020 to rates more than four-times higher than in 2019. We also found evidence of growing unmet need for mental health services. Rising mental health challenges are being borne largely by young, less advantaged people of color and women. Growing disparities in mental health disorders and treatment raise concerns for psychological, social, and economic recovery from COVID-19.