The year 2020 has been unlike any other. The ongoing global pandemic has threatened public health and safety, paralyzed the economy, killed hundreds of thousands of Americans (and more than one million worldwide), and profoundly shaped the daily lives of millions of people. These staggering effects have undoubtedly impacted the emotional well-being and functioning of the population, but these effects are difficult to measure. A national survey completed in May of 2020 by researchers at Harvard Medical School and the University of North Carolina revealed high rates of emotional distress and substantially reduced engagement in normal activities in the U.S. population in the early months of the COVID-19 pandemic1. The authors of this “Impact Report” concluded that, at the time of the study, most adults in the United States experienced at least some pandemic-related emotional distress, and one quarter or more experienced “high emotional distress directly attributable to the pandemic.” Younger adults and people of color were disproportionately impacted. Although these data provide a useful estimate of the actual emotional impact of the global pandemic in the United States, they provide just a snapshot in time, from a moment when the pandemic was much newer, and its impact was narrower than today.
It is clear that many people have suffered emotionally during this pandemic. It is less apparent that Americans who would benefit from mental health treatment are aware of and accessing the care they need. At least one study found a substantial decline in the use of behavioral health services in the New York area during the spring peak in coronavirus cases, despite the increased stressors and growing availability of telehealth services2. Even before the global pandemic, there was a gap between supply and demand for mental health services; the pandemic has served to exacerbate and shine a light on the unmet mental health needs of the U.S. population. If history is any indication, even after the pandemic subsides, the economic and psychological effects could continue for years. Persistently elevated unemployment and financial insecurity, for example, have correlated with higher rates of suicide five years or more after past recessions have ended3.
A crucial step in addressing the unmet mental health needs of the U.S. population is to identify who exactly would benefit from mental health treatment. With primary care and specialty mental health visits down during much of the pandemic4, novel solutions are required. One promising approach involves meeting people where they are: at home and online. Connected Mind offers a free self-screening tool to help individuals assess their own risk for a variety of mental health and chemical dependency conditions. Individuals can then share their results with their healthcare provider or otherwise use the information gleaned from their personal report to make decisions about pursuing specialized mental healthcare. Learning about oneself empowers a person to act in his or her own best interest. In this case, the outcome may be improved emotional well-being and functioning.
Connected Mind recently compiled data from 4,354 individuals who used the screening tool from June through November of 2020. Like the Impact Report, these data reveal concerningly high levels of psychological distress across respondents. They also add nuance to the clinical picture, particularly regarding diagnostic impressions. Complaints of severe anxiety and inattention were especially high, falling in the severe range in 58% and 50% of respondents, respectively. Reports of depression and other mood disorder symptoms fell within the highest possible range (“very severe”) in approximately one-fifth of respondents, with another 22% reporting severe levels of depressive symptoms. Endorsement of somatic (physiological or body-focused) and chemical health complaints were less frequent, falling in the severe range in 16% and 8% of respondents, respectively. Perhaps most alarmingly, 17% of those who completed the screening tool scored in the high-risk range for suicide and 41% scored in the medium-risk range.
These data illustrate both the diversity and severity of psychological symptoms affecting the U.S. population during the ongoing global pandemic. Compared to a national survey of similar size conducted before the pandemic, rates of self-assessed severe depression in individuals have skyrocketed from less than 3% to over 40%5. These findings suggest there is a significant unmet need for mental health services in the second half of 2020 as the pandemic rages on. Particularly prevalent are symptoms related to anxiety, inattention, and depression. A concerning level of suicide risk factors is also present in a sizable minority of people who completed the Connected Mind self-assessment tool. Although much about these findings is alarming – particularly regarding the mental health needs of the U.S. population – these findings also provide hope. They illuminate the immense opportunity that exists to better identify and intervene in high-risk, high-need individuals who are not presently connected with mental health services.
1Palsson, O. S., Ballou, S. K., & Gray, S. (2020, June 29). The U.S. National Pandemic Emotional Impact Report. Retrieved December 19, 2020, from http://pandemicimpactreport.com/summary.html
2Patel, U., & Bryt, A. B. (2020, September 18). Mental health care is suffering during the pandemic; new data shows how much. Retrieved December 19, 2020, from https://medcitynews.com/2020/09/mental-health-care-is-suffering-during-the-pandemic-new-data-shows-how-much/
3Brenner, M. H. (2018). Social class and mental health: The impact of international recession and austerity. In B. Buhgra, K. Bhui, S. Y. Wong, & S. E. Gilman (Eds.), Oxford Textbook of Public Mental Health. Oxford University Press.
4Mehrotra, A., Chernew, M., Linetsky, D., Hatch, H., Cutler, D., & Schneider, E. (2020, October 15). The Impact of the COVID-19 Pandemic on Outpatient Care: Visits Return to Prepandemic Levels, but Not for All Providers and Patients. Retrieved December 19, 2020, from https://www.commonwealthfund.org/publications/2020/oct/impact-covid-19-pandemic-outpatient-care-visits-return-prepandemic-levels
5Ettman, C. K., Abdalla, S. M., Cohen, G. H., Sampson, L., Vivier, P. M., & Galea, S. (2020). Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic. JAMA Network Open, 3(9). doi:10.1001/jamanetworkopen.2020.19686