The COVID-19 response in America has focused on several fronts. The main goals are stopping the spread of the virus, mitigating economic damages, and creating a vaccine or discovering therapeutics. A new survey from the Centers for Disease Control and Prevention highlights another area of concern, one that could challenge communities, the health care industry, and public health officials for some time after the virus subsides: mental health issues.
America was facing a mental health crisis before the pandemic started. Our nation’s youngest, in particular, were already seeing the fastest rise in mental health-related issues. This unsettling rise in mental health issues impacts everyone through increased health care spending. Mental health disorders are some of the most expensive conditions to treat. Moreover, emergency departments, one of the most expensive venues to receive care, are becoming havens for young people with mental health issues.
Now it’s becoming clear that months of COVID-related issues have exacerbated America’s mental health crisis. Social distancing, government lockdowns, lives lost, illnesses, jobs lost, and financial insecurity have devastated America’s mental well-being.
The CDC survey asked people about mental health issues, substance use, and thoughts of suicide. Table 1 from the survey examined respondents’ answers according to their gender, age, and race/ethnicity. Here is that table and some takeaways from it:
The survey found large differences in COVID-related mental health issues by age, with young adults (18 to 24 years old) reporting significantly higher rates than the other age groups in suicidal thoughts, anxiety or depressive disorders, and substance abuse:
- Nearly two-thirds (62.9%) of young adults reported an anxiety or depressive disorder.
- Four out of 10 (40.4%) of the 25-44 age group reported an anxiety or depressive disorder. For the 45-64 age group, it was 20.3%, and for the 65 and older group, it was 8.1%.
- One-fourth (25.5%) of young adults said they had seriously considered suicide in the past 30 days.
- Suicidal thoughts affected 16% in the 25-44 age group; 3.8% of 45-64 age group; and 2% of those 65 and older.
- One-fourth (24.7%) of young adults said they had started or increased substance use to cope with pandemic-related stress, as did about one out of five (19.5%) of people in the 25-44 age group. For the 45-64 age group, it was 7.7%, and for the 65 and older group, it was 3%.
In terms of gender, the survey found men and women similar in the prevalence of an anxiety or depressive disorder. But men were more likely than women to report having seriously considered suicide in the past 30 days (12.6% to 8.9%).
In terms of race/ethnicity, the survey found four out of 10 (40.8%) of Hispanic Americans reported prevalence of an anxiety disorder, which was the highest among the racial and ethnic groups. Blacks and whites reported similar prevalence of anxiety disorders, 30.2% and 29.2%, respectively. For Asians, the number was 18%, whereas for “other race or multiple races,” the prevalence reported was much higher, at 33.2%.
For the population in general, the numbers are concerning:
- Four out of 10 (40.9%) of all respondents reported at least one adverse mental or behavioral health symptoms.
- Three out of 10 (30.9%) reported symptoms of an anxiety or depressive disorder.
- Over one-fourth (26.3%) reported conditions similar to that of post-traumatic stress disorder (the “COVID-19 related TSRD” category).
- 3% of all respondents reported starting or increasing substance use to cope with pandemic-related stress.
The devastating high prevalence of anxiety, depression, and thoughts of suicide will likely have lasting impacts on the younger generations and their families.
Employment and caregiver status
Two other variables worth highlighting are employment status and unpaid adult caregivers. Both variables were self-reported.
Employment status looked at differences among the employed, unemployed, and those who were deemed essential and nonessential. Unemployed students were considered nonessential workers.
Unpaid adult caregivers were defined as an adult who had provided care without pay to a relative or friend older than 18 years old by helping with personal needs, household chores, health care tasks, managing finances, doctors’ appointments, arranging for outside services, and regular visits to see how they were doing.
Here is the CDC table on those characteristics and some takeaways:
The survey found that those deemed essential workers or who classified themselves as unpaid adult caregivers fared far worse in terms of anxiety and depressive disorders, substance abuse, and suicidal thoughts.
Essential workers reported higher rates of anxiety or depressive disorders than nonessential workers, 42.4% vs. 29.9%. They were also far more likely to have started or increased substance use to cope with pandemic-related stress, 24.7% vs. 10.5%.
Over one in five essential workers had seriously considered suicide in the past 30 days. For nonessential workers, that rate was 7.8%.
Anxiety and depressive disorders affected employed and unemployed respondents at similar rates, 37.8% and 36.4%. But the employed were more likely to have experienced serious suicidal thoughts (15% to 4.9%) and to have started or increased substance use (17.9% to 7.7%).
Roughly one-fourth (26.2%) of respondents reported acting as unpaid adult caregivers. The survey found significantly worse mental problems afflicting them:
- More than half (56.1%) of unpaid adult caregivers reported anxiety or depressive disorders (the rate for the other respondents was 22%).
- About one-third (32.9%) of unpaid adult caregivers reported starting or increasing substance use, compared with 6.3% for the other respondents.
- Nearly one in three (30.7%) had seriously considered suicide in the past 30 days, compared with 3.6% of the other respondents.
We know that this can be a deadly virus. As of this writing, more than 172,000 Americans have passed as a result of COVID-19. The mental health damage caused by this disease and government responses to it may not be fully appreciated by the public and government officials.
The CDC survey paints a bleak picture of how Americans are mentally handling the disease. Anxiety and depressive orders, substance abuse, and thoughts of suicide are up, especially among younger and essential workers. Unpaid adult caregivers are especially bearing the brunt of mental damages.
As the country continues to battle the virus and looks forward to a post-COVID world, public health officials and elected officials need to weigh the mental damages that result from a shutdown society with the virus response.
Jordan Roberts is health policy analyst at the John Locke Foundation.