COVID-19’s toll on mental health

This is one in a series of articles about the pandemic and America’s First Female Recession. See more here. The views and opinions expressed in this article are those of the author and do not necessarily reflect the views or policy positions of NCRC.

How is your stress level? Are you feeling anxious? If you answered pretty high or yes, you are not alone. 

The pandemic’s impact on mental health is significant and well-documented. Worry about contracting the virus, loss of loved ones, isolation, sustained disruption in our daily activities, income loss, job loss, etc. have had individual and combined impact – resulting in increased stress and symptoms of anxiety and depression among the general U.S. population. 

A Kaiser Family Foundation (KFF) dashboard drawing on analysis of its own polling as well as others such as the CDC’s Household Pulse Surveys led by the National Center for Health Statistics and the U.S. Census Bureau throughout the pandemic, revealed that 35% to 42% of respondents reported symptoms of anxiety (such as feeling nervous, on edge or unable to stop worrying) or depression (such as feeling hopeless, down or having little interest or pleasure in doing things). For comparison purposes, pre-pandemic responses to the same questions showed only 11% of respondents reporting symptoms of anxiety and depression.

The data shows that the increase in mental health distress has been particularly pronounced among a few groups:  communities of color, women, all adults ages 18 to 29, essential workers, those who have lost jobs or income, and parents. 

Looking at the pandemic’s impact on women, in particular, the gap between the percent of women and the percent of men reporting mental health distress (55% of all women compared to 38% of all men) widens with additional stressors. For example, women with children report stress and symptoms of anxiety and depression at higher rates than men with children (58% of women with children compared to 32% of men with children). The reasons for this gap are unclear. It may be that women – particularly women of color – have been impacted by job loss and furloughs at significantly higher rates than men. It may be that women have borne the brunt of family and home care responsibilities while simultaneously attending to work responsibilities. It may be that stigma and gendered social norms make men less likely to seek help for mental health distress.

Considering compounding stressors within the female-identifying population, it is important to point out the role of combined stressors and uneven impact on mental health among women. For example, women ages 18 to 29 report negative mental health impacts resulting from COVID-19 at higher rates (69%) than women ages 65 and older (36%). Women with children have reported these same symptoms at higher rates than women without children (49% compared to 40%). Standing at the intersection of COVID’s disproportionate impact in terms of diagnoses and deaths, job loss and furloughs, caregiving responsibilities, as well as the ongoing trauma of racism, women of color continue to bear a disproportionate burden of stress. 

Access to mental health services

The increase in reported stress, anxiety and depression symptoms corresponds with an increased demand for mental health services. This has put a strain on our already-limited mental health care infrastructure. Among survey respondents who have reported a need for mental health services or medication, 32% have not gotten them. Reasons for not accessing mental health services include: inability to find a provider, affordability, time constraints, insurance coverage for treatment, and embarrassment. 

Impact of prolonged stress: The connection between mental and physical health

Stress impacts everyone at various points in their lives. It often ebbs and flows, and/or can be managed with self-care practices. However, prolonged periods of stress, or chronic stress, can result in a long-term drain or wear-and-tear on the body as the body’s nervous system remains in a state of high alert over a long period of time. 

We have already seen the increase in reported symptoms of anxiety and depression, substance use, changes in sleep patterns and weight gain. While we do not yet know what COVID-19’s long-term mental health impact will be, we do know that people living with prolonged exposure to stress are disproportionately impacted with chronic conditions such as diabetes, hypertension, and cardiovascular disease.

The impact of COVID-19 on our mental health combined with limited access to mental health services thus presents a significant concern well beyond our mental health and wellbeing. 

Strengthening our Mental Health Care Infrastructure

There are great examples showing how community investment in mental health services can strengthen the wellbeing of communities in clear and direct ways. Drawing on these and prioritizing communities disproportionately impacted by COVID-19, opportunities to increase access to mental health services include:

  • Financing and other support to expand capacity and/or establish access to telehealth services among mental health care providers that reflect the needs of the communities they intend to serve;
  • Financing to support community health centers that provide integrated primary and behavioral health; and 
  • Advocacy to support continued coverage of mental health services, including coverage for mental health services delivered via telehealth that reflect the cost of care provided. 

We do not yet know what the long-term effects of the COVID-19 pandemic will be. We do know that, left untreated, the mental health distress that many of us are experiencing now can have ripple effects that impact mental and physical wellbeing years into the future. Opportunities abound to strengthen support systems to meet growing demands on a mental health care infrastructure that needs tending. Alongside other investments and supports for economic rebound and inclusion, investments in community assets and mental health services in communities disproportionately impacted by COVID-19 holds potential to pay dividends well beyond financial return.

Christina Miller, MSS, is an experienced nonprofit public health and social services leader. She currently works as an independent consultant serving business and nonprofit partners that seek to address health inequities.

Photo by Anh Nguyen on Unsplash

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