August 14, 2020

Charted: The coronavirus' staggering toll on America's mental health

Daily Briefing

    The United States' coronavirus epidemic has taken a significant toll on Americans' mental health—but some groups have been hit far harder than others, according to a CDC Morbidity and Mortality Weekly Report published Friday.

    US new coronavirus cases near 5.3M, deaths top 167K

    The report comes as U.S. officials on Thursday reported about 53,956 new cases of the novel coronavirus, bringing the total number of coronavirus cases reported in the country since the epidemic began to 5,262,700 as of Friday morning—up from 5,208,700 cases reported as of Thursday morning.

    Data from the New York Times shows that Guam, Puerto Rico, the U.S. Virgin Islands, and five states— Hawaii, Illinois, North Dakota, South Dakota, and Vermont—saw their average daily numbers of newly reported coronavirus cases rise over the past 14 days.

    The Times' data also shows that the average daily numbers of newly reported coronavirus cases over the past two weeks remained mostly stable in Washington, D.C., and 22 states: Arkansas, California, Connecticut, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, Montana, Nebraska, New Jersey, New York, Oregon, Texas, Virginia, Washington, West Virginia, and Wisconsin.

    Although California's average daily number of newly reported cases stabilized over the past two week, the state on Thursday became America's first to report a total of more than 600,000 cases of the novel coronavirus since the country's epidemic began.

    Meanwhile, the Times' data shows that 23 states saw their average daily numbers of newly confirmed coronavirus cases decrease over the past 14 days: Alabama, Alaska, Arizona, Colorado, Delaware, Florida, Louisiana, Maine, Maryland, Mississippi, Missouri, Nevada, New Hampshire, New Mexico, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Utah, and Wyoming.

    U.S. officials also reported about 1,219 new deaths tied to the coronavirus on Thursday, bringing the country's total of reported coronavirus-linked deaths since the epidemic began to 167,165 as of Friday morning—up from 165,936 deaths reported as of Thursday morning.

    According to the Times' data, Puerto Rico and 16 states saw their average daily numbers of newly reported deaths linked to the coronavirus rise over the past 14 days: Arkansas, California, Georgia, Hawaii, Illinois, Indiana, Iowa, Minnesota, Montana, Nevada, North Dakota, Pennsylvania, Tennessee, Texas, Washington, and West Virginia.

    The epidemic's toll on Americans' mental health

    As America's coronavirus epidemic persists, CDC researchers between June 24 and June 30 surveyed 5,412 U.S. adults to gauge how the crisis has affected Americans' mental health—and they discovered some striking and concerning statistics.

    According to the report, over 40% of those surveyed said they had experienced a mental or behavioral health condition related to the coronavirus epidemic. Overall, 25.5% of respondents said they had experienced symptoms of anxiety disorder, while 24.3% said they had experienced symptoms of depression. Further, the researchers found that 10.7% of all respondents said they had considered suicide at some point during the 30 days leading up to the survey.

    The researchers also found that reports of anxiety, depression, and suicidal ideation were up significantly this year when compared with previous years. For example, the reported prevalence of anxiety disorder symptoms was about three times higher this June when compared with reported prevalence of anxiety disorder symptoms during the second quarter of 2019, while the reported prevalence of depression symptoms was about four times higher this June when compared with the second quarter of 2019.

    In addition, about twice as many respondents in June said they had considered suicide in the preceding 30 days when compared with the number of U.S. adults who in 2018 said they had considered suicide in the preceding 12 months, according to the report.

    Moreover, data from the separate, online Household Pulse Survey conducted by CDC's National Center for Health Statistics, which surveyed nearly 996,000 U.S. adults from April 23 through July 21, shows that reported rates of anxiety and depression have been rising since America's coronavirus epidemic reached its first peak in April.

    The epidemic has disproportionately affected the mental wellbeing of Americans ages 18 to 24, with more than half of adults in that age group who responded to CDC's June survey reporting symptoms of depression, just under half reporting symptoms of anxiety disorder, and more than a quarter reporting that they had considered suicide within the preceding 30 days.

    The epidemic also has taken a heavier toll on Hispanic and Black Americans' mental health, with more than a third of Hispanic respondents saying they had experienced symptoms of depression or anxiety and nearly 20% saying they had considered suicide in the preceding 30 days. Meanwhile, just under a quarter of Black respondents said they had experienced symptoms of depression or anxiety and around 15% said they had considered suicide in the preceding 30 days.

    In addition, unpaid caregivers and essential workers reported comparatively higher rates of anxiety disorder and depressive symptoms, as well as suicide ideation. For instance, 31% of respondents who reported being unpaid caregivers said they had considered suicide in the preceding 30 days, compared with 3.6% among respondents who did not report being an unpaid caregiver. Likewise, 22% of respondents who reported being an essential worker said they had considered suicide in the preceding 30 days, compared with 7.8% of respondents who reported being nonessential workers, 4.7% among unemployed respondents, and 2.5% among retired respondents.

    Researchers also found that 13.3% of all respondents said they had begun or increased substance use to cope with stress related to the epidemic. For the survey, substance use was defined as using "alcohol, legal or illegal drugs, or prescriptions drugs that are taken in a way not recommended by your doctor."

    American adults aren't all right

    Ken Duckworth, CMO of the National Alliance on Mental Illness, said CDC's findings represent "a virtually real-time biopsy of the American mental health experience." He added, "[Y]ou can criticize this study for being internet-based. You can criticize this study for not having formal diagnostic interviews. But you can conclusively say the adults are not [all right] in America."

    Anna Mueller, a professor of sociology at the Indiana University Bloomington who conducts research on suicide, said CDC's report shows that the "breakdown in our society, the breakdown of the safety net, the breakdown of economic security is taking a massive toll. These breakdowns really show how crucial economic stability and economic security are to an individual's well-being."

    In addition, Mueller said uncertainty may be a contributing factor to the proportion of 18- to 24-year-olds who reported suicide ideation. "They're watching their world crumble, and probably struggling to imagine a future," she explained. "I mean, we all are. What is the world going to look like? What is college going to look [like]? What is employment going to look like if they were hoping to enter the labor force?"

    Nadine Kaslow, a professor of psychiatry at the Emory University School of Medicine, said, "We need to recognize the profound effects of the [epidemic], of racial injustice, of economic instability. Those people whose symptoms of anxiety or depression, or substance use or suicidal ideations are really interfering with their functioning, where the symptoms are extreme, those people need help."

    Kaslow added that access to affordable mental health care will be vital to addressing the ongoing mental health crisis, as will compassion.

    "No matter how tired and burnt out we each are, we need to check in with people, to see how they're doing, to let people know that we care," she said. "People did a lot of that at the beginning. ... As we get into this phase that people sort of call the disillusionment phase, I personally think we're seeing a lot less of that. We have to be in this for the long haul. We have to take care of each other for the long haul" (Ehley, Politico, 8/13; Dastagir, USA Today, 8/13; Howard/Kane, CNN, 8/13; CDC website, 7/29; CDC Morbidity and Mortality Weekly Report, 8/14; New York Times [1], 8/14; New York Times [2], 8/14).

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