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Impact of Mental health has during the Coronavirus on sleep issues, eating increases and alcohol consumption/substance abuse due to worry and stress over the virus.
The Implications of COVID-19 for Mental Health and Substance Use
Nirmita Panchal, Rabah Kamal, Kendal Orgera, Cynthia Cox, Rachel Garfield, Liz Hamel, Cailey Muñana, and Priya Chidambaram
Published: Aug 21, 2020The COVID-19 pandemic and the resulting economic recession have negatively affected many people’s mental health and created new barriers for people already suffering from mental illness and substance use disorders. In a KFF Tracking Poll conducted in mid-July, 53% of adults in the United States reported that their mental health has been negatively impacted due to worry and stress over the coronavirus. This is significantly higher than the 32% reported in March, the first time this question was included in KFF polling. Many adults are also reporting specific negative impacts on their mental health and wellbeing, such as difficulty sleeping (36%) or eating (32%), increases in alcohol consumption or substance use (12%), and worsening chronic conditions (12%), due to worry and stress over the coronavirus. As the pandemic wears on, ongoing and necessary public health measures expose many people to experiencing situations linked to poor mental health outcomes, such as isolation and job loss.This brief explores mental health and substance use in light of the spread of coronavirus. Specifically, we discuss the implications of social distancing practices and the economic recession on mental health, as well as challenges to accessing mental health or substance use services. We draw on data on mental health prior to the COVID-19 pandemic and, where possible, include recent KFF Tracking Poll data and data from the Census Bureau’s Household Pulse Survey, a new survey created to capture data on health and economic impacts of the pandemic. Key takeaways include:- A broad body of research links social isolation and loneliness to poor mental health, and data from late March shows that significantly higher shares of people who were sheltering in place (47%) reported negative mental health effects resulting from worry or stress related to coronavirus than among those not sheltering-in-place (37%). In particular, isolation and loneliness during the pandemic may present specific mental health risks for households with adolescents and for older adults. The share of older adults (ages 65 and up) reporting negative mental health impacts has increased since March. Polling data shows that women with children under the age of 18 are more likely to report major negative mental health impacts than their male counterparts.
- Research shows that job loss is associated with increased depression, anxiety, distress, and low self-esteem and may lead to higher rates of substance use disorder and suicide. Recent polling data shows that more than half of the people who lost income or employment reported negative mental health impacts from worry or stress over coronavirus; and lower income people report higher rates of major negative mental health impacts compared to higher income people.
Background
Prior to the COVID-19 pandemic, nearly one in five of U.S. adults (47 million) reported having a mental illness in the past year, and over 11 million had a serious mental illness, which frequently results in functional impairment and limits life activities. In 2017-2018, more than 17 million adults and an additional three million adolescents had a major depressive episode in the past year.
Deaths due to drug overdose have increased more than threefold over the past 19 years (from 6.1 deaths per 100,000 people in 1999 to 20.7 deaths per 100,000 people in 2018). In 2018, over 48,000 Americans died by suicide,1 and in 2017-2018, nearly eleven million adults (4.3%) reported having serious thoughts of suicide in the past year.
During this unprecedented time of uncertainty and fear, it is likely that mental health issues and substance use disorders among people with these conditions will be exacerbated. In addition, epidemics have been shown to induce general stress across a population and may lead to new mental health and substance use issues. More than one in three adults in the U.S. have reported symptoms of anxiety or depressive disorder during the pandemic (weekly average for May: 34.5%; weekly average for June: 36.5%; weekly average for July: 40.1%) (Figure 1). In comparison, from January to June 2019, more than one in ten (11%) adults reported symptoms of anxiety or depressive disorder. Additionally, a recent study found that 13.3% of adults reported new or increased substance use as a way to manage stress due to the coronavirus; and 10.7% of adults reported thoughts of suicide in the past 30 days.
Figure 1: Average Share of Adults Reporting Symptoms of Anxiety or Depressive Disorder During the COVID-19 Pandemic, May-July 2020Mental Health Risks Due to Social Isolation
As an initial response to the coronavirus crisis, most state and local governments required closures of non-essential businesses and schools and declared mandatory stay-at-home orders for all but non-essential workers, which generally included prohibiting large gatherings, requiring quarantine for travelers, and encouraging social distancing. States are now in the process of re-opening, which has been followed by many seeing a resurgence in coronavirus cases. It is unknown whether stay-at-home orders will be enforced again as spikes occur, or how long general social distancing practices will need to be encouraged.
A broad body of research links social isolation and loneliness to both poor mental and physical health. Former U.S. Surgeon General Vivek Murthy has brought attention to the widespread experience of loneliness as a public health concern in itself, pointing to its association with reduced lifespan and greater risk of both mental and physical illnesses (Dr. Murthy serves on the KFF Board of Trustees). Additionally, studies of the psychological impact of quarantine during other disease outbreaks indicate such quarantines can lead to negative mental health outcomes. There is particular concern about suicidal ideation during this time, as isolation is a risk factor for suicide.
In the KFF Tracking Poll conducted in late March, shortly after many stay-at-home orders were issued, we found that 47% of those sheltering-in-place reported negative mental health effects resulting from worry or stress related to coronavirus (Figure 2). This rate was significantly higher than the 37% among people who were not sheltering-in-place reporting negative mental health impacts from coronavirus. Of those sheltering-in-place, 21% reported a major negative impact on their mental health from stress and worry about coronavirus, compared to 13% of those not sheltering-in-place. -
