Who’s Most At Risk in the Covid-19 Mental Health Crisis

New research points to the role of job loss and the media in a worsening mental health landscape

Credit: Klaus Vedfelt / Getty Images

It doesn’t take a scientific study to know that the coronavirus pandemic is taking a tremendous toll on the mental health of people around the world. Maybe you’re feeling it yourself, your brain and body buckling under unprecedented levels of prolonged stress.

But scientific research is capturing the scale of the mental health crisis in numbers, helping reveal its full scope and the factors underlying it. This information is crucial for public health experts to develop a public mental health response to the pandemic. A paper published in the journal Science on Friday shows the link between psychological symptoms and the Covid-19 pandemic between March and April in the U.S. Empirical studies on the mental health effects of Covid-19, the University of California, Irvine researchers note, are rare — making up just 3% of the published literature on the coronavirus.

Between March 18 and April 18 of this year, which the authors describe as an “escalating period of illness and death in the United States,” acute stress and depressive symptoms significantly increased among Americans. The researchers based their analysis on survey data from a nationally representative group of 6,514 people who were asked not only about their experience of stress and depression during the pandemic but also about coronavirus-related job loss, social media exposure, and personal loss.

In addition to showing evidence for the link between worsening mental health and the worsening pandemic, the study identifies the people who are most likely to experience worsening mental health. The survey data allowed the researchers to identify “predictors” — factors that suggest someone is more likely to suffer mental health issues due to Covid-19.

People who have preexisting mental or physical health conditions, for example, are more likely to have both acute stress and depressive symptoms related to the coronavirus. In particular, having a preexisting psychiatric condition is the strongest predictor of depressive symptoms. Prior victimization, like being bullied, was also linked with the emotional responses of young adults during the pandemic. Another strong predictor of acute stress and depression is losing one’s job or wages and experiencing shortages of necessities. And a particularly eye-opening finding is that one of the strongest predictors of pandemic-related acute stress is extensive exposure to Covid-19-related media — which includes exposure to conflicting information in the news.

The survey data also revealed that more young people experienced acute stress and depression related to the coronavirus; that psychological symptoms didn’t abate after lockdown; and, interestingly, that people who continued to work during the early part of the pandemic were less depressed than people who didn’t, even though they were at higher risk of getting Covid-19. One explanation for the latter observation might be that people who lost their jobs were more depressed, but an alternative explanation is that people who continued working in “essential” services had found renewed meaning in their jobs.

So, how can this information help?

Public health officials can use these learnings to target the people who are most at risk and support them accordingly, the researchers write. Clearly, people with preexisting mental and physical health conditions must be a priority when allocating mental health services. Those who have lost their jobs or are struggling to make ends meet are likewise in crucial need of mental health support, as well as help mitigating their economic losses so they don’t enter a “loss spiral” in which their financial stress causes psychological distress. And public health messaging needs to be crystal clear — no more flip-flopping guidance on whether to wear masks, for example (you should definitely wear a mask). Young people, facing uncertainty, are also in need of mental health support.

One factor this study doesn’t specifically look into is the role of race, although the data the researchers used is meant to be a representative snapshot of the entire U.S. population. People of color, especially Black Americans, have been hit especially hard by the coronavirus; Black, Hispanic, and other people of color are not only dying at higher rates than white Americans but also experiencing disproportionate job loss. A few studies have shown that their mental health is disproportionately suffering, too. These people must also be taken into account by public health officials when deciding whose mental health to prioritize.

As early as April, my colleague Alexandra Sifferlin argued that the U.S. needed a national mental health response to Covid-19. To “adequately address the mental health impacts of the coronavirus,” she wrote in Elemental, “the nation needs a call-to-action to provide the resources and expertise for the treatment of Americans affected by the pandemic, with particular attention paid to health care workers.” There has been no such response from the Trump administration. The World Health Organization in Europe, in contrast, has responded to Covid by launching an initiative in August to reprioritize mental health by increasing access to mental health services and relocating mental health care away from institutions and toward community services.

The spread of Covid-19 should end with the development and distribution of a vaccine, if all goes accordingly. But it’s time that our leaders understand that the psychological trauma of living through the pandemic — especially for the vulnerable people identified by this study and others — may continue far into the future if nothing is done to help them now.

Editor, Medium Coronavirus Blog. Senior editor at Future Human by OneZero. Previously: science at Inverse, genetics at NYU.

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