William A. Haseltine Ph.D.

Best Practices in Health

The Mental Health Toll of COVID-19

Some American communities carry a disproportionate burden.

Posted Nov 24, 2020

In September, the American businessman Ted Leonsis tweeted about an “underreported pandemic: mental health.” His comment about friends he’d lost to suicide sparked a public discussion on the impact of the pandemic on our mental well-being and raised awareness of an issue many kept hidden in the shadows. But if the pandemic has taken a toll on a billionaire like Leonsis, with easy access to the best in mental health support, pity its impact on the rest of us.

A slew of studies shows just how damaging COVID-19 and its ensuing lockdowns have been on the mental health of specific communities in America. No group has been left untouched—no gender, ethnicity, age, or income bracket—but some have suffered much more than others from what I have termed CVTSD, COVID-19 Traumatic Stress Disorder.

Age and mental well-being

In the spring, when the pandemic surged in hotspots across the country, much was made of the impact of COVID-19 on the mental health of older Americans, who were being cautioned to stay home and isolate for their own safety. Isolation and loneliness among the elderly were a cause for concern before COVID and many feared that lockdowns would worsen isolation for older adults and, consequently, depression and anxiety. A recent Kaiser Family Foundation study suggests these fears were realized, with one in four adults ages 65 and older reporting anxiety or depression in the months between the start of the pandemic and August—a rate substantially higher than the one in 10 older adults who reported depression or anxiety in 2018. 

What surprised many experts though was the toll COVID is taking on the mental health of younger Americans. A CDC study shows that while 40 percent of Americans are now grappling with at least one mental health or drug-related problem following the pandemic, young adults have been hit harder than any other age group, with 75 percent struggling. Even more alarming, was the finding that one in four young adults, age 18-24, had contemplated suicide over a 30-day period in the summer. While official figures are slow to roll in to confirm an increase in suicides among younger Americans, anecdotal reports from coroners and medical examiners suggest significant spikes in suicides across the country, in children as young as 9 years old.

Race, suicide, and mental health

Trend lines also suggest that suicides are higher among some racial communities, suggesting that the mental toll on these communities is far greater than others. Cook County, Illinois, reported more suicides among African Americans in the first six months of 2020 than in all of 2019 combined. While SARS-CoV-2 is indiscriminate in terms of who it infects, the structure of American society has resulted in higher rates of infection, hospitalization, and death among Black, Latinx, and Native American populations. These communities are two to five times more likely to be infected with the virus and suffer its consequences than their white communities. 

As a result, people within these communities are more likely to have directly suffered with the loss of a loved one, whether a family member or friend, and more likely to report anxiety and fear around becoming infected. These communities also face much greater challenges because of the economic downturn. Black and Latinx families have median net worths that are significantly lower than their white counterparts—around 10 times lower—which means job losses and financial stresses have hit these communities more than most, increasing the risk of depression, anxiety, substance use, and suicide. 

Gender and coping with COVID

Women have been disproportionately affected by COVID-19 in many of the same ways that Black, Latinx, and Native American communities have been disproportionately affected. Women make up the majority of the essential workforce in America, putting them more at risk of infection. They are also more likely to have experienced job loss due to the economic downturn, with more women employed in the hospitality and food service sectors that were among the hardest hit by the pandemic. 

These stressors—already significant—were compounded by school and daycare closures which continue across much of the country today. Women have taken on more of the burden of caring for children throughout the pandemic, forcing some to give up jobs, juggle working hours, and adding to their overall stress, frustration, and anxiety. As a result, 83% of women compared to 36% of men are reporting significant increases in depression. 

A path forward

There are no quick fixes to the mental health problems COVID-19 has created among Americans overall and these key communities in particular. But there are a few things we can think about as we try to move forward.

For example, as a vaccine becomes available, we should think about how we might prioritize distribution based not just on the physical risk of infection and serious disease, but also on the secondary risks to a person’s mental health and wellbeing. Similarly, as we think about how we might restructure our healthcare system to prepare ourselves for future pandemics, we should think about the systemic change needed across sectors to protect ourselves against future equivalents of CVTSD—the emotional fallout from a pandemic. 

Finally, and perhaps the step most simple for each of us to accomplish today, we should begin to talk much more openly about mental health, in homes, businesses, and schools alike. Research shows even modest interventions—such as asking people if they’re OK—can reduce suicides. Physical and mental health are intertwined, and we should speak as openly about the latter as we do of the former.