Mental health encompasses an individual’s emotional, psychological, and social well-being, influencing cognition, emotional regulation, and behavior. This article explores the shifts in societal mental well-being observed in relation to the COVID-19 pandemic.
Mental Health Before the Pandemic
Prior to the COVID-19 pandemic, mental health conditions were already a global concern. In 2019, one in eight people, or 970 million individuals worldwide, were living with a mental disorder. Anxiety disorders and depressive disorders were the most commonly reported conditions. For instance, 301 million people were living with an anxiety disorder, including 58 million children and adolescents, while 280 million people were living with depression, including 23 million children and adolescents.
The prevalence of any mental illness (AMI) among adults in the U.S. had been on an upward trend, increasing from 17.7% in 2008 to 20.6% in 2019. Similarly, the prevalence of serious mental illness (SMI) rose from 3.7% to 5.2% during the same period. Despite this growing prevalence, access to effective care remained a challenge for most individuals with mental disorders, compounded by experiences of stigma and discrimination.
The Pandemic’s Impact on Mental Well-being
The COVID-19 pandemic impacted global mental health, increasing the prevalence and severity of various conditions. In the first year of the pandemic, global prevalence of anxiety and depression increased by 25%. The Centers for Disease Control and Prevention (CDC) reported that anxiety disorder was three times greater in 2020 compared to 2019 (25.5% versus 8.1%), and depression was four times greater (24.3% versus 6.5%). By early 2021, four in ten adults reported symptoms consistent with anxiety and depression.
Multiple factors contributed to this decline in mental well-being. Social isolation, stemming from stay-at-home orders, travel restrictions, and social distancing measures, emerged as a key stressor. This isolation limited people’s ability to work, seek support from loved ones, and engage in their communities, fostering feelings of loneliness. Economic insecurity, including job loss, unemployment, and income uncertainty, also played a role in exacerbating mental distress. Many workers faced fear of job loss (52%) and worry about income loss (45%) in April 2020.
The disruption of daily routines, fear of illness and death for oneself and loved ones, and grief after bereavement further compounded psychological distress. Remote work and school arrangements introduced new stressors, such as balancing work demands with parenting and distance learning responsibilities. Caregiver burdens, particularly for those caring for elderly parents, added another layer of stress. The uncertainty surrounding the pandemic’s duration and its long-term effects also contributed to increased anxiety.
Different demographic groups experienced unique or exacerbated challenges. Young people, for instance, were more affected, with studies showing levels of clinical depression (48%) and anxiety (51%) among youth during the pandemic. They also experienced disruptions to key developmental milestones, including social delays and a lack of social confidence.
Healthcare workers faced pressure due to patient surges, longer working hours, and shortages of supplies, leading to rates of burnout, anxiety, depression, and post-traumatic stress disorder (PTSD). In 2022, 46% of healthcare workers reported feeling burned out often or very often, compared to 32% in 2018. Vulnerable populations, such as those with pre-existing mental disorders or chronic health conditions, and individuals experiencing household job loss, were more likely to report symptoms of anxiety and depression.
Strategies for Mental Health Support
In response to the pandemic’s impact, various approaches emerged for supporting mental health. Increasing mental health awareness and actively working towards destigmatization are key steps. Educating the public about mental health issues, dispelling myths, and promoting open conversations can help normalize discussions and reduce judgmental attitudes. Initiatives that encourage sharing personal stories of recovery and resilience can also shift public perceptions.
The expansion of accessible mental health resources has become important. Telehealth services, including virtual therapy and peer support, emerged as a flexible alternative to in-person care, removing traditional barriers like accessibility and availability. Community-based programs, such as gardening classes and walking groups that foster social connection, have also demonstrated positive impacts on mental well-being. Peer support networks, where individuals with shared experiences offer mutual aid, have proven beneficial in addressing conditions like depression and hostility in various contexts. Organizations like NAMI provide peer-led support groups, many of which are now virtual, offering opportunities for individuals and families to share experiences and gain support.
Broad policy considerations include incorporating mental health and psychosocial support into public health response plans, as 90% of countries surveyed by the WHO had already begun to do. Ensuring equitable access to affordable mental health services for uninsured or underinsured individuals is also a policy goal. On an individual level, coping mechanisms like limiting alcohol consumption, engaging in regular exercise, and practicing mindfulness techniques can help manage stress and anxiety.