Update on Americans' Mental Health Status

Megan Brooks

September 23, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

In 2019, before the pandemic hit, nearly one in five US adults experienced symptoms of depression and nearly one in six suffered symptoms of anxiety, with women and young adults most at risk, the US Centers for Disease Control and Prevention (CDC) reports.

The new data released today are based on a nationally representative sample of nearly 32,000 adults and 6800 children aged 5-17 from more than 33,000 US households participating in the 2019 National Health Interview Survey (NHIS). 

The CDC said data collection for the 2020 NHIS is ongoing but these 2019 data provide "informative pre-pandemic benchmarks."

Among the key findings on depression, in 2019, 18.5% of adults reported symptoms of depression that were mild (11.5%), moderate (4.2%), or severe (2.8%) in the prior 2 weeks.

Depressive symptoms were most common in young adults aged 18-29 years (21.0%), followed by those aged 45-64 years (18.4%) and 65 years and over (18.4%), and lastly, by those aged 30-44 years (16.8%).

Women were more likely than men to experience symptoms of depression (21.8% vs 15.0%).

Non-Hispanic Asian adults were least likely to experience symptoms of depression compared with Hispanic, non-Hispanic White, and non-Hispanic Black adults.

The NHIS uses the 8-item Patient Health Questionnaire (PHQ-8), a validated diagnostic and severity measure of symptoms of depressive disorders.

The 2019 data on anxiety showed that 15.6% of adults experienced symptoms of anxiety that were mild (9.5%), moderate (3.4%), or severe (2.7%) in the prior 14 days.

Anxiety was most common in adults aged 18-29 years (19.5%) and 30-44 years (16.6%). Women were more likely than men to suffer anxiety (19.0% vs 11.9%). 

Non-Hispanic White adults were the most likely and non-Hispanic Asian adults were least likely to suffer mild, moderate, or severe anxiety compared with the other race and Hispanic groups.

The NHIS uses the 7-item Generalized Anxiety Disorder (GAD-7) questionnaire, a validated brief self-report measure to screen for GAD and assess symptom severity.

Two related reports also released today by the CDC provide data on mental health treatment among adults and children in 2019. 

Key Findings

Nearly one in five (19.2%) adults received any mental health treatment in 2019, with 15.8% taking prescription medication for their mental health and 9.5% receiving counseling or therapy from a mental health professional. Women were more likely than men to have received any mental health treatment.

Non-Hispanic White adults (23.0%) were more likely than non-Hispanic Black (13.6%) and Hispanic (12.9%) adults to receive mental health treatment.

Older children aged 12-17 years were more likely to receive prescription medication, counseling, or therapy for a mental health problem than younger children aged 5-11 years (16.8% vs 10.8%). Boys (9.8%) were more likely than girls (7.0%) to have taken medication for their mental health.

Both school-aged children and adults in the largest urban areas were less likely than similarly aged persons in smaller urban areas and rural areas to take prescription medication for their mental health in 2019.

The CDC emphasizes that the estimates released today are pre-pandemic. Since the onset of the COVID-19 pandemic, research has shown that symptoms of depression and anxiety have grown increasingly common among US adults.

One study showed that internet searches regarding acute anxiety reached an all-time high between March and May 2020, as reported by Medscape Medical News.

In July, an online survey conducted by Mental Health America (MHA) found a dramatic increase in depression, anxiety, psychosis, and suicidality since the start of the pandemic.

MHA has been conducting online screenings for 6 years. To date, nearly 5.5 million screenings have been completed, making it the largest screening program of its kind in the United States.

As of the end of June 2020, over 169,000 additional participants reported having moderate to severe depression or anxiety compared with participants who completed the screen prior to the pandemic, as reported by Medscape Medical News.  

In June alone, 18,000 additional participants were at risk for psychosis, continuing a rising pattern that began in May, when 16,000 reported psychosis risk.

"We continue to see staggering numbers that indicate increased rates in depression and anxiety because of COVID-19," Paul Gionfriddo, MHA president and CEO, said in a news release.

Last month, the World Health Organization said the COVID-19 pandemic is causing a mental health crisis in the Americas due to heightened stress and use of drugs and alcohol during 6 months of lockdowns and stay-at-home measures.

National Center for Health Statistics. Data briefs 378, 379, 380, 381. Published online September 23, 2020.

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