11% of US adults seriously considered suicide in June even as 41% faced adverse mental, behavioral issues: CDC
The Covid-19 pandemic has been associated with mental health challenges and a new report now reveals how significant the impact has been. An estimated 11% of adults in the US have seriously considered suicide in June, approximately double the percentage of those who did so in 2018, according to the US Centers for Disease Control and Prevention (CDC).
The authors found that symptoms of anxiety disorder and depressive disorder increased considerably in the US during April-June of 2020, compared with the same period in 2019. To assess mental health, substance use and suicidal ideation during the pandemic, surveys were conducted among adults aged 18 years and above across the US during June 24-30, 2020.
The percentage of respondents who reported having seriously considered suicide in the 30 days before completing the survey (10.7%) was significantly higher among those aged 18-24 years (25.5%), minority racial/ ethnic groups (Hispanic respondents at 18.6%, non-Hispanic Black respondents at 15.1%), self-reported unpaid caregivers for adults (30.7%) and essential workers (21.7%).
Overall, 40.9% of 5,470 respondents who completed surveys during June said they were struggling with at least one adverse mental or behavioral health condition, including those who reported symptoms of anxiety disorder or depressive disorder (30.9%). According to the researchers, the prevalence of symptoms of anxiety disorder was approximately three times more as compared to the second quarter of 2019 (25.5% versus 8.1%), and prevalence of depressive disorder was approximately four times those reported in the second quarter of 2019 (24.3% versus 6.5%).
Adults also had symptoms of trauma- and stressor-related (TRSD) disorder connected to Covid-19 (26.3%). According to the analysis, 13.3% said they started or increased substance use to cope with stress or emotions related to the pandemic. “Approximately one-quarter of respondents reported symptoms of a TSRD related to the pandemic, and approximately one in 10 reported that they started or increased substance use because of Covid-19. Suicidal ideation was also elevated. Approximately twice as many respondents reported serious consideration of suicide in the previous 30 days than did adults in the US in 2018, referring to the previous 12 months (10.7% versus 4.3%),” write the authors.
Some are more affected than others
The team found that mental health conditions are disproportionately affecting specific populations, especially young adults, Hispanic persons, Black persons, essential workers, unpaid caregivers for adults and those receiving treatment for preexisting psychiatric conditions. At least one adverse mental or behavioral health symptom was reported by more than one-half of respondents who were aged 18-24 years (74.9%) and 25-44 years (51.9%), of Hispanic ethnicity (52.1%), and who held less than a high school diploma (66.2%), as well as those who were essential workers (54%), and unpaid caregivers for adults (66.6%) at the time of the survey.
Suicidal ideation was more prevalent among males than among females. Symptoms of anxiety disorder or depressive disorder, Covid-19-related TSRD, initiation of or increase in substance use to cope with Covid-19-associated stress and serious suicidal ideation in the previous 30 days were most commonly reported by persons aged 18-24 years. Prevalence decreased progressively with age.
Hispanic respondents had a higher prevalence of symptoms of anxiety disorder or depressive disorder, Covid-19-related TSRD, increased substance use, and suicidal ideation than did non-Hispanic Whites or non-Hispanic Asian respondents. According to the analysis, Black respondents reported increased substance use and past 30-day serious consideration of suicide in the previous 30 days more commonly than did White and Asian respondents.
Respondents who reported treatment for diagnosed anxiety, depression, or PTSD at the time of the survey had a higher prevalence of symptoms of adverse mental and behavioral health conditions compared with those who did not. At least one adverse mental or behavioral health symptom was experienced by those who reported treatment for diagnosed anxiety (72.7%), depression (68.8%) or PTSD (88.0%).
Unpaid caregivers for adults, many of whom are currently providing critical aid to persons at increased risk for severe illness from Covid-19, also had a higher incidence of adverse mental and behavioral health conditions compared with others. Adverse conditions were more prevalent among unpaid caregivers for adults than among those who were not, with particularly large differences in increased substance use (32.9% versus 6.3%) and suicidal ideation (30.7% versus 3.6%) in this group. “Although unpaid caregivers of children were not evaluated in this study, approximately 39% of unpaid caregivers for adults shared a household with children (compared with 27% of other respondents). Caregiver workload, especially in multigenerational caregivers, should be considered for future assessment of mental health, given the findings of this report and hardships potentially faced by caregivers,” the study recommends.
Recommendations
Based on their findings, the team recommends that the public health response to the coronavirus pandemic should increase intervention and prevention efforts to address associated mental health conditions. Community-level efforts, including health communication strategies, should prioritize young adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers.
“Identification of populations at increased risk for psychological distress and unhealthy coping can inform policies to address health inequity, including increasing access to resources for clinical diagnoses and treatment options. Expanded use of telehealth, an effective means of delivering treatment for mental health conditions, including depression, substance use disorder, and suicidal ideation, might reduce Covid-19-related mental health consequences,” the investigators recommended.
According to the researchers, community-level intervention and prevention efforts should include strengthening economic supports to reduce financial strain, addressing stress from experienced racial discrimination, promoting social connectedness, and supporting persons at risk for suicide. Communication strategies should focus on the promotion of health services, and culturally and linguistically tailored prevention messaging regarding practices to improve emotional well-being, they added.
To reduce potential harms of increased substance use related to Covid-19, resources, including social support, comprehensive treatment options, and harm reduction services, are essential and should remain accessible, say experts. “Periodic assessment of mental health, substance use, and suicidal ideation should evaluate the prevalence of psychological distress over time. Addressing mental health disparities and preparing support systems to mitigate mental health consequences as the pandemic evolves will continue to be needed urgently,” they emphasize.
The authors also suggest that future studies should identify drivers of adverse mental and behavioral health during the pandemic and whether factors such as social isolation, absence of school structure, unemployment, and other financial worries, and various forms of violence (such as physical, emotional, mental, or sexual abuse) serve as additional stressors.