JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic presented numerous worldwide effects. In the U.S., there have been 2.1 million cases and nearly 116,000 deaths as of June 17, 2020. Based on previous studies of mental health during outbreaks, the mental health of the population will be negatively affected in the aftermath. The long-term nature of this pandemic may lead to unforeseen mental health outcomes and/or unexpected relationships between demographic factors and mental health outcomes.

Objective:

This research focused on assessing the mental health status of adults in the U.S. during the early weeks of an unfolding pandemic.

Methods:

Data was collected from English-speaking adults using an online survey from early April to early June 2020. The final convenience sample included 1,083 U.S. residents. The 71-item survey consisted of demographic questions, mental health and wellbeing measures, a coping mechanisms checklist, and questions about COVID-19-specific concerns. Hierarchical multivariable logistic regression was utilized to explore associations among demographic variables and mental health outcomes. Hierarchical linear regression was conducted to examine associations among demographic variables, COVID-19-specific concerns, and mental health and wellbeing outcomes.

Results:

Approximately 50% of the U.S. sample was aged 45 and older. Most of the sample was White (96%), Non-Hispanic (93%), and female (82%). Participants reported high rates of depression (29%), anxiety (34%), and stress (73%). Older individuals were less likely to report depressive symptomology (OR=0.78, P<0.001) and anxiety symptomology (OR=0.72, P<0.001); and they had lower stress scores (-.15 points, SE=.01, P<.001), and increased wellbeing scores (+1.86 points, SE=22, P<.001). Individuals who were no longer working due to COVID-19 were 2.25 times more likely to report symptoms of depression (P=.02), had a .51-point increase in stress (SE=.17, P=.015), and a 3.9-point decrease in wellbeing scores (SE=1.49, P=.009) compared to individuals who were working remotely before and after COVID. Individuals who have partial or no insurance coverage were 2-3 times more likely to report depressive symptomology compared to individuals with full coverage (P=.02; P=.01). Individuals who were on Medicare/Medicaid were 1.97 times more likely, and individuals with no coverage were 4.48 times more likely, to report moderate or severe anxiety (P=.03; P=.01). Financial and food access concerns were significantly and positively related to depression, anxiety, and stress (all P<.05), and significantly negatively related to wellbeing (both P<.001). Economy, illness, and death concerns were significantly positively related to overall stress scores (all P<.05).

Conclusions:

Our findings suggest that many US residents are experiencing high stress, depressive, and anxiety symptomatology, especially among those under/uninsured or unemployed. Longitudinal investigation of these variables is recommended. Health practitioners may provide opportunities to allay concerns or offer coping techniques to individuals in need of mental health care. These messages should be shared in person and through practice websites and social media.