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Disclosures: Healio Psychiatry was unable to confirm relevant financial disclosures at time of reporting.
March 16, 2021
3 min read

Mental wellbeing declined significantly during 2020, global report finds

Disclosures: Healio Psychiatry was unable to confirm relevant financial disclosures at time of reporting.
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A report that outlined global mental health during 2020 found societal circumstance and behavior had an “enormous impact” on mental wellbeing.

Further, researchers noted a crisis of mental wellbeing among young people and individuals who identify as nonbinary or third gender.

infographic showing mental wellbeing between 2019 and 2020
Reference: Sapien Labs. Mental state of the world 2020. Available at: Accessed March 16, 2020.

“This represents the first annual report of the Mental Health Million project, an ongoing effort to measure and track the mental wellbeing of our global population, with the goal of providing deep insights into its drivers that can be used to guide the development of effective policy and intervention,” Jennifer Newson, PhD, lead scientist for cognitive and mental Health at Sapien Labs, and colleagues wrote. “Mental wellbeing, as measured by the Mental Health Quotient or MHQ, a free and anonymous online assessment tool, encompasses a comprehensive view of our emotional, social and cognitive function and capability. In its first year, the Mental Health Million project obtained data from [approximately] 49,000 people across [eight] English speaking countries: United States, Canada, United Kingdom, Australia, New Zealand and the substantial English-speaking populations of South Africa, India and Singapore.”

Data revealed several significant mental health-related findings for 2020, although the researchers noted that the included samples may not be fully representative of a country. The overall mental wellbeing score in the aggregate was 66 for 2020 vs. 90 in 2019. The 2019 data were obtained from a different and relatively smaller sample of individuals from the same countries. The 2020 results marked an 8% shift down the MHQ scale. A total of 14% of respondents in 2019 had clinical level risk vs. 26% in 2020. The drop in mental wellbeing between the two years was most pronounced among young adults aged 18 to 24 years.

On a country level, Singapore and U.S. respondents had the highest average mental wellbeing scores, with the lowest among those from the U.K. and South Africa overall and across multiple dimensions.

Young adults aged 18 to 24 years had MHQ scores that were 86 points lower vs. older adults aged 65 years or older, which demonstrated a shift of 27% along the MHQ scale. Each younger generation had a systematic decrease in mental wellbeing. A total of 44% of young adult respondents had clinical level risk, whereas adults aged 65 years or older had a risk of 6%. Specifically, young adults’ self-worth and confidence appeared significantly compromised, as well as their focus and concentration. They also struggled with feelings of sadness and distress and unwanted and obsessive thoughts.

Individuals who identified as nonbinary or third gender were at highest risk for suicide, with adults in these populations having significantly compromised mental wellbeing; over 50% were in the category of clinical level risk and average MHQ scores were approximately 47 points lower than males and females combined. These individuals reported substantial suicidal thoughts and intentions relative to other groups.

The COVID-19 pandemic appeared to play an important role in changes in mental wellbeing between 2019 and 2020. A total of 57% of respondents experienced various negative health, financial or social consequences. The 2% of respondents who were not able to receive critical care for other existing health conditions because of the pandemic had the worst mental wellbeing, which was 61 points lower on the MHQ scale vs. those who did not experience these negative consequences.

Sleep, socializing and exercise appeared to affect all facets of mental wellbeing, although certain aspects of mental wellbeing that were most impacted across these three domains differed.

“Altogether we advocate for embedding a population-based approach to mental wellbeing into social and economic policy,” Newson and colleagues wrote. “We also join a growing call for greater research investment into understanding the drivers of the mental health crisis of young adults and nonbinary/third gender adults, and in understanding the factors that impact people’s lifestyle habits relating to exercising, socializing and sleep. Finally, we encourage a greater role for schools, universities and companies in actively enabling the mental wellbeing of their students and workforce.”


Sapien Labs. Mental state of the world 2020. Available at: Accessed March 16, 2020.