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Disclosures: The authors report no relevant financial disclosures.
April 01, 2021
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Adults' unmet mental health care need has increased since onset of COVID-19 pandemic

Disclosures: The authors report no relevant financial disclosures.
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Unmet mental health care need among adults has increased since the start of the COVID-19 pandemic, according to study results published in MMWR.

Adults also have exhibited increases in anxiety or depressive disorder symptoms.

infographic with quote from Anjel Vahratian

“The Household Pulse Survey began as a weekly data collection but evolved into a biweekly data collection,” Anjel Vahratian, PhD, associate director for science at the CDC National Center for Health Statistics’ division of health interview statistics, told Healio Psychiatry. “It would provide an opportunity to look at change over time overall, as well as among subgroups and later into the pandemic. As such, we could look at whether symptoms of an anxiety disorder or depressive disorder, the use of prescription medication and/or counseling for their mental health and unmet mental health care need changed over the course of the pandemic.”

The CDC and the U.S. Census Bureau conducted the Household Pulse Survey (HPS), which incorporated a probability-based design into a rapid-response online survey to assess the COVID-19 pandemic’s social and economic effects on U.S. households. The researchers based questions on mental health symptoms on the validated four-item Patient Health Questionnaire (PHQ-4) for depression and anxiety. Questions assessed how often in the past week participants had “been bothered” by feelings of nervousness, anxiousness or being on edge; an inability to stop or control worrying; a lack of interest or pleasure in doing things; and feeling down, depressed or hopeless. The researchers classified those with symptoms that generally occurred more than half of the days or almost daily as having symptoms.

To assess mental health care use, they included questions regarding whether in the past 4 weeks participants had taken prescriptions medication for their mental health, received counseling or therapy from a mental health professional, or needed but did not receive mental health professional intervention, which signified an unmet mental health need.

A total of 790,633 adults composed the sample size.

Results showed a significant increase between Aug. 19, 2020, to Feb. 1, 2021, in the percentage of adults with symptoms of an anxiety or depressive disorder in the past week, from 36.4% to 41.5%. Moreover, the percentage of participants who reported needing but not receiving mental health counseling or therapy in the past 4 weeks increased from 9.2% to 11.7%. Those aged 18 to 29 years, as well as those with less than a high school education, exhibited the largest increases.

Between Jan. 20, 2021, and Feb. 1, 2021, 23.8% of participants with symptoms of an anxiety or depressive disorder reported unmet mental health needs, with the percentage having increased 2.8 points between August 2020 and February 2021.

“Continued near real-time monitoring of mental health trends by demographic characteristics is critical during the COVID-19 pandemic,” Vahratian and colleagues wrote. “These trends might be used to evaluate the impact of strategies that address mental health status and care of adults during the pandemic and to guide interventions for groups that are disproportionately affected.”