Abstract
Background: By March 2020, the World Health Organization declared the COVID-19 crisis as a worldwide pandemic and many local governments instituted stay-at-home orders and closed non-essential businesses. Within the United States, tens of millions of workers lost their jobs and financial security during the first few weeks of the national response, in an attempt to slow the global pandemic. Because of the enormity of the pandemic and its potential impact on mental health, the objective of the present study was to document the prevalence of mental health problems and their association with pandemic-related job loss during the third week of the nationwide shutdown.Methods: Mental health was assessed via online questionnaires among a representative sample of 1,013 U.S. adults on April 9–10, 2020. Rates of clinically significant mental health outcomes were compared between participants who lost their job as a result of COVID-19 restrictions (17.4%) vs. those who did not (82.6%). Bivariate multiple logistic regression identified factors that were predictive of, and protective against, mental health problems.Results: The prevalence of clinically significant symptoms was significantly higher than prior population estimates, ranging from 27 to 32% for depression, 30 to 46% for anxiety disorders, 15 to 18% for acute/post-traumatic stress, 25% for insomnia, and 18% for suicidal ideation. Prevalence estimates were 1.5–1.7 times higher for those who reported job loss due to COVID-19 restrictions than those who did not. Mental health problems were predicted by worry over financial instability, insomnia, social isolation, and alcohol consumption, while getting outside more often, perceived social support, and older age were protective against these problems.Conclusions: During the first 3 weeks of lockdowns/stay-at-home restrictions, mental health problems, including depression, anxiety, insomnia, and acute stress reactions were notably elevated relative to prior population estimates. Job loss related to the nationwide shutdown was particularly associated with poorer mental health. These findings provide a baseline of mental health functioning during the first weeks of the national emergency and lockdown orders in response to COVID-19.
Highlights
To that end, we studied the point prevalence of mental health problems in a nationally representative sample of adults in theU.S collected at the very outset of the pandemic, during the third week of the nationwide stay-at-home restrictions
For the sample as a whole, the proportions of individuals screening positive for probable mental health problems was notably higher than would be expected in a similar sample based on prior research [30, 31]
Other clinically significant anxiety disorders, the screenpositive prevalence ranged from 29.8% (STAI-State) to 45.8%
Summary
We studied the point prevalence of mental health problems in a nationally representative sample of adults in theU.S collected at the very outset of the pandemic, during the third week of the nationwide stay-at-home restrictions. We identified overall rates of mental health concerns in this sample and determined the differences in mental health outcomes between those who had lost their primary employment due to the economic shutdown and those who had not. We believe that these data will be critical for documenting the mental health status of the population during the initial phase of the COVID19 pandemic and will serve as a benchmark for future research on the long-term psychiatric outcomes of the crisis. By March 2020, the World Health Organization declared the COVID-19 crisis as a worldwide pandemic and many local governments instituted stay-at-home orders and closed non-essential businesses. Because of the enormity of the pandemic and its potential impact on mental health, the objective of the present study was to document the prevalence of mental health problems and their association with pandemic-related job loss during the third week of the nationwide shutdown
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