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America's Mental Health Is the Lowest it's Been in Two Decades

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Key Takeaways

  • An annual survey, which began in 2001, found that Americans' mental and emotional well-being was lower than ever in 2020.
  • Experts believe that the COVID-19 crisis, plus financial pressures, systemic racism, and the stress of the election, have all contributed to widespread mental health issues.

Gallup’s annual Health and Healthcare survey has revealed the state of America’s mental and emotional well-being since 2001. Unsurprisingly, it took a bit of a hit in 2020. In fact, the nation’s collective mental health is currently worse than in any other year since the survey began, Gallup reported.  

Those who take the survey rate their own mental or emotional well-being as excellent, good, fair, or poor. From 2001 to 2019, the reading for those who chose excellent or good ranged from 81% to 89%. In November 2020, it was 76%, and the latest excellent ratings are 8 points lower than Gallup has recorded in any previous year.

Survey Results

The fall in Americans' mental and emotional well-being ratings isn't consistent across demographic subgroups. Since 2019, women, Republicans, independents, those who attend religious services less than weekly, white adults, unmarried people, older adults, and lower-income Americans all reported a double-digit drop in their excellent rating since 2019.

Meanwhile, Democrats and frequent church-goers reported the smallest change in their mental health ratings.

Gail Saltz, MD

Myself and most mental health professionals have been saying we are at a very low point in national mental health due to the pandemic, systemic racism, economic strain, etc.

— Gail Saltz, MD

However, the subgroups showing the greatest declines in excellent mental health are not necessarily the groups with the lowest positive ratings. For instance, Republicans and independents are more likely to say their mental health is excellent than Democrats. And women rate their mental and emotional well-being less positively than men.

These demographic patterns haven't changed significantly over the past 20 years, said Gallup.

The COVID-19 Effect

It doesn’t take too much guesswork to figure out why America’s mental health ratings have dropped in 2020. “Myself and most mental health professionals have been saying we are at a very low point in national mental health due to the pandemic, systemic racism, economic strain, etc.,” says Gail Saltz, MD, an associate professor of psychiatry at the NY Presbyterian Hospital Weill-Cornell School of Medicine and host of the “Personology” podcast from iHeartRadio. 

The COVID-19 pandemic, which has taken its toll on many people, has shown that nobody is immune to poor mental health. “Even those who have never experienced mental health concerns may see an uptick in emotions during the pandemic,” says Aron Tendler, MD, chief medical officer of BrainsWay.There may be increased feelings of anxiety resulting from the unknown—we don’t know what’s coming next, and we don’t have a definitive timeline for COVID-19 immunity yet.”

And while the last few weeks have brought positive developments, with two COVID-19 vaccines granted emergency use authorization by the Food and Drug Administration (FDA), there remain many unknowns. How will the pandemic impact the economy? What will happen to our jobs? What about the most vulnerable members of our community? Feelings of depression may also come from social distancing and loss of the usual societal support, says Dr. Tendler.  

Mental health can also fluctuate by season. “The winter months typically make it more difficult to socialize and spend time outdoors due to colder temperatures and fewer hours of daylight,” Dr. Tendler says. “Coupled with the additional isolation and anxiety caused by the pandemic, the winter months could create a ‘perfect storm’ for another spike in symptoms of depression and seasonal affective disorder (SAD).” 

A National Mental Health Crisis?

Another survey, published in August 2020 in the Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report, reported that more than 40% of Americans are struggling with mental health conditions as a result of the COVID-19 crisis. Some individuals have developed new conditions, while others have seen their symptoms worsen due to the pandemic.

Aron Tendler, MD

Even those who have never experienced mental health concerns may see an uptick in emotions during the pandemic. There may be increased feelings of anxiety resulting from the unknown.

— Aron Tendler, MD

According to the survey, 31% of respondents said they'd experienced symptoms of anxiety or depression, 26% said they'd experienced trauma or stressor-related disorder symptoms, 13% said they'd started or increased substance use, and 11% said they'd seriously considered suicide in the last 30 days. 

In response to what seems to be a national mental health crisis, the White House, the U.S. Department of Health and Human Services (HHS), the CDC, the CDC Foundation, and the Ad Council have joined forces to launch COPING-19, a national public service advertising (PSA) campaign. Its goal is to raise awareness of mental health conditions and provide people with tips and resources to help them face their personal mental health challenges. 

“With the prolonged health crisis and the isolation and economic challenges stemming from Covid-19, many aren’t talking about what’s happening with our mental health. COPING-19 is a far-reaching platform that provides self-care and coping tips, as well as resources, to address the struggles people are facing,” said Heidi Arthur, the chief campaign development officer at Ad Council, in a press release. 

Visitors to the campaign website, coping-19.org, will find more than 100 vetted resources (in both English and Spanish) to help with their mental health needs, as well as a set of self-care best practices and principles in line with recommendations from the CDC and leading scientists. Each category will also contain links to more in-depth information. 

Looking After Your Mental Health

As well as taking advantage of online resources such as COPING-19, American Foundation for Suicide Prevention, Mental Health America, and National Institute of Mental Health (NIMH), try to reach out to friends or family if you're struggling.

Face-to-face interaction may be difficult when COVID-19 restrictions are in place, but Dr. Tendler recommends calling a loved one on the phone, or using video chat. "If you're feeling isolated, try to remember why—it's for the greater good," he adds. "By self-quarantining and practicing social distancing, you are helping to flatten the curve and prevent the spread of coronavirus."

What This Means For You

If you think your mental and emotional health has suffered in 2020, you might find some comfort in knowing that you're definitely not alone. The events of this year are unprecedented, and it's completely natural to feel overwhelmed, stressed, anxious, or lonely—or all of the above. Be kind to yourself, and get support wherever you can find it.

If you don't feel mentally well, Dr. Saltz recommends seeking professional help sooner rather than later. "Reach out to find a therapist," she says. "You don’t need to wait until you are utterly in crisis mode."

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  1. Gallup. Americans' mental health ratings sink to new low. Published December 7, 2020. 

  2. Czeisler M, Lane RI, Petrosky E, et al. Mental health, substance use, and suicidal ideation during the COVID-19 pandemic — United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:1049-1057. doi:10.15585/mmwr.mm6932a1