With a current infection scope of more than 16.3 million cases and a further death toll surpassing 649,000, the novel coronavirus is rapidly growing to be the worst pandemic of the 21st century (WHO, 2020). While these statistics might represent the disease’s impact, the Canadian Health Association asserts that the epidemic has implicated more strain on Canada’s psychological and mental health due to increased stress and suicidal thoughts among its residents. A recent study by the Canadian Mental Health Association (CMHA) revealed that 2.5% of all Canadians had suicidal thoughts in 2018. In 2019, however, the same study highlighted a surge of 6% in Canadians with a recent suicidal thought (CMHA, 2020). This report was further complemented by an experimental data system conducted by the National Center for Health Statistics (NCHS) to monitor recent mental health changes. The National Health Interview, conducted by the NCHS, affirmed a constant upward projection in the national percentage of individuals highlighting symptoms of anxiety disorder or depressive disorder across April to July. The national scope in figures erupted from 35.9% as of April 23 to reach a 41.2% peak on July 14. Although the positive projection was evident across most social and demographic groups, females were more prone to mental health instability by highlighting a 45.5% peak against 37.4% across males (CDC, 2020).
Pre COVID-19 Mental State
Before the advent of COVID-19, nearly 20% of the adults in the United States had reported having a mental illness. A further 11 million, as expressed by the Substance Abuse and Mental Health Services Administration, were asserted as having a severe mental illness that limited their normalcy in life activities (SAMHSA, 2019). Ideally, more than 20 million individuals, including both adults and children, had reported a major depressive episode as of 2018. With reference to the previously relayed NCHS report, anxiety and depression symptoms, which are taken to be indicative of an individual’s mental state, continue to assume higher tolls as the effects of COVID-19 intensify. To gauge the mental health crisis in the United States effectively, the Center for Disease Control and Prevention (CDC) availed the National Vital Statistics System mortality data that revealed a 35% surge in suicide rates from 1999 through 2018 (Hedegaard et al., 2018). The National Center for Health Statics also identified that this depressive state was expected to continue in the absence of the current pandemic despite the national interventions to lower suicide rates. The Mental Health of America also warns that the condition is not set to change as more strain is expected in the health department in the next months and years. Specifically, a higher downgrade is expected on mental health as a result of increased worry from COVID-19.
Further from suicide, the Center for Disease Control and Prevention conducted a meta-analysis of the prevalence rates in depression across American adults aged 20 and above. The results were also assertive of a depressed state, with 8.1% of all Americans aged 20 and above recording having depression between 2013-2016 (Brody et al., 2018). While suicides were more dominant across the male gender, the female gender again proved to be more prone to mental illness by assuming twice as likely a probability scope of 10.4% compared to the 5.5% of men who suffered from depression. Similar to previous revelations, mental illness, as defined by the prevalence rate of depression, was also dependent on the level of income. Specifically, the prevalence of depression decreased as family income level increased (Brody et al., 2018). The opposite is also true as equally basses the current mental health condition, where increased levels of unemployment are bound to increase the levels of depression among adults. The figure below represents the prevalence rates of depression by age and sex over the 2013-2016 period.
Figure 1: Percentage of persons aged 20 and over with depression, by age and sex: the United States, 2013–2016 (Brody et al., 2018)
According to the National Institute of Mental Health, mental illnesses are very common in the United States, with an approximate 46.6million people suffering as of 2017. Individuals encompassed in this clause consider any degree of severity. NIMH asserts that this figure was within an 18.9% toll of all U.S. adults. In contrast, NIMH also affirmed that only 19.8 million reported cases of mental illness had sought intervention (Substance Abuse and Mental Health Services Administration, 2018). This leaves more than 26 million adults with unattended mental illness (Figure 2). In 2017, SAMHSA reported an estimated 11.2 million cases of adults above 18 years suffering from severe mental illness. Out of this, only 7.5 million representing 66.7% of the population had received mental health treatment by 2018 (Figure 3). Current statistics only reveal a depressing world where most people suffer from mental illnesses without seeking professional intervention.
Figure 2: Prevalence of any mental illness among U.S. adults in 2017 (Substance Abuse and Mental Health Services Administration, 2018).
Figure 3: Prevalence of serious mental illness among U.S. adults in 2017 (Substance Abuse and Mental Health Services Administration, 2018).
Mental Health State During and Post-COVID-19
As the world prepares to return to normalcy amid the growing cases of COVD-19 infection and death cases, data from the Mental Health America stands indicative of a different comeback. According to the report, 4,895 more people have already recorded increased anxiety and depression conditions as opposed to what was recorded in the past two months (MHA, 2020). 58% of the study participants attributed their current depression state to loneliness and isolation. 48% of the cases were directly linked COVID-19 while a further 34% to other problems related to the current crisis. In asserting the condition’s adversity, 29% attributed their current mental status to low economic status, and 22% to grief from COVID-19 related worries (MHA, 2020). The direct link of such factors to the current COVID-19 crisis is expected to implicate an inevitable rise in percentages.
The mental health concerns of COVID-19 have grown beyond the scope of those directly infected also to include secondary beneficiaries. A perfect paradigm to this notion is the previously asserted relationship between unemployment and suicide rates (Figure 3. below). In a previous economic recession, the link was statistically expressed as a standard ration where a 1% increase in unemployment resulted in a 0.99% increase in the annual suicide rate (Reeves et al., 2012). Several studies have utilized time-trend regressions to assess and forecast excess suicides by the end of 2021, attributable to the economic effects of COVID-19 (McIntyre & Lee, 2020). With an already asserted downrange in employment, the model predicted a 15.7% suicide rate in 2020 and a further 16.2% in 2021. According to the CDC’s National Center for Health Statistics, the preliminary numbers would be a toll of 51,657 suicides in 2020 compared to the 48,344 cases in 2018 ( CDC, 2020). In the second scenario of a moderate surge in the unemployment rates, an excess of 3,235 suicides would have been recorded between 2020 and 2021, representing a 3.3% increase in the annual suicide cases. On the other hand, an extreme case of unemployment was expected to result in a 17.0 suicide rate, implying a further 8.4% annual increase in suicide rates (McIntyre & Lee, 2020).
Figure 4: Projected Excess Suicides from 2020 to 2021 (McIntyre & Lee, 2020)
Figure 5: The Relationship between suicide, age and income level (World Health Organization, 2019)
Although most of the effects attributed to COVID-19 have been mainly constrained to the economic sector, the Canadian Mental Health association asserts that the pandemic is bound to affect the mental health status of all demographics including parents, those with existing mental conditions, indigenous people, the disabled and the socially underrepresented groups in the community. In their recent study on the mental health of Canada during COVID-19, CMHA illustrated an effect of increased suicidal thoughts across 6% of the whole population, 18% of people already struggling with mental illnesses, 15% of people with disabilities, 14% of people with low incomes and 16% of indigenous people in Canada (CMHA, 2020). A similar scope was identified in the mental health of frontline health workers who reported increased psychological burdens and depression from the pandemic. This condition is indicative of the global state, implying a higher prevalence in mental health issues attributable to the current COVID-19 epidemic.
References
Brody, D. J., Pratt, L. A., & Hughes, J. P. (2018). Prevalence of depression among adults aged 20 and over the United States, 2013-2016 (pp. 1-8). U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.
CDC. (2020). Mental Health – Household Pulse Survey – COVID-19. Retrieved July 27, 2020, from https://www.cdc.gov/nchs/covid19/pulse/mental-health.htm
CMHA. (2020). Warning signs: more Canadians are thinking about suicide during a pandemic – CMHA National. Retrieved July 27, 2020, from https://cmha.ca/news/warning-signs-more-canadians-thinking-about-suicide-during-pandemic#_ftn1
Hedegaard, H., Curtin, S. C., & Warner, M. (2018). Suicide rates in the United States continue to increase. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.
McIntyre, R. S., & Lee, Y. (2020). Projected increases in suicide in Canada as a consequence of COVID-19. Psychiatry Research, 113104. https://doi.org/10.1016/j.psychres.2020.113104
MHA. (2020). Mental Health Concerns Growing as COVID-19 Pandemic Spreads and Intensifies. Retrieved July 27, 2020, from https://mhanational.org/mental-health-concerns-growing-covid-19-pandemic-spreads-and-intensifies
Reeves, A., Stuckler, D., McKee, M., Gunnell, D., Chang, S. S., & Basu, S. (2012). Increase in state suicide rates in the USA during an economic recession. The Lancet, 380(9856), 1813-1814.
SAMHSA. (2019). 2017-2018 NSDUH State Estimates of Substance Use And Mental Disorders. U.S. Department of Health & Human Health Services Retrieved July 27, 2020, from https://www.samhsa.gov/data/report/comparison-2008-2009-and-2017-2018-nsduh-state-prevalence-estimates
Substance Abuse and Mental Health Services Administration. (2018). Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health (HHS Publication No. SMA 18-5068, NSUDH Series H-53). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse, and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHFFR2017/NSDUHFFR2017.pdf.
World Health Organization. (2020). Coronavirus disease (COVID-19) – World Health Organization. Retrieved July 27, 2020, from https://www.who.int/emergencies/diseases/novel-coronavirus-2019
World Health Organization. (2019) . Suicide in the world: global health estimates. World Health Organization. https://apps.who.int/iris/handle/10665/326948. License: CC BY-NC-SA 3.0 IGO