ISSUES & TRENDS: The Impacts of COVID-19 and Culture on Mental Health
Pre and Post-COVID Mental Health Statistics
The past two years have been a challenge for most Americans, and people all around the world, due to the COVID-19 pandemic that disrupted life as we knew it. Now that we are beginning to rebuild, recover, and redefine a new normal in a lot of ways, we are also able to see the true impact of the peak of the pandemic reflected in the data about mental health.
During the pandemic, the Census Bureau surveyed American adults with a Household Pulse Survey that included questions asking about depression (hopelessness and loss of interest in activities) and anxiety (nervousness and uncontrollable worrying) symptoms. The Household Pulse Survey found that in May 2021, 30% of American adults had symptoms consistent with an anxiety or depression diagnosis compared to 21% reporting facing mental illness issues in 2019 according to the Substance Abuse Mental Health Services Administration (SAMHSA). The highest number of Americans that reported symptoms consistent with depression and anxiety diagnosis was in November 2020 at 43%. In the Household Pulse Survey there were disparities in the results by age, gender, education, and race.
Americans ages 18-29 were more likely to report higher rates of anxiety and depression symptoms than other age groups. While almost half of Americans ages 18-29 (45%) reported symptoms of anxiety and depression during COVID on the Household Pulse Survey, 29% of young people reported experiencing mental illness in 2019 on the SAMHSA survey. In both surveys, young people were the highest reporting age group. This could reflect younger generations having more awareness and less stigma about discussing mental health issues; embracing social media movements focused on reducing stigma, self-care, and mindfulness; and using technology as a means to therapy and self help through apps like Better Help, Headspace, and Calm etc. Older generations may still have more of a stigma about discussing mental health issues, especially to people outside of the family.
Women are more likely to report a mental health challenge than men. The Household Pulse Survey found that 29% of women reported anxiety symptoms while only 22% of men reported anxiety symptoms. 23% of women reported depression symptoms while only 20% of men reported depression symptoms. This is consistent with the disparity pre-COVID, with women reporting mental illness (25%) being higher than men reporting mental illness (16%) according to SAMHSA. Society’s expectations of how men handle and acknowledge their emotions may play in the number of men that are comfortable reporting that they have anxiety or depression symptoms.
Adults with 4-year degrees (24%) reported fewer mental health challenges than adults that had not received a high school diploma (37%) according to the Household Pulse Survey. Pre-COVID there was very little disparity between people who had earned a 4-year degree (20%), 2-year degree (24%), high school diploma (19%), and not high school diploma (18%) according to SAMHSA. This could relate to the employment and economic challenges many families faced as shutdowns began to happen as a result of the pandemic. People with 4-year degrees may have had the ability to maintain employment that was reliable and secure whereas a person who had not received a high school diploma may have had a more unreliable employment situation throughout the pandemic.
While there were disparities in age, gender, and education as briefly described above, the remainder of this blog will look more deeply at the impact of culture and race on mental health. During the pandemic Hispanic (36%) and African Americans (34%) reported having anxiety or depression symptoms more than their White (28%) and Asian (25%) counterparts. Pre-COVID, Hispanics, Blacks, and Asian-Americans reported less mental illness than Whites in 2019 according to SAMSHA. The rise in reporting of anxiety and depression could be due to the disproportionate impact of COVID and other events happening the past 2 years (hate crimes, protests against police brutality, and unemployment) on people of color.
Cultural Implications Seeking Mental Health Care
During the pandemic, people of color faced health and economic challenges that white people did not have to endure, at least not at the same rate. These disparate pandemic-related outcomes had a corresponding adverse impact on mental health and wellness for people of color. To compound the situation, differences in norms, practices and beliefs in these communities also affected the propensity of members of these racial/ethnic communities to seek help with mental health.
Access to health care, itself, represents a barrier to seeking mental health care. According to research from The Commonwealth Fund, there is a large difference in the proportion of minority people who have a regular health care provider (66%) and their white counterparts who have a regular provider (80%), with Hispanics (58%) and Asians (60%) reporting the lowest rates. Not having a regular health care provider makes it difficult to see a professional that can help identify symptoms of mental health challenges and provide guidance to receive further help.
For some cultures, even if they have a regular provider, it would still be unlikely for them to discuss mental health issues. This is because, historically, it may be a cultural taboo. Mental health issues are seen as something to hide, something that can be used against you, something that makes you weak, instead of something that requires professional help, like a broken leg. If someone has a broken leg, it is normal amongst all cultures to seek medical attention to receive care. The same logic doesn’t always apply to the invisible wounds of mental health that people can’t see.
Once people make it past the barrier of the stigma of seeking mental health care, they may also face challenges with regard to finding a provider that understands them not only clinically, but also culturally and linguistically. According to the American Psychological Association (APA), in 2019, 7% of psychologists were Hispanic, 4% Asian, 3% Black, and 83% White. While 22% of households spoke a language other than English in 2019 (with 13.5 % speaking Spanish), only 10.8% of psychologists in the United States at that time reported being able to provide services in a language other than English (only 5.5% in Spanish). There is an overall shortage of mental health providers in the United States, but there is also a lack of diversity in the available providers. Having more providers of color would help ensure that clients’ needs are being met culturally and would create spaces to let clients express themselves in their native languages.
What Can We Do?
The data shared in the blog was national data, but our Austin community is experiencing this mental health crisis and these disparities just the same. We can plug in by joining mental health efforts in our community.
- Get trained in Mental Health First Aid – https://www.mentalhealthfirstaid.org/take-a-course/find-a-course/
- Join a committee focused on increasing mental health awareness for the Spanish speaking community – email jtunstill@canatx.org
Jelina Tunstill, CAN Program Coordinator
Sources
Mental Health First Aid https://www.mentalhealthfirstaid.org/2019/07/four-ways-culture-impacts-mental-health/
Counseling Today https://ct.counseling.org/2021/02/wanted-bilingual-and-bicultural-counselors/
American Psychological Association https://www.apa.org/workforce/data-tools/demographics