Mental Health and COVID-19 2021 Data

Mental Health and COVID-19 | Two years into the pandemic, mental health concerns continue to increase

In 2014, Mental Health America (MHA) created the Online Screening Program (www.mhascreening.org), a collection of 10 free, anonymous, confidential, and clinically validated screens that are among the most commonly used mental health screening tools in clinical settings. Since its launch, over 14 million people have taken a screen to check their mental health concerns online, making this program the nation’s largest ongoing, real-time mental health early identification program.

COVID-19 has had a profound negative effect on the mental health of the nation. Throughout the COVID-19 pandemic, MHA has witnessed increasing numbers of people experiencing anxiety, depression, psychosis, loneliness, and other mental health concerns.

Key Findings

In 2021, over 5.4 million (N=5,441,125) people took a mental health screen, representing a nearly 500% increase over the number of people who completed a screening in 2019 and a 103% increase over 2020.

The following findings emerged from analysis of the over 4.1 million people who took a mental health screen in the United States from January-December 2021.

2021 Screening Demographics

In total, 4,155,728 people from the United States took a screen through MHA Screening in 2021. Of them, the majority took a depression screen (32%), followed by the anxiety screen (20%), and the bipolar screen (16%).

The percentage of individuals who took a depression screen decreased slightly from 2020-2021

The percentage of individuals who took a depression screen decreased slightly from 2020-2021, while the percentage of individuals who took an anxiety screen remained the same. Individuals were more likely to take eating disorder, PTSD, youth, alcohol or substance use, parent, and postpartum depression screens in 2021 compared to 2020.

Depression screen

2021: 32.26%
2020: 35.26%

Anxiety screen

2021: 20.46%
2020: 20.36%

Bipolar screen

2021: 16.48%
2020: 17.21%

Psychosis screen

2021: 8.71%
2020: 9.27%

Eating disorder screen

2021: 7.37%
2020: 5.47%

Youth screen

2021: 5.57%
2020: 5.25%

PTSD screen

2021: 5.46%
2020: 4.24%

Alcohol or substance use screen

2021: 1.54%
2020: 1.30%

Parent screen

2021: 1.08%
2020: 0.79%

Postpartum depression screen

2021: 1.06%
2020: 0.85%

Seventy percent of screeners identified as female and 25% as male

Seventy percent of screeners identified as female, 25% identified as male, and 5% identified as another gender. The percentage of screeners who identified as another gender increased 2.35% from 2020 to 2021. In April 2020, MHA added a separate option to identify as transgender. Four percent of screeners from the U.S. (N=177,425) identified as transgender in 2021.

People who accessed screening in 2021 were younger than the 2019 and 2020 averages. Forty-five percent of screeners in 2021 were youth ages 11-17, a 16% increase over 2019 (29%) and a 3% increase over 2020 (42%).

The race/ethnicity demographics in 2021 largely matched 2020

The race/ethnicity demographics of U.S. screeners in 2021 largely matched the race/ethnicity of screeners in 2020. Similar to 2020, 15% of individuals who took a screen in the U.S. in 2021 identified as Asian or Pacific Islander, a 6% increase over the percentage in 2019, prior to the COVID-19 pandemic.

In May 2021, MHA added “Middle Eastern or North African” to the race/ethnicity categories. Two percent of screeners from the U.S. identified as Middle Eastern or North African in 2021.

Asian or Pacific Islander

Black or African American (non-Hispanic)

Hispanic or Latino

More than one of the above

Native American or American Indian

Other

White (non-Hispanic)

Middle Eastern or North African

2021 count: 64,648
2021 percentage: 2.09%

Middle Eastern or North African was not added as an option on the demographic questions until May 2021.

Grand Total

2019 count: 383,523
2020 count: 1,900,409
2021 count: 3,097,099

Screeners in 2021 reported slightly higher household incomes

Screeners in 2021 reported slightly higher household incomes than those in 2019 and 2020. Forty-nine percent of screeners in the U.S. reported a household income of less than $40,000 in 2021, compared to 52% in 2019 and 50% in 2020. One quarter (25%) of screeners in the U.S. reported a household income greater than $80,000 in 2021, compared to 22% in 2019 and 24% in 2020.

Less than $20,000

$20,000 - $39,999

$40,000 - $59,999

$60,000 - $79,999

$80,000 - $99,999

$100,000 - $149,999

$150,000+

Grand Total

2019 count: 255,490
2020 count: 1,273,950
2021 count: 2,328,350

Mental Health Conditions Scores

Across all screens, 76% (N=3,177,747) of users in the U.S. scored positive or with moderate to severe symptoms of a mental health condition in 2021. This was a 2% increase over the average in 2019 (74%, N=673,696) and a 1% increase over the percentage of individuals who screened at risk in 2020 (75%, N=2,018,627). Since August 2020, the percentage of individuals scoring positive or with moderate to severe symptoms of any mental health condition has been higher than pre-COVID-19 rates.

Among people who screened positive or with moderate to severe symptoms, 66% (N= 1,706,300) had never been diagnosed with a mental health condition. Sixty-four percent (N= 1,647,492) had never received treatment or support before, which was equivalent to 2020 and 7% higher than the percentage who had not received treatment in 2019 (57%).

The largest increases in the percentage of people scoring positive were on the parent screen

The largest increases in the percentage of people scoring positive from both 2019-2021 and 2020-2021 were on the parent screen (12% increase from 2019-2021 and 3% increase from 2020-2021). This was followed by the youth screen (9% increase from 2019-2021 and 3% increase from 2020-2021). Both screens are designed to measure emotional, attentional, or behavioral difficulties among youth, and these increases reflect the increasing mental health needs among youth in the United States during the COVID-19 pandemic.

From 2019-2021 there were also significant increases in the percentage of individuals who scored at risk for PTSD (5% increase, from 84% screening positive in 2019 to 89% screening positive in 2021), severe anxiety (5% increase, from 43% in 2019 to 48% in 2021), and risk for psychosis (3% increase, from 73% scoring at risk in 2019 to 76% in 2021). The increased rates of severe anxiety, PTSD, and psychosis continued throughout 2021, indicating a meaningful change during the pandemic for these conditions.

Alcohol or substance use screening results

Likely substance use results

Unlikely substance use results

Anxiety screening results

Minimal anxiety results

Mild anxiety results

Moderate anxiety results

Severe anxiety results

Bipolar screening results

Negative bipolar results

Positive bipolar results

Depression screening results

Minimal depression results

Mild depression results

Moderate depression results

Moderately severe depression results

Severe depression results

Eating disorder results

At risk for eating disorder results

Avoidant/Restrictive food intake disorder results

Low risk for eating disorder results

Postpartum depression results

2020 count: 22,851
2020 percentage: 0.85%
2021 count: 44,692
2021 percentage: 1.08%

The Postpartum Depression Screen was not implemented utnil May 2020.

Postpartum depression is not likely results

2020 count: 998
2020 percentage: 4.37%
2021 count: 1,936
2021 percentage: 4.40%

Postpartum depression is possible results

2020 count: 1,323
2020 percentage: 5.79%
2021 count: 4,074
2021 percentage: 9.27%

Postpartum depression is highly possible results

2020 count: 1,447
2020 percentage: 6.33%
2021 count: 3,827
2021 percentage: 8.71%

Postpartum depression is probable results

2020 count: 19,083
2020 percentage: 83.51%
2021 count: 34,124
2021 percentage: 77.62%

Parent screening results

At risk results

Low risk results

Psychosis screening results

Low/No risk results

Possible risk results

PTSD screening results

Negative PTSD results

Positive PTSD results

Youth screening results

At risk results

Low risk results

Grand total

2019 count: 910,750
2020 count: 2,677,734
2021 count: 4,155,728

High Rates of Anxiety Persist in the U.S., Especially for Youth and Black or African American Individuals

MHA uses the Generalized Anxiety Disorder 7-item (GAD-7) tool to screen for anxiety. The number of help-seekers experiencing anxiety and the severity of that anxiety increased in 2020-2021. In total, 850,267 people in the U.S. took an anxiety screen in 2021, which was 422% higher than the total number of anxiety screens taken in 2019 and 56% higher than the number taken in 2020. On average, 2,329 people in the U.S. took an anxiety screen each day in 2021.

Rates of moderate to severe anxiety began increasing in June 2020 and have remained above pre-COVID-19 levels through December 2021. Of the nearly 1 million people who took an anxiety screen in 2021, 79% (N=673,811) scored with symptoms of moderate to severe anxiety. This was equal to the average rate in 2020, and nearly 5% higher than the average rate in 2019 (74%, N=120,948).

Youth ages 11-17 were most likely age group to score with moderate to severe symptoms of anxiety

Throughout the pandemic, youth ages 11-17 were more likely to score with moderate to severe symptoms of anxiety than any other age group. Eighty-four percent (N=254,807) of 11-17-year-olds who took an anxiety screen in 2021 scored with symptoms of moderate to severe anxiety, equal to the rate of youth who scored at risk for anxiety in 2020.

Minimal to mild anxiety

Moderate to severe anxiety

Grand total

Rates of moderate to severe anxiety continue to be much higher in 2021

Rates of moderate to severe anxiety continue to be much higher in 2021 than the pre-pandemic average for screeners of every race/ethnicity. The percentage of people in 2021 scoring with moderate to severe symptoms of anxiety was highest among individuals who identified as more than one race (83%). Between 2020-2021, rates of anxiety only increased for individuals who identified as Black or African American (1.02% increase), more than one race (0.53% increase), and Hispanic or Latino (0.08% increase).

The largest increases in the percentage of people scoring for moderate to severe anxiety between 2019 and 2021 was for Black screeners (4.63% increase), followed by screeners who identified their race as “other” (3.55% increase), and Asian or Pacific Islander screeners (3.54% increase).

Average rate of moderate to severe anxiety by race/ethnicity