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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.

  • The number of people looking online for help with their mental health increased significantly from 2019-2021. 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.
  • More youth are struggling with their mental health and are seeking support online. Forty-five percent of individuals in the U.S. who took a screen in 2021 were youth ages 11-17 – 16% higher than the average in 2019.
  • The largest increases in the percentage of people scoring positive from 2019-2021 were on the parent and youth screens, indicating a large increase in the percentage of youth experiencing emotional, attentional, or behavioral difficulties during the pandemic. There were also significant increases in the percentage of people scoring at risk for PTSD, severe anxiety, and psychotic-like experiences from 2019-2021.
  • 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 and a 1% increase over the percentage of individuals who screened at risk in 2020.
  • The number and percentage of people screening with moderate to severe symptoms of anxiety remain higher than rates prior to COVID-19, and are particularly severe for youth and multiracial screeners. 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. Of the nearly one million people who took an anxiety screen in 2021, 79% (N=673,811) scored with symptoms of moderate to severe anxiety.
  • Black individuals in the U.S. had the largest increase in anxiety during the pandemic, compared to other races/ethnicities. The percentage of Black individuals screening with symptoms of moderate to severe anxiety increased 5% from 2019-2021.
  • The percentage of people in the U.S. reporting frequent thoughts of suicide and self-harm in 2021 is the highest recorded since the MHA Screening Program launched in 2014. Overall, 39% (N=516,372) of individuals in the U.S. who took the depression screen reported frequent suicidal ideation in 2021. This was 8% higher than the average rate of suicidal ideation in 2019 (31%, N=101,815) and 2% higher than the rate in 2020 (37%, N=347,782).
  • Rates of suicidal ideation are highest among youth, especially LGBTQ+ youth. Overall, 51% (N=245,979) of all youth depression screeners ages 11-17 reported frequent suicidal ideation on more than half or nearly every day of the previous two weeks. Sixty-three percent (N=99,048) of youth ages 11-17 who identified as LGBTQ+ reported frequent suicidal ideation.
  • Suicidal ideation has increased most for Black youth and adults from 2019-2021. Black or African American screeners had the highest increase in reported suicidal ideation from 2019-2021 (8.59% increase) and 2020-2021 (1.70% increase). The increase in rate of reported suicidal ideation for Black screeners from 2019-2021 was nearly 2% higher than the increase among screeners of any other race/ethnicity.
  • Over 300,000 people took a psychosis screen in 2021, with 78% scoring at risk for psychotic-like episodes in February and March. In total, 362,144 individuals took the psychosis screen in 2021, a 188% increase over the number of psychosis screens taken in 2019 (N=125,461) and a 46% increase over 2020 (N=248,186).
  • People screening at risk for mental health conditions are struggling most with loneliness or isolation. The differences in the things contributing most to mental health concerns among individuals of different races and ethnicities reveal inequities in the experience of 2020-2021. Among individuals who screened positive or moderate to severe for a mental health condition in 2021, 63% reported that one of the top three things contributing to their mental health concerns was loneliness or isolation. This was followed by 49% reporting past trauma and 37% reporting relationship problems.

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.

Line graph of number of screens taken by month, years 2014-2021

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%). 

Largest percentage of screeners take depression, anxiety screens in 2021 (with chart)

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, 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%).

Bar graph comparing the percentage of screeners by age in 2021

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

  • 2019 count: 35,021
  • 2019 percentage: 9.13%
  • 2020 count: 293,721
  • 2020 percentage: 15.46%
  • 2021 count: 474,987
  • 2021 percentage: 15.34%

Black or African American (non-Hispanic)

  • 2019 count: 33,696
  • 2019 percentage: 8.79%
  • 2020 count: 159,449
  • 2020 percentage: 8.39%
  • 2021 count: 235,795
  • 2021 percentage: 7.61%

Hispanic or Latino

  • 2019 count: 47,414
  • 2019 percentage: 12.36%
  • 2020 count: 232,274
  • 2020 percentage: 12.22%
  • 2021 count: 365,168
  • 2021 percentage: 11.79%

More than one of the above

  • 2019 count: 20,883
  • 2019 percentage: 5.45%
  • 2020 count: 95,631
  • 2020 percentage: 5.03%
  • 2021 count: 158,212
  • 2021 percentage: 5.11%

Native American or American Indian

  • 2019 count: 5,020
  • 2019 percentage: 1.31%
  • 2020 count: 22,969
  • 2020 percentage: 1.21%
  • 2021 count: 44,745
  • 2021 percentage: <1.44%

Other

  • 2019 count: 12,893
  • 2019 percentage: 3.36%
  • 2020 count: 94,510
  • 2020 percentage: 4.97%
  • 2021 count: <159,312
  • 2021 percentage: <5.14%

White (non-Hispanic)

  • 2019 count: 228,596
  • 2019 percentage: 59.60%
  • 2020 count: 1,001,855
  • 2020 percentage: 52.72%
  • 2021 count: <1,594,232
  • 2021 percentage: <51.48%

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 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

  • 2019 count: 77,086
  • 2019 percentage: 30.17%
  • 2020 count: 374,020
  • 2020 percentage: 29.36%
  • 2021 count: 672,301
  • 2021 percentage: 28.87%

$20,000 - $39,999

  • 2019 count: 56,749
  • 2019 percentage: 22.21%
  • 2020 count: 263,897
  • 2020 percentage: 20.71%
  • 2021 count: 469,120
  • 2021 percentage: 20.15%

$40,000 - $59,999

  • 2019 count: 38,840
  • 2019 percentage: 15.20%
  • 2020 count: 187,123
  • 2020 percentage: 14.69%
  • 2021 count: 339,598
  • 2021 percentage: 14.59%

$60,000 - $79,999

  • 2019 count: 26,309
  • 2019 percentage: 10.30%
  • 2020 count: 138,027
  • 2020 percentage: 10.83%
  • 2021 count: 256,506
  • 2021 percentage: 11.02%

$80,000 - $99,999

  • 2019 count: 19,034
  • 2019 percentage: 7.45%
  • 2020 count: 96,813
  • 2020 percentage: 7.60%
  • 2021 count: 180,041
  • 2021 percentage: 7.73%

$100,000 - $149,999

  • 2019 count: 22,050
  • 2019 percentage: 8.63%
  • 2020 count: 117,331
  • 2020 percentage: 9.21%
  • 2021 count: 218,009
  • 2021 percentage: 9.36%

$150,000+

  • 2019 count: 15,422
  • 2019 percentage: 6.04%
  • 2020 count: 96,739
  • 2020 percentage: 7.59%
  • 2021 count: 192,775
  • 2021 percentage: 8.28%

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.

Percentage of all screeners scoring at risk elevated since August 2020 - bar graph

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%).

Have you ever received treatment or support for a mental health problem? with two pie charts, one from 2019 and one from 2021

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

  • 2019 count: 15,086
  • 2019 percentage: 1.66%
  • 2020 count: 34,823
  • 2020 percentage: 1.30%
  • 2021 count: 64,126
  • 2021 percentage: 1.54%

Likely substance use results

  • 2019 count: 11,815
  • 2019 percentage: 78.32%
  • 2020 count: 28,398
  • 2020 percentage: 81.55%
  • 2021 count: 50,797
  • 2021 percentage: 79.21%

Unlikely substance use results

  • 2019 count: 3,721
  • 2019 percentage: 21.68%
  • 2020 count: 6.425
  • 2020 percentage: 18.45%
  • 2021 count: 13,329
  • 2021 percentage: 20.79%

Anxiety screening results

  • 2019 count: 162,958
  • 2019 percentage: 17.89%
  • 2020 count: 545,150
  • 2020 percentage: 20.36%
  • 2021 count: 850,264
  • 2021 percentage: 20.46%

Minimal anxiety results

  • 2019 count: 9,982
  • 2019 percentage: 6.13%
  • 2020 count: 22,102
  • 2020 percentage: 4.05%
  • 2021 count: 33,637
  • 2021 percentage: 3.96%

Mild anxiety results

  • 2019 count: 32,028
  • 2019 percentage: 19.65%
  • 2020 count: 95,359
  • 2020 percentage: 17.13%
  • 2021 count: 142,816
  • 2021 percentage: 16.80%

Moderate anxiety results

  • 2019 count: 50,323
  • 2019 percentage: 30.88%
  • 2020 count: 170,206
  • 2020 percentage: 31.22%
  • 2021 count: 265,199
  • 2021 percentage: 31.19%

Severe anxiety results

  • 2019 count: 70,625
  • 2019 percentage: 43.34%
  • 2020 count: 259,483
  • 2020 percentage: 47.60%
  • 2021 count: 408,612
  • 2021 percentage: 48.06%

Bipolar screening results

  • 2019 count: 138,130
  • 2019 percentage: 15.17%
  • 2020 count: 460,914
  • 2020 percentage: 17.21%
  • 2021 count: 685,026
  • 2021 percentage: 16.48%

Negative bipolar results

  • 2019 count: 83,359
  • 2019 percentage: 60.35%
  • 2020 count: 273,493
  • 2020 percentage: 59.34%
  • 2021 count: 401,322
  • 2021 percentage: 58.58%

Positive bipolar results

  • 2019 count: 54,771
  • 2019 percentage: 39.65%
  • 2020 count: 187,421
  • 2020 percentage: 40.66%
  • 2021 count: 283,704
  • 2021 percentage: 41.42%

Depression screening results

  • 2019 count: 331,089
  • 2019 percentage: 36.35%
  • 2020 count: 944,108
  • 2020 percentage: 35.26%
  • 2021 count: 1,340,791
  • 2021 percentage: 32.26%

Minimal depression results

  • 2019 count: 13,552
  • 2019 percentage: 4.09%
  • 2020 count: 33,877
  • 2020 percentage: 3.59%
  • 2021 count: 50,764
  • 2021 percentage: 3.79%

Mild depression results

  • 2019 count: 37,495
  • 2019 percentage: 11.32%
  • 2020 count: 111,646
  • 2020 percentage: 11.83%
  • 2021 count: 153,792
  • 2021 percentage: 11.47%

Moderate depression results

  • 2019 count: 70,693
  • 2019 percentage: 21.35%
  • 2020 count: 217,031
  • 2020 percentage: 22.99%
  • 2021 count: 296,471
  • 2021 percentage: 22.11%

Moderately severe depression results

  • 2019 count: 89,294
  • 2019 percentage: 26.97%
  • 2020 count: 283,212
  • 2020 percentage: 30.00%
  • 2021 count: 391,882
  • 2021 percentage: 29.23%

Severe depression results

  • 2019 count: 120,055
  • 2019 percentage: 36.26%
  • 2020 count: 298,342
  • 2020 percentage: 31.60%
  • 2021 count: 447,882
  • 2021 percentage: 33.40%

Eating disorder results

  • 2019 count: 43,340
  • 2019 percentage: 4.76%
  • 2020 count: 146,341
  • 2020 percentage: 5.47%
  • 2021 count: 306,141
  • 2021 percentage: 7.37%

At risk for eating disorder results

  • 2019 count: 39,338
  • 2019 percentage: 90.77%
  • 2020 count: 131,603
  • 2020 percentage: 89.93%
  • 2021 count: 283,535
  • 2021 percentage: 92.62%

Avoidant/Restrictive food intake disorder results

  • 2019 count: 2,975
  • 2019 percentage: 6.86%
  • 2020 count: 11,378
  • 2020 percentage: 7.77%
  • 2021 count: 18,584
  • 2021 percentage: 6.07%

Low risk for eating disorder results

  • 2019 count: 1,027
  • 2019 percentage: 2.37%
  • 2020 count: 3,360
  • 2020 percentage: 2.30%
  • 2021 count: 4,022
  • 2021 percentage: 1.31%

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

  • 2019 count: 11,927
  • 2019 percentage: 1.31%
  • 2020 count: 21,095
  • 2020 percentage: 0.79%
  • 2021 count: 43,961
  • 2021 percentage: 1.06%

At risk results

  • 2019 count: 7,219
  • 2019 percentage: 60.53%
  • 2020 count: 14,704
  • 2020 percentage: 69.70%
  • 2021 count: 32,485
  • 2021 percentage: 72.69%

Low risk results

  • 2019 count: 4,708
  • 2019 percentage: 39.47%
  • 2020 count: 6,391
  • 2020 percentage: 30.30%
  • 2021 count: 12,207
  • 2021 percentage: 27.31%

Psychosis screening results

  • 2019 count: 125,461
  • 2019 percentage: 13.78%
  • 2020 count: 248,186
  • 2020 percentage: 9.27%
  • 2021 count: 362,144
  • 2021 percentage: 8.71%

Low/No risk results

  • 2019 count: 33,387
  • 2019 percentage: 26.61%
  • 2020 count: 60,613
  • 2020 percentage: 24.42%
  • 2021 count: 85,143
  • 2021 percentage: 23.51%

Possible risk results

  • 2019 count: 92,074
  • 2019 percentage: 73.39%
  • 2020 count: 187,573
  • 2020 percentage: 75.58%
  • 2021 count: 277,001
  • 2021 percentage: 76.49%

PTSD screening results

  • 2019 count: 43,838
  • 2019 percentage: 4.81%
  • 2020 count: 113,668
  • 2020 percentage: 4.24%
  • 2021 count: 226,998
  • 2021 percentage: 5.46%

Negative PTSD results

  • 2019 count: 6,933
  • 2019 percentage: 15.82%
  • 2020 count: 11,829
  • 2020 percentage: 10.41%
  • 2021 count: 24,671
  • 2021 percentage: 10.87%

Positive PTSD results

  • 2019 count: 36,905
  • 2019 percentage: 84.18%
  • 2020 count: 101,839
  • 2020 percentage: 89.59%
  • 2021 count: 202,327
  • 2021 percentage: 89.13%

Youth screening results

  • 2019 count: 38,921
  • 2019 percentage: 4.27%
  • 2020 count: 140,598
  • 2020 percentage: 5.25%
  • 2021 count: 231,585
  • 2021 percentage: 5.57%

At risk results

  • 2019 count: 27,609
  • 2019 percentage: 70.94%
  • 2020 count: 108,344
  • 2020 percentage: 77.06%
  • 2021 count: 185,144
  • 2021 percentage: 79.95%

Low risk results

  • 2019 count: 11,312
  • 2019 percentage: 29.06%
  • 2020 count: 32,254
  • 2020 percentage: 22.94%
  • 2021 count: 46,441
  • 2021 percentage: 20.05%

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).

Rates of Moderate to Severe Anxiety: 2019-2021 (line graph)

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

  • Age 11-17 count: 49,874
  • Age 11-17 percentage: 16.37%
  • Age18-24 count: 40,439
  • Age 18-24 percentage: 19.94%
  • Age 25-34 count: 22,875
  • Age 25-34 percentage: 23.86%
  • Age 35-44 count: 11,165
  • Age 35-44 percentage: 27.75%
  • Age 45-54 count: 6,193
  • Age 45-54 percentage: 32.10%
  • Age 55-64 count: 4,141
  • Age 55-64 percentage: 36.96%
  • Age 65+ count: 2,201
  • Age 65+ percentage: 42.62%

Moderate to severe anxiety

  • Age 11-17 count: 254,807
  • Age 11-17 percentage: 83.63%
  • Age18-24 count: 162,370
  • Age 18-24 percentage: 80.06%
  • Age 25-34 count: 72,983
  • Age 25-34 percentage: 76.14%
  • Age 35-44 count: 29,071
  • Age 35-44 percentage: 72.25%
  • Age 45-54 count: 13,099
  • Age 45-54 percentage: 67.90%
  • Age 55-64 count: 7,063
  • Age 55-64 percentage: 63.04%
  • Age 65+ count: 2,963
  • Age 65+ percentage: 57.38%

Grand total

  • Age 11-17 count: 304,681
  • Age18-24 count: 202,809
  • Age 25-34 count: 95,858
  • Age 35-44 count: 40,236
  • Age 45-54 count: 19,292
  • Age 55-64 count: 11,204
  • Age 65+ count: 5,164

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

Asian or Pacific Islander
  • 2019 average: 73.71%
  • 2020 average: 78.24%
  • 2021 average: 77.25%
Black or African American (non-Hispanic)
  • 2019 average: 72.94%
  • 2020 average: 76.55%
  • 2021 average: 77.57%
Hispanic or Latino
  • 2019 average: 76.81%
  • 2020 average: 79.12%
  • 2021 average: 79.20%
More than one of the above
  • 2019 average: 80.67%
  • 2020 average: 82.76%
  • 2021 average: 83.29%
White (non-Hispanic)
  • 2019 average: 77.84%
  • 2020 average: 80.84%
  • 2021 average: 80.69%
Native American or American Indian
  • 2019 average: 80.88%
  • 2020 average: 84.00%
  • 2021 average: 82.94%
Other
  • 2019 average: 77.91%
  • 2020 average: 82.58%
  • 2021 average: 81.46%
Middle Eastern or North African
  • 2021 average: 81.24%

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

Suicidal ideation and thoughts of self-harm reach a new high

Suicidal/self-harm thinking, especially among young people, was epidemic in 2020 and 2021. Overall, 39% (N=516,372) of individuals in the U.S. who took the Patient Health Questionnaire 9-item (PHQ-9) screen for depression reported frequent suicidal ideation (defined as more than half or nearly every day of the previous two weeks) in 2021. This was 8% higher than the average rate of suicidal ideation in 2019 (31%, N=101,815) and 2% higher than the rate in 2020 (37%, N=347,782).

Rate of reported frequent suicidal ideation 2015-2021 line graph

When examined by age, youth ages 11-17 have the highest rate of suicidal ideation. Overall, 51% (N=245,979) of all youth depression screeners ages 11-17 reported frequent suicidal ideation on more than half or nearly every day of the previous two weeks. This was 2% higher than the average reported rate of suicidal ideation among 11-17-year-olds in 2019 (49%, N=20,263) and equivalent to the percentage of youth reporting suicidal ideation in 2020 (51%, N=158,490).

Thoughts that you would be better off dead, or of hurting yourself (youth ages 11-17)

Of or nearly every day
  • 2019 count: 20,263
  • 2019 percentage: 48.92%
  • 2020 count: 158,490
  • 2020 percentage: 50.73%
  • 2021 count: 245,979
  • 2021 percentage: 50.76%
Not at all or several days
  • 2019 count: 21,161
  • 2019 percentage: 51.08%
  • 2020 count: 153,947
  • 2020 percentage: 49.27%
  • 2021 count: 238,586
  • 2021 percentage: 49.24%
Grand total
  • 2019 count: 41,424
  • 2020 count: 312,437
  • 2021 count: 484,565

When examined by month, there are larger differences between reported rates of suicidal ideation from 2019-2021. In 2019, rates of reported suicidal ideation were elevated in the summer months, between April and August, and lower from September-December. In 2020, rates of reported frequent suicidal ideation among youth increased drastically in March, decreased in April and May, and increased each month from June-December. In 2021, there was a very slight increase in rates of reported suicidal ideation from March-June, but overall suicidal ideation among youth remained steady at 51-52% throughout the year. November and December 2020 were the two months with the highest percentages of youth reporting frequent suicidal ideation during the 36-month period from January 2019 through December 2021.

Rates of frequent suicidal ideation among youth (ages 11-17): 2019-2021 line graph

Rates of frequent suicidal ideation are also higher among people who identify as LGBTQ+, particularly among LGBTQ+ youth. Fifty-six percent of LGBTQ+ individuals who took a depression screen in 2021 reported experiencing suicidal ideation more than half or nearly every day of the previous two weeks (N=139,265). This was nearly 7% higher than the reported rate in 2019 (49%, N=15,586) and 2% higher than the rate in 2020 (54%, N=86,416). Sixty-three percent (N=99,048) of youth ages 11-17 who identified as LGBTQ+ reported frequent suicidal ideation, 3% higher than the average rate reported by LGBTQ+ youth in 2019 (60%, N=7,104) and 1% higher than the rate in 2020 (62%, N=58,873).

Rates of suicidal ideation continue to be much higher than the pre-pandemic average for screeners of every race/ethnicity. The proportion of people reporting frequent thoughts of suicide or self-harm was highest among screeners who identified their race/ethnicity as “other” in 2021 (46%), followed by Native American or American Indian screeners (46%). Black or African American screeners had the highest increase in reported suicidal ideation from 2019-2021 (8.59% increase) and 2020-2021 (1.70% increase). The increase in rate of reported suicidal ideation for Black screeners from 2019-2021 was nearly 2% higher than the increase among screeners of any other race/ethnicity.

Suicidal ideation more than half or nearly every day by race/ethnicity

Asian or Pacific Islander
  • 2019 average: 37.97%
  • 2020 average: 42.36%
  • 2021 average: 42.67%
Black or African American (non-Hispanic)
  • 2019 average: 30.55%
  • 2020 average: 37.44%
  • 2021 average: 39.14%
Hispanic or Latino
  • 2019 average: 31.85%
  • 2020 average: 37.95%
  • 2021 average: 38.37%
More than one of the above
  • 2019 average: 39.44%
  • 2020 average: 43.71%
  • 2021 average: 44.56%
White (non-Hispanic)
  • 2019 average: 30.56%
  • 2020 average: 35.32%
  • 2021 average: 35.58%
Native American or American Indian
  • 2019 average: 38.77%
  • 2020 average: 46.27%
  • 2021 average: 45.54%
Other
  • 2019 average: 42.06%
  • 2020 average: 46.07%
  • 2021 average: 46.24%
Middle Eastern or North African
  • 2021 average: 40.74%

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

Rates of suicidal ideation were also higher among Black, Indigenous, and youth of color than among white youth. Among youth of color, 52% (N=130,896) reported thoughts of suicide or self-harm more than half or nearly every day, compared to 49% (N=91,705) of white youth. The percentage of youth ages 11-17 reporting frequent thoughts of suicide or self-harm was also highest among those who identified their race as “other” (56%, N=17,208), youth who identified as Native American or American Indian (54%, N=5,016), and Black or African American youth (53%, N=17,438) in 2021.

The largest increases in the percentage of youth experiencing suicidal ideation between 2019 and 2021 were for Black or African American youth (5% increase) and Hispanic or Latino youth (4% increase).

Thoughts that you would be better off dead, or of hurting yourself among youth (ages 11-17) by race/ethnicity

Asian or Pacific Islander
  • 2019 count: 4,412
  • 2019 percentage: 12.12%
  • 2020 count: 48,897
  • 2020 percentage: 17.18%
  • 2021 count: 86,580
  • 2021 percentage: 19.75%
Asian or Pacific Islander more than half or nearly every day
  • 2019 count: 2,397
  • 2019 percentage: 54.33%
  • 2020 count: 26,345
  • 2020 percentage: 53.88%
  • 2021 count: 45,831
  • 2021 percentage: 52.93%
Asian or Pacific Islander not at all or several days
  • 2019 count: 2,015
  • 2019 percentage: 45.67%
  • 2020 count: 22,552
  • 2020 percentage: 46.12%
  • 2021 count: 40,749
  • 2021 percentage: 47.07%
Black or African American (non-Hispanic)
  • 2019 count: 2,557
  • 2019 percentage: 7.02%
  • 2020 count: 23,226
  • 2020 percentage: 8.16%
  • 2021 count: 32,855
  • 2021 percentage: 7.49%
Black or African American more than half or nearly every day
  • 2019 count: 1,240
  • 2019 percentage: 48.49%
  • 2020 count: 12,308
  • 2020 percentage: 52.99%
  • 2021 count: 17,438
  • 2021 percentage: 53.08%
Black or African American not at all or several days
  • 2019 count: 1,317
  • 2019 percentage: 51.51%
  • 2020 count: 10,918
  • 2020 percentage: 47.01%
  • 2021 count: 15,417
  • 2021 percentage: 46.92%
Hispanic or Latino
  • 2019 count: 5,148
  • 2019 percentage: 14.14%
  • 2020 count: 40,471
  • 2020 percentage: 14.22%
  • 2021 count: 55,238
  • 2021 percentage: 12.60%
Hispanic or Latino more than half or nearly every day
  • 2019 count: 2,336
  • 2019 percentage: 45.38%
  • 2020 count: 19,865
  • 2020 percentage: 49.08%
  • 2021 count: 27,138
  • 2021 percentage: 49.13%
Hispanic or Latino not at all or several days
  • 2019 count: 2,812
  • 2019 percentage: 54.62%
  • 2020 count: 20,606
  • 2020 percentage: 50.92%
  • 2021 count: 28,100
  • 2021 percentage: 50.87%
Middle Eastern or North African
  • 2021 count: 9,850
  • 2021 percentage: 2.25%

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

Middle Eastern or North African more than half or nearly every day
  • 2021 count: 4,910
  • 2021 percentage: 49.85%
Middle Eastern or North African not at all or several days
  • 2021 count: 4,940
  • 2021 percentage: 50.15%
More than one of the above
  • 2019 count: 2,842
  • 2019 percentage: 7.81%
  • 2020 count: 17,451
  • 2020 percentage: 6.13%
  • 2021 count: 25,328
  • 2021 percentage: 5.78%
More than one of the above more than half or nearly every day
  • 2019 count: 1,462
  • 2019 percentage: 51.44%
  • 2020 count: 9,143
  • 2020 percentage: 52.39%
  • 2021 count: 13,355
  • 2021 percentage: 52.73%
More than one of the above not at all or several days
  • 2019 count: 1,380
  • 2019 percentage: 48.56%
  • 2020 count: 8,308
  • 2020 percentage: 47.61%
  • 2021 count: 11,973
  • 2021 percentage: 47.27%
Native American or American Indian
  • 2019 count: 501
  • 2019 percentage: 1.38%
  • 2020 count: 4,132
  • 2020 percentage: 1.45%
  • 2021 count: 9,242
  • 2021 percentage: 2.11%
Native American or American Indian more than half or nearly every day
  • 2019 count: 286
  • 2019 percentage: 57.09%
  • 2020 count: 2,348
  • 2020 percentage: 56.82%
  • 2021 count: 5,016
  • 2021 percentage: 54.27%
Native American or American Indian not at all or several days
  • 2019 count: 215
  • 2019 percentage: 42.91%
  • 2020 count: 1,784
  • 2020 percentage: 43.18%
  • 2021 count: 4,226
  • 2021 percentage: 45.73%
Other
  • 2019 count: 1,584
  • 2019 percentage: 4.35%
  • 2020 count: 17,154
  • 2020 percentage: 6.03%
  • 2021 count: 30,813
  • 2021 percentage: 7.03%
Other more than half or nearly every day
  • 2019 count: 897
  • 2019 percentage: 56.63%
  • 2020 count: 9,754
  • 2020 percentage: 56.86%
  • 2021 count: 17,208
  • 2021 percentage: 55.85%
Other not at all or several days
  • 2019 count: 687
  • 2019 percentage: 43.37%
  • 2020 count: 7,400
  • 2020 percentage: 43.14%
  • 2021 count: 13,605
  • 2021 percentage: 44.15%
White (non-Hispanic)
  • 2019 count: 19,368
  • 2019 percentage: 53.19%
  • 2020 count: 133,358
  • 2020 percentage: 46.84%
  • 2021 count: 188,540
  • 2021 percentage: 43.00%
White (non-Hispanic) more than half or nearly every day
  • 2019 count: 9,118
  • 2019 percentage: 47.08%
  • 2020 count: 65,001
  • 2020 percentage: 48.74%
  • 2021 count: 91,705
  • 2021 percentage: 48.64%
White (non-Hispanic) not at all or several days
  • 2019 count: 10,250
  • 2019 percentage: 52.92%
  • 2020 count: 68,357
  • 2020 percentage: 51.26%
  • 2021 count: 96,835
  • 2021 percentage: 51.36%
Grand total
  • 2019 count: 36,412
  • 2020 count: 284,689
  • 2021 count: 438,446

Rates of suicidal ideation were particularly high among people of color who identified as LGBTQ+. LGBTQ+ individuals who identified their race as “other” had the highest reported rates of suicidal ideation (65%, N=8,080), followed by LGBTQ+ individuals identifying as Native American or American Indian (62%, N=2,872) and those identifying as Middle Eastern or North African (61%, N=1,929).

Thoughts that you would be better off dead, or of hurting yourself among LGBTQ+ individuals by race/ethnicity

Asian or Pacific Islander
  • 2021 count: 26,720
  • 2021 percentage: 11.40%
Asian or Pacific Islander more than half or nearly every day
  • 2021 count: 16,004
  • 2021 percentage: 59.90%
Asian or Pacific Islander not at all or several days
  • 2021 count: 10,716
  • 2021 percentage: 40.10%
Black or African American (non-Hispanic)
  • 2021 count: 18,546
  • 2021 percentage: 7.91%
Black or African American more than half or nearly every day
  • 2021 count: 10,477
  • 2021 percentage: 56.49%
Black or African American not at all or several days
  • 2021 count: 8,069
  • 2021 percentage: 43.51%
Hispanic or Latino
  • 2021 count: 31,335
  • 2021 percentage: 13.37%
Hispanic or Latino more than half or nearly every day
  • 2021 count: 17,274
  • 2021 percentage: 55.13%
Hispanic or Latino not at all or several days
  • 2021 count: 14,061
  • 2021 percentage: 44.87%
Middle Eastern or North African
  • 2021 count: 3,171
  • 2021 percentage: 1.35%
Middle Eastern or North African more than half or nearly every day
  • 2021 count: 1,929
  • 2021 percentage: 60.83%
Middle Eastern or North African not at all or several days
  • 2021 count: 1,242
  • 2021 percentage: 39.17%
More than one of the above
  • 2021 count: 16,335
  • 2021 percentage: 6.97%
More than one of the above more than half or nearly every day
  • 2021 count: 9,384
  • 2021 percentage: 57.45%
More than one of the above not at all or several days
  • 2021 count: 6,951
  • 2021 percentage: 42.55%
Native American or American Indian
  • 2021 count: 4,633
  • 2021 percentage: 1.98%
Native American or American Indian more than half or nearly every day
  • 2021 count: 2,872
  • 2021 percentage: 61.99%
Native American or American Indian not at all or several days
  • 2021 count: 1,761
  • 2021 percentage: 38.01%
Other
  • 2021 count: 12,366
  • 2021 percentage: 5.28%
Other more than half or nearly every day
  • 2021 count: 8,080
  • 2021 percentage: 65.34%
Other not at all or several days
  • 2021 count: 4,286
  • 2021 percentage: 34.66%
White (non-Hispanic)
  • 2021 count: 121,314
  • 2021 percentage: 51.75%
White more than half or nearly every day
  • 2021 count: 64,722
  • 2021 percentage: 53.35%
White not at all or several days
  • 2021 count: 56,592
  • 2021 percentage: 46.65%
Grand total
  • 2021 count: 234,420

Number of individuals screening for depression increased

MHA uses the Patient Health Questionnaire 9-item (PHQ-9) tool to screen for depression. Over 1 million – 1,340,791 – people in the U.S. took a depression screen in 2021, which was 304% higher than the total number of depression screens taken in 2019 (N=331,089) and 42% higher than the number of depression screens taken in 2020 (N=944,108). On average, 3,673 people in the U.S. took a depression screen per day in 2021.

Of those who took a depression screen in 2021, 85% (N=1,136,235) scored with moderate to severe symptoms of depression. This was equal to the proportion of people who screened at risk for depression in 2019 (85%, N=280,042) and 2020 (85%, N=798,585), although the number of people was significantly higher in 2021.

Rates of moderate to severe depression: 2019-2021 line graph

On average, 90% (N=434,447) of 11-17-year-olds in the U.S. who took a depression screen scored with symptoms of moderate to severe depression in 2021, 1% lower than the percentage of youth who scored with moderate to severe depression in 2020.

11-17 years old minimal to mild depression

  • 2021 count: 50,118
  • 2021 percentage: 10.34%

11-17 years old moderate to severe depression

  • 2021 count: 434,447
  • 2021 percentage: 89.66%

18-24 years old minimal to mild depression

  • 2021 count: 45,208
  • 2021 percentage: 13.27%

18-24 years old moderate to severe depression

  • 2021 count: 295,552
  • 2021 percentage: 86.73%

25-34 years old minimal to mild depression

  • 2021 count: 32,116
  • 2021 percentage: 19.56%

25-34 years old moderate to severe depression

  • 2021 count: 132,111
  • 2021 percentage: 80.44%

35-44 years old minimal to mild depression

  • 2021 count: 17,440
  • 2021 percentage: 25.20%

35-44 years old moderate to severe depression

  • 2021 count: 51,779
  • 2021 percentage: 74.80%

45-54 years old minimal to mild depression

  • 2021 count: 10,119
  • 2021 percentage: 28.57%

45-54 years old moderate to severe depression

  • 2021 count: 25,300
  • 2021 percentage: 71.43%

55-64 years old minimal to mild depression

  • 2021 count: 7,084
  • 2021 percentage: 33.34%

55-64 years old moderate to severe depression

  • 2021 count: 14,162
  • 2021 percentage: 66.66%

65+ years old minimal to mild depression

  • 2021 count: 4,088
  • 2021 percentage: 38.41%

65+ years old moderate to severe depression

  • 2021 count: 6,554
  • 2021 percentage: 61.59%

Adults who identified as LGBTQ+ and took a depression screen were nearly 10% more likely to screen with moderate to severe depression than non-LGBTQ+ adults (90.38% and 80.66%, respectively). LGBTQ+ youth ages 11-17 were more likely than non-LGBTQ+ youth to screen with symptoms of moderate to severe depression. Ninety-five percent (N=150,560) of youth ages 11-17 who took a depression screen and identified as LGBTQ+ scored with moderate to severe depression, compared to 87% (N=283,887) of youth who did not identify as LGBTQ+.

LGBTQ+ adults negative or minimal to mild

  • Count: 7,951
  • Percentage: 9.62%

LGBTQ+ adults positive or moderate to severe

  • Count: 74,661
  • Percentage: 90.38%

Non-LGBTQ+ adults negative or minimal to mild

  • Count: 108,104
  • Percentage: 19.34%

Non-LGBTQ+ adults positive or moderate to severe

  • Count: 450,797
  • Percentage: 80.66%

LGBTQ+ youth (ages 11-17) negative or minimal to mild

  • Count: 7,748
  • Percentage: 4.89%

LGBTQ+ youth (ages 11-17) positive or moderate to severe

  • Count: 150,560
  • Percentage: 95.11%

Non-LGBTQ+ youth (ages 11-17) negative or minimal to mild

  • Count: 42,370
  • Percentage: 12.99%

Non-LGBTQ+ youth (ages 11-17) positive or moderate to severe

  • Count: 283,887
  • Percentage: 87.01%

The percentage of people scoring with moderate to severe symptoms of depression was highest among screeners who identified as more than one race in 2021 (89%). Average rates of moderate to severe depression were lower in 2021 than in 2019 for screeners of nearly every race/ethnicity, except for Black or African American screeners.

Average rates of moderate to severe depression by race/ethnicity

Asian or Pacific Islander
  • 2019 average: 85.52%
  • 2020 average: 84.98%
  • 2021 average: 84.06%
Black or African American (non-Hispanic)
  • 2019 average: 83.25%
  • 2020 average: 83.18%
  • 2021 average: 83.55%
Hispanic or Latino
  • 2019 average: 87.08%
  • 2020 average: 86.33%
  • 2021 average: 86.02%
More than one of the above
  • 2019 average: 90.97%
  • 2020 average: 89.89%
  • 2021 average: 89.31%
White (non-Hispanic)
  • 2019 average: 86.92%
  • 2020 average: 85.42%
  • 2021 average: 85.17%
Native American or American Indian
  • 2019 average: 88.02%
  • 2020 average: 89.34%
  • 2021 average: 86.17%
Other
  • 2019 average: 88.18%
  • 2020 average: 87.89%
  • 2021 average: 86.85%
Middle Eastern or North African
  • 2021 average: 87.21%

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

Rates of moderate to severe depression among youth of color were slightly lower than white youth in the U.S. In 2021, 89% (N=223,245) of youth of color ages 11-17 who took a depression screen scored with moderate to severe depression, compared to 90% (N=169,876) of white youth.

However, when results are broken down by race/ethnicity, there are more notable differences. Rates of moderate to severe depression were highest among youth who identified as more than one race (92%, N= 23,178) and youth who identified their race as “other” (91%, N= 27,899).

Asian or Pacific Islander youth negative or minimal to mild

  • 2020 count: 4,953
  • 2020 percentage: 10.13%
  • 2021 count: 10,147
  • 2021 percentage: 11.72%

Asian or Pacific Islander youth positive or moderate to severe

  • 2020 count: 43,943
  • 2020 percentage: 89.87%
  • 2021 count: 76,433
  • 2021 percentage: 88.28%

Black or African American (non-Hispanic) youth negative or minimal to mild

  • 2020 count: 2,453
  • 2020 percentage: 10.56%
  • 2021 count: 3,724
  • 2021 percentage: 11.33%

Black or African American (non-Hispanic) youth positive or moderate to severe

  • 2020 count: 20,773
  • 2020 percentage: 89.44%
  • 2021 count: 29,131
  • 2021 percentage: 88.67%

Hispanic or Latino youth negative or minimal to mild

  • 2020 count: 3,782
  • 2020 percentage: 9.34%
  • 2021 count: 5,839
  • 2021 percentage: 10.57%

Hispanic or Latino youth positive or moderate to severe

  • 2020 count: 36,689
  • 2020 percentage: 90.66%
  • 2021 count: 49,399
  • 2021 percentage: 89.43%

More than one of the above youth negative or minimal to mild

  • 2020 count: 1,283
  • 2020 percentage: 7.35%
  • 2021 count: 2,150
  • 2021 percentage: 8.49%

More than one of the above youth positive or moderate to severe

  • 2020 count: 16,168
  • 2020 percentage: 92.65%
  • 2021 count: 23,178
  • 2021 percentage: 91.51%

Middle Eastern or North African youth negative or minimal to mild

  • 2021 count: 1,006
  • 2021 percentage: 10.21%

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

Middle Eastern or North African youth positive or moderate to severe

  • 2021 count: 8,844
  • 2021 percentage: 89.79%

Native American or American Indian youth negative or minimal to mild

  • 2020 count: 300
  • 2020 percentage: 7.26%
  • 2021 count: 881
  • 2021 percentage: 9.53%

Native American or American Indian youth positive or moderate to severe

  • 2020 count: 3,832
  • 2020 percentage: 92.74%
  • 2021 count: 8,361
  • 2021 percentage: 90.47%

Other youth negative or minimal to mild

  • 2020 count: 1,425
  • 2020 percentage: 8.31%
  • 2021 count: 2,914
  • 2021 percentage: 9.46%

Other youth positive or moderate to severe

  • 2020 count: 15,729
  • 2020 percentage: 91.69%
  • 2021 count: 27,899
  • 2021 percentage: 90.54%

White (non-Hispanic) youth negative or minimal to mild

  • 2020 count: 12,271
  • 2020 percentage: 9.20%
  • 2021 count: 18,664
  • 2021 percentage: 9.90%

White (non-Hispanic) youth positive or moderate to severe

  • 2020 count: 121,087
  • 2020 percentage: 90.80%
  • 2021 count: 169,876
  • 2021 percentage: 90.10%

Continued increases in emotional, attentional, or behavioral difficulties among youth

MHA uses the Pediatric Symptom Checklist (PSC-35) tool to screen youth for emotional, attentional, or behavioral difficulties. In total, 231,585 individuals in the U.S. took the youth screen in 2021, a 495% increase over the number of youth screens taken in 2019 (N=38,921) and a 64% increase over the number taken in 2020.

Of the individuals who took the youth screen in 2021, 80% (N=185,144) scored at risk for emotional, attentional, or behavioral difficulties. This was 9% higher than the average rate in 2019 (71%, N=27,609) and 3% higher than the average rate in 2020 (77%, N=108,344). The percentage of youth scoring at risk for emotional, attentional, or behavioral difficulties was higher throughout 2021 than in either 2019 or 2020. In December 2021, 82% (N=18,305) of youth scored at risk for emotional, attentional, or behavioral difficulties, the highest percentage recorded in any month from 2019-2021, and 11% higher than the average rate prior to the pandemic.

Percent of youth scoring at risk on the youth screen: 2019-2021 line graph

Highest rates of psychosis risk in early 2021

MHA uses the Prodromal Questionnaire – Brief version (PQ-B) to screen for psychosis. In total, 362,144 individuals took the psychosis screen in 2021, a 188% increase over the number of psychosis screens taken in 2019 (N=125,461) and a 46% increase over 2020 (N=248,186).

Of the individuals who took the psychosis screen, 76% (N=277,001) scored at risk for psychotic-like experiences. This was 2% higher than the average rate in 2019 (73%, N=92,074) and equal to the rate in 2020 (76%, N=187,573), but over three times the number of people scoring at risk for psychotic-like experiences prior to the COVID-19 pandemic. In early 2021, the percentage of people scoring at risk for psychotic-like experiences reached the highest levels recorded from 2019-2021. Of those individuals who took a psychosis screen, 78% scored at risk for psychotic-like experiences in February and March of 2021.

Percent of people scoring at risk for psychotic-like episodes: 2019-2021 line graph

In April 2020, MHA added the question, “Think about your mental health test. What are the main things contributing to your mental health problems right now? Choose up to three.” Similar to 2020, feelings of loneliness and isolation were cited by screeners as a major reason for their mental health struggles in 2021. Among individuals who screened positive or moderate to severe for a mental health condition in 2021, 63% reported that one of the top three things contributing to their mental health concerns was loneliness or isolation. This was followed by 49% reporting past trauma and 37% reporting relationship problems. The percentage of individuals reporting coronavirus as one of the three things contributing to their mental health concerns was lower in 2021 than in 2020 (17% in 2021, compared to 26% in 2020).

Main concerns: People scoring at risk for any screen (excluding parent and youth screens)

Loneliness or isolation
  • 2021 count: 1,446,349
  • 2021 percentage: 63.46%
Past trauma
  • 2021 count: 1,118,358
  • 2021 percentage: 49.07%
Relationship problems
  • 2021 count: 845,076
  • 2021 percentage: 37.08%
Grief or loss of someone or something
  • 2021 count: 496,662
  • 2021 percentage: 21.74%
Coronavirus
  • 2021 count: 384,802
  • 2021 percentage: 16.88%
Current events (news, politics, etc.)
  • 2021 count: 358,684
  • 2021 percentage: 15.74%
Financial Problems
  • 2021 count: 390,634
  • 2021 percentage: 17.14%
Racism
  • 2021 count: 78,339
  • 2021 percentage: 3.44%

Main concerns among youth

Among youth ages 11-17 who scored positive or with moderate to severe symptoms of a mental health condition, the top three contributors to their mental health problems were the same as the general population of screeners – loneliness or isolation, past trauma, and relationship problems. However, 11-17-year-olds were even more likely to report experiencing loneliness than the general population of screeners (70%, compared to 63%). They were also more likely to report coronavirus (18%, compared to 17%) and racism (5%, compared to 3%) as one of their top three concerns than the general screening population.

Main concerns, scoring positive for a mental health condition (excluding parent and youth screens) for ages 11-17

Loneliness or social isolation
  • 2021 count: 687,254
  • 2021 percentage: 70.19%
Past trauma
  • 2021 count: 463,585
  • 2021 percentage: 47.34%
Relationship problems
  • 2021 count: 339,711
  • 2021 percentage: 34.69%
Grief or loss of someone or something
  • 2021 count: 208,110
  • 2021 percentage: 21.25%
Coronavirus
  • 2021 count: 180,310
  • 2021 percentage: 18.41%
Current events (news, politics, etc.)
  • 2021 count: 159,585
  • 2021 percentage: 16.30%
Financial problems
  • 2021 count: 53,862
  • 2021 percentage: 5.50%
Racism
  • 2021 count: 44,594
  • 2021 percentage: 4.55%

Individuals who took the parent or youth screens were offered different options than the above, including other concerns that are more likely to affect youth, such as difficulties at school or bullying. Among youth who screened at risk for emotional, attentional, or behavioral difficulties, loneliness or social isolation was the most frequently reported contributor to mental distress (63%). This was followed by social life or relationships (57%) and past trauma (38%).

Main concerns, scoring at risk on parent and youth screens

Loneliness or social isolation
  • 2021 count: 95,689
  • 2021 percentage: 62.58%
Social life or relationships
  • 2021 count: 87,212
  • 2021 percentage: 57.04%
Past trauma
  • 2021 count: 57,852
  • 2021 percentage: 37.84%
Difficulties at school (academics or learning)
  • 2021 count: 53,941
  • 2021 percentage: 35.28%
Coronavirus
  • 2021 count: 24,060
  • 2021 percentage: 15.74%
Grief or loss of someone or something
  • 2021 count: 23,953
  • 2021 percentage: 15.67%
Current events (news, politics, etc.)
  • 2021 count: 18,267
  • 2021 percentage: 11.95%
Financial problems
  • 2021 count: 13,720
  • 2021 percentage: 8.97%
Being bullied
  • 2021 count: 11,646
  • 2021 percentage: 7.62%

Profoundly different mental health impacts on different racial and ethnic groups

Although the averages across screeners reveal the main concerns of the population throughout this year, the events of 2020 and 2021 had profoundly different mental health impacts on different racial and ethnic groups, and the differences reveal some of the inequities that Black, Indigenous, and people of color face in the U.S. that directly affect their mental health.

  • Asian screeners were most likely to select coronavirus (19%), followed by white screeners (17%) and screeners who identified their race as “other” (16%).
  • White screeners were most likely out of all racial/ethnic groups to select current events (17%) as one of their top three concerns, followed by Middle Eastern or North African screeners (17%) and screeners who identified as more than one race (16%).
  • Black or African American screeners were most likely to select financial problems (22%), followed by Middle Eastern or North African screeners (18%) and Asian or Pacific Islander screeners (17%).
  • Native American or American Indian screeners were most likely to select grief or loss (29%) followed by white screeners (22%), and screeners who identified as more than one race (22%).
  • Screeners who identified as Hispanic or Latino were most likely to select loneliness or isolation (69%), followed by screeners who identified with more than one race (66%) and Black or African American screeners (64%).
  • Screeners who identified as more than one race were most likely to select past trauma (56%), followed by Native American or American Indian screeners (55%) and Hispanic or Latino screeners (53%).
  • Black or African American screeners were most likely to report racism as one of the three things contributing to their mental health problems (11%), followed by screeners who identified as more than one race (6%) and Native American or American Indian screeners (5%).
  • Black or African American screeners were most likely to select relationship problems (36%) followed by Hispanic or Latino screeners (35%) and white screeners (35%).

Coronavirus

  • Native American or American Indian: 14.44%
  • Asian or Pacific Islander: 18.66%
  • Black or African American (non-Hispanic): 14.54%
  • Hispanic or Latino: 16.23%
  • Middle Eastern or North African: 14.89%
  • More than one of the above: 15.30%
  • Other: 16.24%
  • White (non-Hispanic): 16.89%

Current events (news, politics, etc.)

  • Native American or American Indian: 15.58%
  • Asian or Pacific Islander: 13.42%
  • Black or African American (non-Hispanic): 11.63%
  • Hispanic or Latino: 14.09%
  • Middle Eastern or North African: 17.10%
  • More than one of the above: 15.66%
  • Other: 13.40%
  • White (non-Hispanic): 17.23%

Financial problems

  • Native American or American Indian: 13.08%
  • Asian or Pacific Islander: 17.36%
  • Black or African American (non-Hispanic): 21.76%
  • Hispanic or Latino: 17.08%
  • Middle Eastern or North African: 17.58%
  • More than one of the above: 14.82%
  • Other: 14.44%
  • White (non-Hispanic): 16.64%

Grief or loss of someone or something

  • Native American or American Indian: 28.75%
  • Asian or Pacific Islander: 17.97%
  • Black or African American (non-Hispanic): 21.73%
  • Hispanic or Latino: 20.61%
  • Middle Eastern or North African: 18.02%
  • More than one of the above: 22.34%
  • Other: 21.33%
  • White (non-Hispanic): 22.35%

Loneliness or isolation

  • Native American or American Indian: 64.06%
  • Asian or Pacific Islander: 62.92%
  • Black or African American (non-Hispanic): 64.23%
  • Hispanic or Latino: 68.64%
  • Middle Eastern or North African: 62.58%
  • More than one of the above: 66.16%
  • Other: 59.34%
  • White (non-Hispanic): 62.68%

Past trauma

  • Native American or American Indian: 55.09%
  • Asian or Pacific Islander: 38.85%
  • Black or African American (non-Hispanic): 49.58%
  • Hispanic or Latino: 52.93%
  • Middle Eastern or North African: 41.33%
  • More than one of the above: 55.86%
  • Other: 44.43%
  • White (non-Hispanic): 50.07%

Racism

  • Native American or American Indian: 4.74%
  • Asian or Pacific Islander: 4.71%
  • Black or African American (non-Hispanic): 11.15%
  • Hispanic or Latino: 3.36%
  • Middle Eastern or North African: 4.17%
  • More than one of the above: 5.99%
  • Other: 4.32%
  • White (non-Hispanic): 1.19%

Relationship problems

  • Native American or American Indian: 34.90%
  • Asian or Pacific Islander: 35.12%
  • Black or African American (non-Hispanic): 36.45%
  • Hispanic or Latino: 35.22%
  • Middle Eastern or North African: 34.53%
  • More than one of the above: 34.23%
  • Other: 32.10%
  • White (non-Hispanic): 35.14%