Mental Health and COVID-19: What MHA Screening Data Tells Us about the Impact of the Pandemic
Last Updated: March 29, 2021
In 2014, Mental Health America (MHA) created the Online Screening Program (www.mhascreening.org), a collection of ten free, anonymous, confidential, and clinically validated screens that are among the most commonly used mental health screening tools in clinical settings. Since its launch, nearly 7.5 million people have taken a screen to check on 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.
In 2020, over 2.6 million (N=2,677,734) people took a mental health screen, comprising the largest dataset compiled for a mental health help-seeking population during the pandemic, and representing a nearly 200% increase over the number of people who completed a screening in 2019 (N=910,750).
The following findings emerged from an analysis of the over 2.6 million people who took a mental health screen from January-December 2020.
2020 Screening Demographics Anxiety and Depression on the Rise Suicidal Ideation and Thoughts of Self-Harm Reach A New High Increases in Emotional, Attentional, or Behavioral Difficulties Among Youth Dramatic Increases in Symptoms of Psychosis Loneliness, Past Trauma, and Relationship Problems Continue to be Main Concerns
2020 Screening Demographics
In total, 2,677,734 people took a screen through MHA Screening in 2020. Of them, the majority took a depression screen (35%), followed by the anxiety screen (20%), and the bipolar screen (17%).
Seventy-three percent of screeners identified as female, 25% identified as male and 2% identified as another gender. In April 2020, MHA added a separate option to identify as transgender. Three percent of screeners (N=74,096) from April to December 2020 identified as transgender.
People who accessed screening in 2020 were younger than the 2019 average. Forty-two percent of screeners from January-December 2020 were youth ages 11-17, a 13% increase over 2019 (29%). The percentage of 18-24-year-olds remained about the same from 2019 to 2020 (32% in 2019 and 31% in 2020).
There have also been changes in the race/ethnicity of screeners in 2020, as compared to 2019. The proportion of screeners identifying as Asian or Pacific Islander increased 6%, from 9% of screeners in 2019 to 15% in 2020. The percentage of screeners identifying their race as “Other” increased as well, from 3% to 5%. The proportion of White screeners decreased, from 60% to 53%.
Race/Ethnicity |
2019 Count |
2019 Percentage |
2020 Count |
2020 Percentage |
Asian or Pacific Islander |
35,021 |
9.13% |
293,721 |
15.46% |
Black or African American (non-Hispanic) |
33,696 |
8.79% |
159,449 |
8.39% |
Hispanic or Latino |
47,414 |
12.36% |
232,274 |
12.22% |
More than one of the above |
20,883 |
5.45% |
95,631 |
5.03% |
Native American or American Indian |
5,020 |
1.31% |
22,969 |
1.21% |
Other |
12,893 |
3.36% |
94,510 |
4.97% |
White (non-Hispanic) |
228,596 |
59.60% |
1,001,855 |
52.72% |
Grand Total |
383,523 |
100.00% |
1,900,409 |
100.00% |
Screeners in 2020 reported slightly higher household incomes than those in 2019. Half (50%) of screeners reported a household income less than $40,000 in 2020, compared to 52% in 2019. Over 24%reported a household income greater than $80,000, compared to 22% in 2019.
Household Income |
2019 Count |
2019 Percentage |
2020 Count |
2020 Percentage |
Less than $20,000 |
77,086 |
30.17% |
374,020 |
29.36% |
$20,000 - $39,999 |
56,749 |
22.21% |
263,897 |
20.71% |
$40,000 - $59,999 |
38,840 |
15.20% |
187,123 |
14.69% |
$60,000 - $79,999 |
26,309 |
10.30% |
138,027 |
10.83% |
$80,000 - $99,999 |
19,034 |
7.45% |
96,813 |
7.60% |
$100,000 - $149,999 |
22,050 |
8.63% |
117,331 |
9.21% |
$150,000+ |
15,422 |
6.04% |
96,739 |
7.59% |
Grand Total |
255,490 |
100.00% |
1,273,950 |
100.00% |
Across all screens, 75% (N=2,018,617) of people scored positive or with moderate to severe symptoms of a mental health condition in 2020. This was slightly higher than 2019, in which 74% (N=673,696) of individuals screened at risk.
Among people who screened at risk for a mental health condition, 68% (N= 1,028,008) had never been diagnosed with a mental health condition in 2020. Sixty-four percent (N= 1,026,249) had never received treatment or support before, compared to 57% in 2019. This indicates that in 2020, MHA Screening was reaching an even greater number of people who had never received any supports for their mental health before.
Have You Ever Received Treatment or Support for a Mental Health Problem?
The largest increase in the percentage of people scoring positive from 2019 to 2020 was for the Parent screen (9% increase, from 61% scoring at risk in 2019 to 70% in 2020). This was followed by the Youth screen (6% increase, from 71% in 2019 to 77% in 2020), PTSD (5% increase, from 84% screening positive in 2019 to 90% screening positive in 2020), Anxiety (5% increase, from 74% to 79% moderate to severe) and Substance Use (3% increase, from 78% scoring at risk to 82% in 2020).
Screen Results: |
2019 Count |
2019 Percentage |
2020 Count |
2020 Percentage |
Alcohol or Substance Use Screening |
15,086 |
1.66% |
34,823 |
1.30% |
Likely Substance Use |
11,815 |
78.32% |
28,398 |
81.55% |
Unlikely Substance Use |
3,271 |
21.68% |
6,425 |
18.45% |
Anxiety Screening |
162,958 |
17.89% |
545,150 |
20.36% |
1 Minimal Anxiety |
9,982 |
6.13% |
22,102 |
4.05% |
2 Mild Anxiety |
32,028 |
19.65% |
93,359 |
17.13% |
3 Moderate Anxiety |
50,323 |
30.88% |
170,206 |
31.22% |
4 Severe Anxiety |
70,625 |
43.34% |
259,483 |
47.60% |
Bipolar Screening |
138,130 |
15.17% |
460,914 |
17.21% |
Negative Bipolar |
83,359 |
60.35% |
273,493 |
59.34% |
Positive Bipolar |
54,771 |
39.65% |
187,421 |
40.66% |
Depression Screening |
331,089 |
36.35% |
944,108 |
35.26% |
1 Minimal Depression |
13,552 |
4.09% |
33,877 |
3.59% |
2 Mild Depression |
37,495 |
11.32% |
111,646 |
11.83% |
3 Moderate Depression |
70,693 |
21.35% |
217,031 |
22.99% |
4 Moderately Severe Depression |
89,294 |
26.97% |
283,212 |
30.00% |
5 Severe Depression |
120,055 |
36.26% |
298,342 |
31.60% |
Eating Disorder |
43,340 |
4.76% |
146,341 |
5.47% |
At Risk for ED |
39,338 |
90.77% |
131,603 |
89.93% |
Avoidant/Restrictive Food Intake Disorder |
2,975 |
6.86% |
11,378 |
7.77% |
Low Risk for ED |
1,027 |
2.37% |
3,360 |
2.30% |
Postpartum Depression |
* |
|
22,851 |
0.85% |
Depression is not likely |
|
|
998 |
4.37% |
Depression is possible |
|
|
1,323 |
5.79% |
Depression is highly possible |
|
|
1,447 |
6.33% |
Depression is probable |
|
|
19,083 |
83.51% |
Parent Screening |
11,927 |
1.31% |
21,095 |
0.79% |
At Risk |
7,219 |
60.53% |
14,704 |
69.70% |
Low Risk |
4,708 |
39.47% |
6,391 |
30.30% |
Psychosis Screening |
125,461 |
13.78% |
248,186 |
9.27% |
Low/No Risk |
33,387 |
26.61% |
60,613 |
24.42% |
Possible Risk |
92,074 |
73.39% |
187,573 |
75.58% |
PTSD Screening |
43,838 |
4.81% |
113,668 |
4.24% |
Negative PTSD |
6,933 |
15.82% |
11,829 |
10.41% |
Positive PTSD |
36,905 |
84.18% |
101,839 |
89.59% |
Youth Screening |
38,921 |
4.27% |
140,598 |
5.25% |
At Risk |
27,609 |
70.94% |
108,344 |
77.06% |
Low Risk |
11,312 |
29.06% |
32,254 |
22.94% |
Grand Total |
910,750 |
100.00% |
2,677,734 |
100.00% |
*The Postpartum Depression Screen was not implemented until May 2020.
Anxiety and Depression on the Rise
MHA uses the Generalized Anxiety Disorder 7-item (GAD-7) tool to screen for anxiety. Both the number of help-seekers experiencing anxiety and the severity of that anxiety increased in 2020. In total, 545,150 people took an anxiety screen in 2020, which was 234% higher than the total number of anxiety screens taken in 2019. On average, 1,493 people took an anxiety screen each day.
Of the more than half a million people who took an anxiety screen, 79% (N=429,689) scored with symptoms of moderate to severe anxiety. This was nearly 5% higher than the average rate in 2019 (74%, N=120,948).
In November and December 2020, anxiety severity reached the highest levels recorded in 2020. In total, 81% (N=117,564) of individuals who took an anxiety screen scored with symptoms of moderate to severe anxiety, and half (50%, N=72,608) scored for severe anxiety. These rates of anxiety severity were nearly 10 percent higher during the final quarter of 2020 than they were during the same quarter in 2019.
MHA uses the Patient Health Questionnaire 9-item (PHQ-9) tool to screen for depression. Almost one million - 944,108 people - took a depression screen in 2020, which was 185% higher than the total number of depression screens taken in 2019 (N=331,089). On average, 2,586 people took a depression screen per day in 2020.
Of those who took a depression screen in 2020, 85% (N=798,585) 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), although the number of people was significantly higher in 2020.
The percentage of people screening at risk for moderate to severe depression was even higher during the last quarter of 2020. November and December 2020 were the two months with the highest percentages of people with moderate to severe depression during the 24-month period from January 2019 through December 2020. In November 2020, 87% (N=127,191) of depression screeners scored for moderate to severe depression, and 35% (N=50,495) scored for severe depression. In December, 86% (N=89,419) of people who took a depression screen scored for moderate to severe depression, and 35% (N=35,755) scored for severe depression.
Anxiety and Depression Highest Among Youth
Throughout the pandemic, youth ages 11-17 were more likely to score with moderate to severe symptoms of anxiety and depression than any other age group. Eighty-four percent (N=139,727) of 11-17-year-olds who took an anxiety screen in 2020 scored with symptoms of moderate to severe anxiety.
Anxiety Screen Result by Age, 2020 |
11-17 |
18-24 |
25-34 |
35-44 |
45-54 |
55-64 |
65+ |
|
Minimal to Mild Anxiety |
% |
15.95% |
19.49% |
23.25% |
26.72% |
30.79% |
36.56% |
42.06% |
Count |
26,508 |
26,026 |
15,362 |
7,189 |
4,137 |
2,780 |
1,311 |
|
Moderate to Severe Anxiety |
% |
84.05% |
80.51% |
76.75% |
73.28% |
69.21% |
63.44% |
57.94% |
Count |
139,727 |
107,512 |
50,719 |
19,717 |
9,297 |
4,823 |
1,806 |
|
Grand Total |
166,235 |
133,538 |
66,081 |
26,906 |
13,434 |
7,603 |
3,117 |
When examined by age, average anxiety rates were about 1% higher among 11-17-year-olds in 2020 than in 2019.
Avg. Rates of Moderate to Severe Anxiety by Age |
11-17 |
18-24 |
25-34 |
35-44 |
45-54 |
55-64 |
65+ |
2019 |
82.74% |
78.97% |
76.35% |
72.93% |
69.10% |
63.65% |
59.32% |
2020 |
84.05% |
80.51% |
76.75% |
73.28% |
69.21% |
63.44% |
57.94% |
On average, 91% (N=283,130) of 11-17-year-olds who took a depression screen scored with symptoms of moderate to severe depression in 2020.
Depression Screen Results by Age, 2020 |
11-17 |
18-24 |
25-34 |
35-44 |
45-54 |
55-64 |
65+ |
|
Minimal to Mild Depression |
% |
9.38% |
13.02% |
20.23% |
25.40% |
28.60% |
33.82% |
38.70% |
Count |
29,306 |
31,662 |
23,901 |
11,762 |
6,644 |
4,607 |
2,161 |
|
Moderate to Severe Depression |
% |
90.62% |
86.98% |
79.77% |
74.60% |
71.40% |
66.18% |
61.30% |
Count |
283,130 |
211,590 |
94,268 |
34,546 |
16,585 |
9,017 |
3,423 |
|
Grand Total |
312,436 |
243,252 |
118,169 |
46,308 |
23,229 |
13,624 |
5,584 |
LGBTQ+ youth ages 11-17 were more likely than non-LGBTQ+ youth to screen at risk for both anxiety and depression. Ninety-five percent (N=90,866) of youth ages 11-17 who took a depression screen and identified as LGBTQ+ scored with moderate to severe depression, compared to 89 percent (N=192,264) of youth who did not identify as LGBTQ+. Among LGBTQ+ youth who took an anxiety screen, 88 percent (N=44,259) scored for moderate to severe anxiety, compared to 82 percent (N=95,468) among non-LGBTQ+ youth.
Screen Results among Youth (11-17) |
LGBTQ+ Youth |
Count |
Non-LGBTQ+ Youth |
Count |
Depression |
||||
Negative or Minimal to Mild |
4.63% |
4,413 |
11.46% |
24,893 |
Positive or Moderate to Severe |
95.37% |
90,866 |
88.54% |
192,264 |
Anxiety |
||||
Negative or Minimal to Mild |
11.83% |
5,941 |
17.72% |
20,567 |
Positive or Moderate to Severe |
88.17% |
44,259 |
82.28% |
95,468 |
Anxiety and Depression Data by Race/Ethnicity
Rates of moderate to severe anxiety continue to be much higher than the 2019 average for screeners of every race/ethnicity. The proportion of people scoring with moderate to severe symptoms of anxiety was highest among Native American or American Indian screeners in 2020 (84%). The largest increases in the proportion of people scoring for moderate to severe anxiety between 2019 and 2020 was for screeners who identified their race as Other (4.67% increase) and Asian or Pacific Islander screeners (4.53% increase).
Average Rates of Moderate to Severe Anxiety, by Race/Ethnicity |
Asian or Pacific Islander |
Black or African American (non-Hispanic) |
Hispanic or Latino |
More than one of the above |
White (non-Hispanic) |
Native American or American Indian |
Other |
May |
74.14% |
70.06% |
74.82% |
78.70% |
74.26% |
80.30% |
76.16% |
June |
75.89% |
74.31% |
77.03% |
80.12% |
79.89% |
81.14% |
78.89% |
July |
78.35% |
75.49% |
78.73% |
84.11% |
81.70% |
83.77% |
84.22% |
August |
77.42% |
77.09% |
79.59% |
82.56% |
81.97% |
86.21% |
81.27% |
September |
80.06% |
77.98% |
79.92% |
82.83% |
81.91% |
86.61% |
83.59% |
October |
78.99% |
78.43% |
80.50% |
83.05% |
82.02% |
83.83% |
84.60% |
November |
79.36% |
79.64% |
81.74% |
85.87% |
83.55% |
85.11% |
83.73% |
December |
80.89% |
79.40% |
81.46% |
83.93% |
83.10% |
85.00% |
84.47% |
2019 Average |
73.71% |
72.94% |
76.81% |
80.67% |
77.84% |
80.88% |
77.91% |
2020 Average |
78.24% |
76.55% |
79.12% |
82.76% |
80.84% |
84.00% |
82.58% |
The proportion of people scoring with moderate to severe symptoms of depression was highest among screeners who identified with more than one race in 2020 (90%).
Average rates of moderate to severe depression were lower in 2020 than in 2019 for screeners of nearly every race/ethnicity, except for Native American or American Indian screeners. However, the percentage of people scoring with moderate to severe symptoms of depression in December 2020 was higher than the 2019 average for every racial/ethnic group.
Average Rates of Moderate to Severe Depression, by Race/Ethnicity |
Asian or Pacific Islander |
Black or African American (non-Hispanic) |
Hispanic or Latino |
More than one of the above |
White (non-Hispanic) |
Native American or American Indian |
Other |
May |
83.31% |
76.97% |
83.41% |
87.24% |
80.30% |
83.76% |
85.59% |
June |
82.35% |
80.82% |
84.59% |
90.09% |
84.91% |
88.17% |
85.39% |
July |
84.64% |
82.47% |
86.95% |
90.02% |
86.14% |
89.72% |
87.87% |
August |
84.94% |
83.41% |
87.18% |
90.15% |
85.74% |
88.64% |
88.08% |
September |
84.60% |
83.56% |
86.42% |
89.37% |
84.51% |
89.87% |
86.88% |
October |
85.05% |
84.18% |
86.41% |
90.33% |
85.47% |
88.73% |
87.43% |
November |
87.15% |
86.11% |
88.16% |
91.14% |
88.19% |
91.59% |
90.17% |
December |
86.76% |
85.45% |
87.82% |
91.27% |
87.49% |
92.79% |
89.66% |
2019 Average |
85.52% |
83.25% |
87.08% |
90.97% |
86.92% |
88.02% |
88.18% |
2020 Average |
84.98% |
83.18% |
86.33% |
89.89% |
85.42% |
89.34% |
87.89% |
Rates of depression among youth of color were the same as White youth. In 2020, 91 percent (N=137,134) of youth of color ages 11-17 who took a depression screen scored with moderate to severe depression, and 91 percent (N=121,087) of White youth scored with moderate to severe depression. However, when results are broken down by race/ethnicity, there are more notable differences. Rates of moderate to severe depression were highest among Native American or American Indian youth (93%, N= 3,832) and youth who identified with more than one race (93%, N= 16,168).
Race/Ethnicity (Youth ages 11-17) |
Depression Screen Result |
Percentage |
Count |
Asian or Pacific Islander |
Negative or Minimal to Mild |
10.13% |
4,953 |
Positive or Moderate to Severe |
89.87% |
43,943 |
|
Black or African American (non-Hispanic) |
Negative or Minimal to Mild |
10.56% |
2,453 |
Positive or Moderate to Severe |
89.44% |
20,773 |
|
Hispanic or Latino |
Negative or Minimal to Mild |
9.34% |
3,782 |
Positive or Moderate to Severe |
90.66% |
36,689 |
|
More than one of the above |
Negative or Minimal to Mild |
7.35% |
1,283 |
Positive or Moderate to Severe |
92.65% |
16,168 |
|
Native American or American Indian |
Negative or Minimal to Mild |
7.26% |
300 |
Positive or Moderate to Severe |
92.74% |
3,832 |
|
Other |
Negative or Minimal to Mild |
8.31% |
1,425 |
Positive or Moderate to Severe |
91.69% |
15,729 |
|
White (non-Hispanic) |
Negative or Minimal to Mild |
9.20% |
12,271 |
Positive or Moderate to Severe |
90.80% |
121,087 |
For more detailed analyses on anxiety and depression data by Race/Ethnicity, click here.
Suicidal Ideation and Thoughts of Self-Harm Reach A New High
Suicidal/self-harm thinking, especially among young people, was epidemic in 2020. Overall, 37% (N=347,782) of individuals who took the PHQ-9 for depression reported frequent suicidal ideation (defined as more than half or nearly every day of the previous two weeks) in 2020. This was 6% higher than the average rate of suicidal ideation in 2019 (31%, N=101,815).
Suicidal Ideation Reported at Highest Rates Among Youth, Especially LGBTQ+ Youth
When examined by age, youth ages 11-17 continue to have the highest rate of suicidal ideation. In December 2020, 53% (N=19,975) of 11-17-year-olds reported having suicidal thoughts more than half the days or nearly every day, the highest rate recorded throughout the year.
Overall, 51% (N=158,490) 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).
Thoughts that you would be better off dead, or of hurting yourself (Youth ages 11-17) |
2019 Count |
2019 Percentage |
2020 Count |
2020 Percentage |
More than half or nearly every day |
20,263 |
48.92% |
158,490 |
50.73% |
Not at all or several days |
21,161 |
51.08% |
153,947 |
49.27% |
Grand Total |
41,424 |
100.00% |
312,437 |
100.00% |
When examined by month, there are larger differences between reported rates of suicidal ideation between 2019 and 2020. In 2019, rates of reported suicidal ideation were elevated in the Summer between March and August and were lower from September-December. In 2020, rates of reported frequent suicidal ideation among youth increased drastically in March, decreased in April and May, and has continued to increase from June-December. November and December 2020 were the two months with the highest percentages of youth reporting frequent suicidal ideation during the 24-month period from January 2019 through December 2020.
Rates of frequent suicidal ideation are also higher among people who identify as LGBTQ+, particularly among LGBTQ+ youth. Fifty-four percent of LGBTQ+ individuals who took a depression screen in 2020 reported experiencing suicidal ideation more than half or nearly every day of the previous two weeks (N=86,416). This was nearly 5% higher than the reported rate in 2019 (49%, N=15,586). Sixty-two percent (N=58,873) of youth ages 11-17 who identified as LGBTQ+ reported frequent suicidal ideation, 2% higher than the average rate reported by LGBTQ+ youth in 2019 (60%, N=7,104).
Rates of Suicidal Ideation by Race/Ethnicity
Rates of suicidal ideation continue to be much higher than the 2019 average for screeners of every race/ethnicity. The proportion of people reporting frequent thoughts of suicide or self-harm was highest among Native American or American Indian screeners in 2020 (46%). The largest increases in the proportion of people experiencing suicidal ideation between 2019 and 2020 was for Native American or American Indian screeners (7.5% increase) and Black or African American screeners (6.89% increase).
Suicidal Ideation More Than Half or Nearly Every Day, by Race/Ethnicity |
Asian or Pacific Islander |
Black or African American (non-Hispanic) |
Hispanic or Latino |
More than one of the above |
White (non-Hispanic) |
Native American or American Indian |
Other |
May |
38.38% |
30.30% |
31.70% |
39.21% |
29.17% |
38.94% |
40.65% |
June |
38.54% |
32.78% |
34.97% |
42.23% |
33.59% |
39.78% |
40.65% |
July |
41.75% |
35.35% |
35.90% |
42.39% |
34.79% |
44.39% |
44.78% |
August |
43.38% |
37.40% |
38.26% |
42.53% |
35.28% |
46.68% |
45.05% |
September |
43.01% |
37.78% |
38.94% |
43.61% |
33.58% |
47.40% |
45.43% |
October |
42.44% |
38.79% |
38.66% |
43.58% |
35.60% |
46.33% |
47.19% |
November |
44.51% |
42.23% |
42.09% |
48.21% |
39.50% |
52.70% |
50.60% |
December |
45.15% |
41.77% |
41.04% |
46.10% |
38.11% |
49.41% |
48.87% |
2019 Average |
37.97% |
30.55% |
31.85% |
39.44% |
30.56% |
38.77% |
42.06% |
2020 Average |
42.36% |
37.44% |
37.95% |
43.71% |
35.32% |
46.27% |
46.07% |
Rates of suicidal ideation were higher among black, indigenous, and youth of color (BIPOC) than White youth. Among BIPOC youth, 53 percent (N=79,763) reported thoughts of suicide or self-harm more than half or nearly every day, compared to 49 percent (N=65,001) of White youth.
The proportion of youth ages 11-17 reporting frequent thoughts of suicide or self-harm was also highest among those who identified their race as “Other” (57%, N=9,754), youth who identified as Native American or American Indian (57%, N=2,348), and Asian or Pacific Islander youth (54%, N=26,345) in 2020. The largest increases in the proportion of youth experiencing suicidal ideation between 2019 and 2020 was for Black or African American screeners (5% increase) and Hispanic or Latinx screeners (4% increase).
Thoughts that you would be better off dead, or of hurting yourself among Youth (Ages 11-17) by Race/Ethnicity |
Count |
Percentage |
Asian or Pacific Islander |
48897 |
17.18% |
More than half or nearly every day |
26345 |
53.88% |
Not at all or several days |
22552 |
46.12% |
Black or African American (non-Hispanic) |
23226 |
8.16% |
More than half or nearly every day |
12308 |
52.99% |
Not at all or several days |
10918 |
47.01% |
Hispanic or Latino |
40471 |
14.22% |
More than half or nearly every day |
19865 |
49.08% |
Not at all or several days |
20606 |
50.92% |
More than one of the above |
17451 |
6.13% |
More than half or nearly every day |
9143 |
52.39% |
Not at all or several days |
8308 |
47.61% |
Native American or American Indian |
4132 |
1.45% |
More than half or nearly every day |
2348 |
56.82% |
Not at all or several days |
1784 |
43.18% |
Other |
17154 |
6.03% |
More than half or nearly every day |
9754 |
56.86% |
Not at all or several days |
7400 |
43.14% |
White (non-Hispanic) |
133358 |
46.84% |
More than half or nearly every day |
65001 |
48.74% |
Not at all or several days |
68357 |
51.26% |
Grand Total |
284689 |
100.00% |
For more detailed analyses on suicidal ideation data by Race/Ethnicity, click here.
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, 140,598 individuals took the Youth screen in 2020, a 261% increase over the number of Youth screens taken in 2019 (N=38,921).
Of the individuals who took the Youth screen, 77% (N=108,344) scored at risk for emotional, attentional, or behavioral difficulties. This was 6% higher than the average rate in 2019 (71%, N=27,609).
In December 2020, the proportion of youth scoring at risk reached the highest levels recorded in 2020. 80% (N=14,556) of youth scored at risk for emotional, attentional, or behavioral difficulties. This was 11% higher than the proportion of youth who screened at risk on the Youth screen in 2019 (69%).
Dramatic Increases in Symptoms of Psychosis
MHA uses the Prodromal Questionnaire – Brief version (PQ-B) to screen for psychosis. In total, 248,186 individuals took the psychosis screen in 2020, a 97% increase over the number of psychosis screens taken in 2019 (N=125,461).
Of the individuals who took the psychosis screen, 76% (N=187,573) scored at risk for psychosis. This was 2% higher than the average rate in 2019 (73%, N=92,074), but over two times the number of people scoring at risk for psychosis.
In November and December 2020, the proportion of people scoring at risk for psychosis reached the highest levels recorded in 2020. Of those individuals who took a psychosis screen, 77% (N=46,765) scored at risk for psychosis in the final two months of 2020.
Beginning in June the percentage of people at risk grew steadily. As a result, while the percentage at risk tracked closely with the 2019 percentages through the first few months of the year, it was 6-10 percentage points higher from September through December 2020 than it was in each of those months in 2019.
Loneliness, Past Trauma, and Relationship Problems Continue to be Main Concerns
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.”
Throughout the year, feelings of loneliness and isolation were cited by screeners as a major reason for their mental health struggles. Among individuals who screened positive or moderate to severe for a mental health condition in 2020, 71% reported that one of the top three things contributing to their mental health concerns was loneliness or isolation. This was followed by 53% reporting past trauma and 42% reporting relationship problems. On average, 26% of individuals who screened positive or moderate to severe in 2020 reported coronavirus, and 26% reported current events (including news and politics) as one of the top three things affecting their mental health.
Main Concerns: People Scoring At Risk for Any Screen (Excluding Parent and Youth Screens) |
% April |
% May |
% June |
% July |
% Aug |
% Sep |
% Oct |
% Nov |
% Dec |
Average 2020 |
Loneliness or isolation |
68.54% |
68.63% |
70.08% |
70.75% |
69.67% |
70.00% |
71.28% |
71.83% |
71.13% |
70.55% |
Past trauma |
52.84% |
53.11% |
52.54% |
53.44% |
52.90% |
51.81% |
51.76% |
51.73% |
54.28% |
52.60% |
Relationship problems |
40.70% |
43.24% |
43.15% |
43.32% |
42.61% |
42.37% |
41.96% |
41.96% |
41.95% |
42.37% |
Grief or loss of someone or something |
27.02% |
27.93% |
27.35% |
27.47% |
27.61% |
27.43% |
27.56% |
28.14% |
28.01% |
27.69% |
Coronavirus |
32.65% |
29.34% |
23.22% |
24.13% |
24.96% |
23.20% |
25.19% |
26.85% |
28.16% |
25.73% |
Current events (news, politics, etc.) |
22.89% |
23.26% |
30.42% |
26.07% |
25.70% |
25.81% |
26.20% |
25.20% |
23.49% |
25.63% |
Financial Problems |
23.11% |
22.98% |
23.85% |
24.73% |
25.39% |
24.19% |
23.47% |
22.50% |
23.76% |
23.81% |
Racism |
|
|
5.85% |
8.62% |
7.94% |
7.86% |
6.92% |
6.92% |
6.16% |
7.27%* |
*Racism average percentage is derived from June-December, as Racism was not added as an option until June 2020
The two responses with the most variability throughout the year were Coronavirus and Current Events (including news and politics). Worry about coronavirus was highest at the beginning of the pandemic, with 33% of individuals reporting it as a top three contributor to their mental distress. In June, as increased media attention, awareness and protests began in response to racial injustice and police brutality, there was a 7% increase in people reporting current events as one of their three main concerns (to over 30%), mirrored by a 7% decrease in those reporting Coronavirus (23%). Current events were reported as a main concern more often than coronavirus from June-November 2020. In December following the Presidential election, those citing current events dropped to an eight-month low of 24%, nearly three points lower than before the election in October.
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 (78%, compared to 71%). They were also more likely to report racism as one of their top three concerns than the general screening population (9%, compared to 7%).
Main Concerns, Scoring Positive for a Mental Health Condition (Excluding Parent and Youth Screens), 11-17-Year-Olds |
% April |
% May |
% June |
% July |
% Aug |
% Sep |
% Oct |
% Nov |
% Dec |
Average 2020 |
Loneliness or Social Isolation |
79.17% |
79.05% |
78.47% |
78.17% |
77.71% |
77.06% |
77.66% |
76.89% |
77.30% |
77.61% |
Past Trauma |
52.79% |
52.79% |
51.52% |
52.95% |
53.15% |
51.02% |
51.20% |
50.63% |
52.72% |
51.82% |
Relationship Problems |
38.89% |
40.38% |
40.05% |
40.04% |
39.89% |
39.73% |
39.69% |
39.92% |
39.52% |
39.83% |
Grief or loss of someone or something |
26.58% |
27.97% |
27.37% |
27.16% |
27.79% |
28.14% |
28.14% |
28.69% |
27.97% |
28.00% |
Current Events (news, politics, etc.) |
19.56% |
21.45% |
28.24% |
24.57% |
24.72% |
25.80% |
25.79% |
25.97% |
24.77% |
25.25% |
Coronavirus |
26.88% |
25.84% |
20.30% |
20.69% |
22.11% |
21.83% |
23.63% |
25.94% |
27.54% |
23.89% |
Financial Problems |
8.35% |
8.79% |
9.01% |
9.71% |
10.24% |
9.52% |
9.69% |
9.60% |
10.07% |
9.64% |
Racism |
|
6.59% |
10.09% |
9.74% |
9.90% |
9.03% |
8.71% |
8.15% |
8.94%* |
*Racism average percentage is derived from June-December, as Racism was not added as an option until June 2020
Individuals who took the Parent or Youth screens were offered different options than the above, to include 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 (72%). This was followed by social life or relationships (65%) and past trauma (42%).
Main Concerns, Scoring At Risk on Parent and Youth Screens |
Apr |
May |
Jun |
Jul |
Aug |
Sept |
Oct |
Nov |
Dec |
2020 Avg |
Loneliness or Social Isolation |
70.03% |
71.93% |
72.26% |
73.05% |
72.60% |
70.89% |
71.05% |
71.15% |
72.33% |
71.81% |
Social life or relationships |
66.06% |
66.93% |
66.90% |
66.71% |
66.66% |
64.31% |
63.82% |
63.71% |
64.07% |
65.20% |
Past Trauma |
42.10% |
41.32% |
41.76% |
42.73% |
43.57% |
42.27% |
42.87% |
41.42% |
43.61% |
42.48% |
Difficulties at school (academics or learning) |
40.29% |
43.57% |
36.47% |
34.33% |
37.25% |
46.06% |
52.28% |
54.24% |
52.01% |
45.40% |
Coronavirus |
25.89% |
24.12% |
20.33% |
20.06% |
22.27% |
21.39% |
23.02% |
24.80% |
26.51% |
23.06% |
Grief or loss of someone or something |
22.39% |
20.90% |
20.24% |
20.72% |
20.97% |
20.90% |
21.15% |
20.64% |
20.61% |
20.81% |
Current Events (news, politics, etc.) |
16.62% |
17.24% |
26.52% |
23.39% |
22.46% |
23.55% |
23.65% |
23.55% |
21.56% |
22.71% |
Financial Problems |
13.76% |
14.59% |
15.20% |
15.83% |
16.18% |
15.93% |
14.84% |
14.88% |
15.59% |
15.33% |
Being Bullied |
10.85% |
12.22% |
12.09% |
13.28% |
12.42% |
11.90% |
11.50% |
11.18% |
11.91% |
11.97% |
Main Concerns by Race/Ethnicity
Although the averages across screeners reveal the main concerns of the population throughout this year, the events of 2020 had profoundly different mental health impacts on different racial and ethnic groups, and the differences reveal some of the inequities that BIPOC communities face in the U.S. that directly affect their mental health.
Among the 1,129,790 screeners who scored positive or moderate to severe for a mental health condition and reported their race/ethnicity from May-December 2020:
- Screeners who identified as more than one race were most likely out of all racial/ethnic groups to select current events (28%) as one of their top three concerns, followed by White screeners (27%) and Hispanic or Latinx screeners (26%).
- Black or African American screeners were most likely to select financial problems (30%), followed by Native American or American Indian screeners (25%) and Asian or Pacific Islander screeners (24%).
- Screeners who identified as Hispanic or Latinx were most likely to select loneliness or isolation (74%), followed by screeners who identified with more than one race (73%) and Asian or Pacific Islander screeners (72%).
- Native American or American Indian screeners were most likely to select grief or loss (39%) followed by screeners who identified as more than one race (29%), and Black or African American screeners (29%).
- Native American or American Indian screeners were most likely to select past trauma (63%), followed by screeners who identified as more than one race (59%) and Hispanic or Latinx screeners (55%).
- Native American or American Indian screeners were most likely to select relationship problems (44%) followed by Asian or Pacific Islander screeners (43%) and Black or African American screeners (43%).
- White screeners were most likely to select coronavirus (27%), followed by Hispanic or Latinx screeners (27%) and screeners who identified as more than one race (25%).
Main Concerns, Scoring Positive for a Mental Health Condition (May-December 2020) Average by Race/Ethnicity |
Current events |
Financial Problems |
Loneliness or isolation |
Grief or loss of someone or something |
Past trauma |
Relationship problems |
Coronavirus |
Asian or Pacific Islander |
21.41% |
24.32% |
71.52% |
24.92% |
45.10% |
42.72% |
22.85% |
Black or African American (non-Hispanic) |
22.74% |
30.35% |
69.24% |
28.59% |
53.10% |
42.58% |
23.76% |
Hispanic or Latino |
25.53% |
24.30% |
73.88% |
26.17% |
55.10% |
39.93% |
27.10% |
More than one of the above |
27.51% |
21.66% |
73.07% |
28.89% |
59.19% |
39.29% |
25.05% |
Native American or American Indian |
25.40% |
25.38% |
71.19% |
38.82% |
63.27% |
43.81% |
23.76% |
Other |
22.34% |
23.15% |
69.54% |
28.14% |
49.33% |
40.43% |
22.11% |
White (non-Hispanic) |
26.99% |
22.54% |
68.40% |
26.98% |
52.07% |
38.98% |
27.11% |
From June-December 2020, Black or African American screeners who screened positive or moderate to severe for a mental health condition were most likely to say that racism was one of their top three concerns (19%, N=18,351), followed by screeners identifying as more than one race (12%, N=7,613) and Native American or American Indian screeners (10%, N=1,457).
Race/Ethnicity |
Number of Individuals Reporting Racism as a Main Concern |
Total Number of Responses to Main Concerns |
Proportion of Individuals Reporting Racism as a Top Three Main Concern |
Black or African American (non-Hispanic) |
18,351 |
96,409 |
19.03% |
More than one of the above |
7,613 |
61,436 |
12.39% |
Native American or American Indian |
1,457 |
15,129 |
9.63% |
Hispanic or Latino |
12,207 |
144,095 |
8.47% |
Other |
5,152 |
60,894 |
8.46% |
Asian or Pacific Islander |
13,195 |
183,390 |
7.20% |
White (non-Hispanic) |
27,573 |
606,827 |
4.54% |
Total |
85,548 |
1,168,180 |
|