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Mental health and the pandemic: What U.S. surveys have found

The coronavirus pandemic has been associated with worsening mental health among people in the United States and around the world . In the U.S, the COVID-19 outbreak in early 2020 caused widespread lockdowns and disruptions in daily life while triggering a short but severe economic recession that resulted in widespread unemployment. Three years later, Americans have largely returned to normal activities, but challenges with mental health remain.

Here’s a look at what surveys by Pew Research Center and other organizations have found about Americans’ mental health during the pandemic. These findings reflect a snapshot in time, and it’s possible that attitudes and experiences may have changed since these surveys were fielded. It’s also important to note that concerns about mental health were common in the U.S. long before the arrival of COVID-19 .

Three years into the COVID-19 outbreak in the United States , Pew Research Center published this collection of survey findings about Americans’ challenges with mental health during the pandemic. All findings are previously published. Methodological information about each survey cited here, including the sample sizes and field dates, can be found by following the links in the text.

The research behind the first item in this analysis, examining Americans’ experiences with psychological distress, benefited from the advice and counsel of the COVID-19 and mental health measurement group at Johns Hopkins Bloomberg School of Public Health.

At least four-in-ten U.S. adults (41%) have experienced high levels of psychological distress at some point during the pandemic, according to four Pew Research Center surveys conducted between March 2020 and September 2022.

Young adults are especially likely to have faced high levels of psychological distress since the COVID-19 outbreak began: 58% of Americans ages 18 to 29 fall into this category, based on their answers in at least one of these four surveys.

Women are much more likely than men to have experienced high psychological distress (48% vs. 32%), as are people in lower-income households (53%) when compared with those in middle-income (38%) or upper-income (30%) households.

In addition, roughly two-thirds (66%) of adults who have a disability or health condition that prevents them from participating fully in work, school, housework or other activities have experienced a high level of distress during the pandemic.

The Center measured Americans’ psychological distress by asking them a series of five questions on subjects including loneliness, anxiety and trouble sleeping in the past week. The questions are not a clinical measure, nor a diagnostic tool. Instead, they describe people’s emotional experiences during the week before being surveyed.

While these questions did not ask specifically about the pandemic, a sixth question did, inquiring whether respondents had “had physical reactions, such as sweating, trouble breathing, nausea, or a pounding heart” when thinking about their experience with the coronavirus outbreak. In September 2022, the most recent time this question was asked, 14% of Americans said they’d experienced this at least some or a little of the time in the past seven days.

More than a third of high school students have reported mental health challenges during the pandemic. In a survey conducted by the Centers for Disease Control and Prevention from January to June 2021, 37% of students at public and private high schools said their mental health was not good most or all of the time during the pandemic. That included roughly half of girls (49%) and about a quarter of boys (24%).

In the same survey, an even larger share of high school students (44%) said that at some point during the previous 12 months, they had felt sad or hopeless almost every day for two or more weeks in a row – to the point where they had stopped doing some usual activities. Roughly six-in-ten high school girls (57%) said this, as did 31% of boys.

On both questions, high school students who identify as lesbian, gay, bisexual, other or questioning were far more likely than heterosexual students to report negative experiences related to their mental health.

Mental health tops the list of worries that U.S. parents express about their kids’ well-being, according to a fall 2022 Pew Research Center survey of parents with children younger than 18. In that survey, four-in-ten U.S. parents said they’re extremely or very worried about their children struggling with anxiety or depression. That was greater than the share of parents who expressed high levels of concern over seven other dangers asked about.

While the fall 2022 survey was fielded amid the coronavirus outbreak, it did not ask about parental worries in the specific context of the pandemic. It’s also important to note that parental concerns about their kids struggling with anxiety and depression were common long before the pandemic, too . (Due to changes in question wording, the results from the fall 2022 survey of parents are not directly comparable with those from an earlier Center survey of parents, conducted in 2015.)

Among parents of teenagers, roughly three-in-ten (28%) are extremely or very worried that their teen’s use of social media could lead to problems with anxiety or depression, according to a spring 2022 survey of parents with children ages 13 to 17 . Parents of teen girls were more likely than parents of teen boys to be extremely or very worried on this front (32% vs. 24%). And Hispanic parents (37%) were more likely than those who are Black or White (26% each) to express a great deal of concern about this. (There were not enough Asian American parents in the sample to analyze separately. This survey also did not ask about parental concerns specifically in the context of the pandemic.)

Looking back, many K-12 parents say the first year of the coronavirus pandemic had a negative effect on their children’s emotional health. In a fall 2022 survey of parents with K-12 children , 48% said the first year of the pandemic had a very or somewhat negative impact on their children’s emotional well-being, while 39% said it had neither a positive nor negative effect. A small share of parents (7%) said the first year of the pandemic had a very or somewhat positive effect in this regard.

White parents and those from upper-income households were especially likely to say the first year of the pandemic had a negative emotional impact on their K-12 children.

While around half of K-12 parents said the first year of the pandemic had a negative emotional impact on their kids, a larger share (61%) said it had a negative effect on their children’s education.

• Coronavirus (COVID-19)
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John Gramlich is an associate director at Pew Research Center .

How Americans View the Coronavirus, COVID-19 Vaccines Amid Declining Levels of Concern

Online religious services appeal to many americans, but going in person remains more popular, about a third of u.s. workers who can work from home now do so all the time, how the pandemic has affected attendance at u.s. religious services, economy remains the public’s top policy priority; covid-19 concerns decline again, most popular.

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About Mental Health

What is mental health?

Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make healthy choices. 1 Mental health is important at every stage of life, from childhood and adolescence through adulthood.

Why is mental health important for overall health?

Mental and physical health are equally important components of overall health.  For example, depression increases the risk for many types of physical health problems, particularly long-lasting conditions like diabetes , heart disease , and stroke. Similarly, the presence of chronic conditions can increase the risk for mental illness. 2

Can your mental health change over time?

Yes, it’s important to remember that a person’s mental health can change over time, depending on many factors.  When the demands placed on a person exceed their resources and coping abilities, their mental health could be impacted. For example, if someone is working long hours, caring for a relative, or experiencing economic hardship, they may experience poor mental health.

How common are mental illnesses?

Mental illnesses are among the most common health conditions in the United States.

• More than 1 in 5 US adults live with a mental illness.
• Over 1 in 5 youth (ages 13-18) either currently or at some point during their life, have had a seriously debilitating mental illness. 5
• About 1 in 25 U.S. adults lives with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression. 6

What causes mental illness?

There is no single cause for mental illness. A number of factors can contribute to risk for mental illness, such as

• Adverse Childhood Experiences , such as trauma or a history of abuse (for example, child abuse, sexual assault, witnessing violence, etc.)
• Experiences related to other ongoing (chronic) medical conditions, such as a traumatic brain injury , cancer, or diabetes
• Biological factors or chemical imbalances in the brain
• Use of alcohol or drugs
• Having feelings of loneliness or isolation

People can experience different types of mental illnesses or disorders, and they can often occur at the same time. Mental illnesses can occur over a short period of time or be episodic. This means that the mental illness comes and goes with discrete beginnings and ends. Mental illness can also be ongoing or long-lasting.

There are more than 200 types of mental illness. Some of the main types of mental illness and disorders are listed here .

• Strengthening Mental Health Promotion . Fact sheet no. 220. Geneva, Switzerland: World Health Organization.
• Chronic Illness & Mental Health . Bethesda, MD: National Institutes of Health, National Institute of Mental Health. 2015.
• Kessler RC, Angermeyer M, Anthony JC, et al. Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry. 2007;6(3):168-176.
• Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality. Substance Abuse and Mental Health Services Administration. 2016.
• Merikangas KR, He J, Burstein M, et al. Lifetime Prevalence of Mental Disorders in US Adolescents: Results from the National Comorbidity Study-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry. 2010;49(10):980-989. doi:10.1016/j.jaac.2010.05.017.
• Health & Education Statistics . Bethesda, MD: National Institute of Mental Health. National Institutes of Health. 2016.
• Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, Severity, and Comorbidity of Twelve-month DSM-IV Disorders in the National Comorbidity Survey Replication (NCS-R). Archives of general psychiatry. 2005;62(6):617-627. doi:10.1001/archpsyc.62.6.617.Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health. Rockville, MD.
• Rui P, Hing E, Okeyode T.  National Ambulatory Medical Care Survey: 2014 State and National Summary Tables. Atlanta, GA: National Center for Health Statistics. Centers for Disease Control and Prevention. 2014.
• Web-based Injury Statistics Query and Reporting System (WISQARS) . Atlanta, GA: National Center for Injury Prevention and Control. Centers for Disease Control and Prevention. 2015.
• Insel, T.R. Assessing the Economic Costs of Serious Mental Illness. Am J Psychiatry. 2008 Jun;165(6):663-5. doi: 10.1176/appi.ajp.2008.08030366.
• HCUP Facts and Figures: Statistics on Hospital-based Care in the United States, 2009. Rockville, MD: Agency for Healthcare Research and Quality. 2009.
• Reeves, WC et al. CDC Report: Mental Illness Surveillance Among Adults in the United States. MMWR Morb Mortal Wkly Rep 2011;60(03);1-32.
• Parks, J., et al. Morbidity and Mortality in People with Serious Mental Illness. Alexandria, VA: National Association of State Mental Health Program Directors Council. 2006.

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The Department of Mental Health covers a wide array of topics related to mental health, mental illness, and substance abuse. We emphasize ongoing research that enriches and stimulates the teaching programs. All students and fellows are encouraged to participate in at least one research group. Faculty and students from multiple disciplines work together within and across several major research areas:

Faculty are working to understand the distribution, causes and consequences of autism and developmental disabilities as well as the impact of public health policy on children and families.

Global Mental Health faculty develop, implement and evaluate measures and interventions to assess and meet mental health needs of communities around the world, with a focus on developing nations.

Mental Health and Aging

Faculty in the Mental Health and Aging Research Area conduct observational and intervention research aimed at enhancing cognitive and mental well being in older adults.

Mental Health and COVID-19

Understanding how mental health evolves as a result of this serious global pandemic will inform prevention and treatment strategies moving forward. 

Mental Health in the Workplace

At the Bloomberg School of Public Health, which houses the only department of mental health in a school of public health, we have a unique ability to define both the problems and potential solutions.

Mental Health Services and Policy

Faculty in this area study mental health and behavioral health services and supports in communities, educational institutions and employment settings. They aim to reduce risk, and provide effective long-term treatment.

The Methods program area develops and applies innovative qualitative and quantitative methods for public mental health research, with a focus on statistical methods and economic models.

Prevention Research

The Prevention Research faculty develop, test, refine and bring to scale prevention programs directed at a range of mental health and behavioral problems in children, adolescents, adults and the elderly.

Psychiatric and Behavioral Genetic Epidemiology

Faculty in this area research genetic factors and how they interact with the physical and social environment to affect the risk for mental disorders.

Psychiatric Epidemiology

Faculty in this area study the occurrence and distribution of mental and behavioral disorders across people, space and time, and examine the causes to develop support and treatment strategies.

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The Department of Mental Health views the education and schools as a key public health context. Multiple faculty members partner with local school systems to develop, refine, and test preventive interventions for school-aged children and aim to promote mental health as well as positive social, emotional, and behavioral development.

Social Determinants of Mental & Behavioral Health Area emphasizes the role of multilevel social and structural factors in shaping mental and behavioral health, such as stigma, social networks, structural racism and policies on housing, drug control, and criminal justice domestically and internationally.

Substance Use Epidemiology

Faculty in this area study the etiology and natural history of substance use, and develop and evaluate interventions to prevent and control substance use disorders.

The Department of Mental Health has projects focused on various aspects of violence such as suicide, intimate partner violence , and youth violence. Faculty and students from multiple disciplines work together within and across several major research areas.

Centers and Institutes

The department houses several school-based centers, and has a significant role in many others across the school. These are described below. Centers help bring together faculty, students, and community partners across multiple departments and schools to meet their particular missions in pursuit of improving public mental health.

• Moore Center for the Prevention of Child Sexual Abuse
• Wendy Klag Center for Autism and Developmental Disabilities
• Center on Aging and Health
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Our Students and Faculty Work in Action

The Johns Hopkins COVID-19 Mental Health Measurement Working Group developed key questions to add to existing large domestic and international surveys to measure the mental health impact of the pandemic.

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NAMI’s primary role in research is to ensure that people affected by mental illness – both individuals and their families – have access to accurate and timely information regarding symptoms, conditions and treatments. This includes sharing new insights from research in brain science, genetics, treatment options, and other discoveries, as well as advocating for current and future research efforts.

Research is vital to help us understand how mental health conditions develop, how they impact individuals and communities, and how symptoms can be most effectively managed. Mental health often leaves us with a lot of questions – and research is one of the most important ways that we can provide answers. As a result, research is a powerful source of hope for people with mental illness and their families.

Each year, NAMI honors innovative work in the field of mental health research with the  NAMI Scientific Research Award . NAMI also collaborates with leading researchers and experts from academia, industry, government and private institutions to voice a unified call for better, more effective treatment for serious mental illness through the  Accelerating Medicines Partnership – Schizophrenia  (AMP-SCZ).

To learn more about how NAMI engages with research, contact us at  [email protected] .

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Physical Fitness Linked to Better Mental Health in Young People

A new study bolsters existing research suggesting that exercise can protect against anxiety, depression and attention challenges.

By Matt Richtel

Physical fitness among children and adolescents may protect against developing depressive symptoms, anxiety and attention deficit hyperactivity disorder, according to a study published on Monday in JAMA Pediatrics.

The study also found that better performance in cardiovascular activities, strength and muscular endurance were each associated with greater protection against such mental health conditions. The researchers deemed this linkage “dose-dependent,” suggesting that a child or adolescent who is more fit may be accordingly less likely to experience the onset of a mental health disorder.

These findings come amid a surge of mental health diagnoses among children and adolescents, in the United States and abroad, that have prompted efforts to understand and curb the problem.

The new study, conducted by researchers in Taiwan, compared data from two large data sets: the Taiwan National Student Fitness Tests, which measures student fitness performance in schools, and the National Insurance Research Databases, which records medical claims, diagnoses prescriptions and other medical information. The researchers did not have access to the students’ names but were able to use the anonymized data to compare the students’ physical fitness and mental health results.

The risk of mental health disorder was weighted against three metrics for physical fitness: cardio fitness, as measured by a student’s time in an 800-meter run; muscle endurance, indicated by the number of situps performed; and muscle power, measured by the standing broad jump.

Improved performance in each activity was linked with a lower risk of mental health disorder. For instance, a 30-second decrease in 800-meter time was associated, in girls, with a lower risk of anxiety, depression and A.D.H.D. In boys, it was associated with lower anxiety and risk of the disorder.

An increase of five situps per minute was associated with lower anxiety and risk of the disorder in boys, and with decreased risk of depression and anxiety in girls.

“These findings suggest the potential of cardiorespiratory and muscular fitness as protective factors in mitigating the onset of mental health disorders among children and adolescents,” the researchers wrote in the journal article.

Physical and mental health were already assumed to be linked , they added, but previous research had relied largely on questionnaires and self-reports, whereas the new study drew from independent assessments and objective standards.

The Big Picture

The surgeon general, Dr. Vivek H. Murthy, has called mental health “the defining public health crisis of our time,” and he has made adolescent mental health central to his mission. In 2021 he issued a rare public advisory on the topic. Statistics at the time revealed alarming trends: From 2001 to 2019, the suicide rate for Americans ages 10 to 19 rose 40 percent, and emergency visits related to self-harm rose 88 percent.

Some policymakers and researchers have blamed the sharp increase on the heavy use of social media, but research has been limited and the findings sometimes contradictory. Other experts theorize that heavy screen use has affected adolescent mental health by displacing sleep, exercise and in-person activity, all of which are considered vital to healthy development. The new study appeared to support the link between physical fitness and mental health.

“The finding underscores the need for further research into targeted physical fitness programs,” its authors concluded. Such programs, they added, “hold significant potential as primary preventative interventions against mental disorders in children and adolescents.”

Matt Richtel is a health and science reporter for The Times, based in Boulder, Colo. More about Matt Richtel

Understanding A.D.H.D.

The challenges faced by those with attention deficit hyperactivity disorder can be daunting. but people who are diagnosed with it can still thrive..

Millions of children in the United States have received a diagnosis of A.D.H.D . Here is how their families can support them .

The condition is also being recognized more in adults . These are some of the behaviors  that might be associated with adult A.D.H.D.

Since a nationwide Adderall shortage started, some people with A.D.H.D. have said their medication no longer helps with their symptoms. But there could be other factors at play .

Everyone has bouts of distraction and forgetfulness. Here is when psychiatrists diagnose it as something clinical .

The disorder can put a strain on relationships. But there are ways to cope .

Though meditation can be beneficial to those with A.D.H.D., sitting still and focusing on breathing can be hard for them. These tips can help .

Media Center 5/1/2024 10:00:00 AM Corbin McGuire

How the NCAA is prioritizing mental health

New resources, initiatives and research driving actions focused on student-athletes.

The NCAA continued its commitment to advancing mental health for its more than 520,000 student-athletes in the 2023-24 academic year. Check out a few ways the NCAA has made progress in this area, including new resources, initiatives and research.  

Mental Health Best Practices

In early 2024, the NCAA released an updated  Mental Health Best Practices  document. The best practices, developed by the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports, reflect a consensus of the Mental Health Advisory Group, which includes representatives from science, medicine, sports medicine organizations and the NCAA membership.  Under the NCAA constitution adopted in January 2022, each member school — regardless of division — must facilitate an environment that reinforces physical and mental health within athletics by ensuring access to appropriate resources and open engagement with respect to physical and mental health.  Schools across all divisions are legislatively required to provide student-athletes mental health resources and education consistent with the Mental Health Best Practices. Additionally, as part of its holistic student-athlete model, Division I is requiring schools to attest to providing services and support consistent with the best practices beginning Aug. 1, 2024. The first attestation deadline is November 2025

"The updated Mental Health Best Practices reflects the highest standards of excellence and evidence-based practice and of comprehensive and up-to-date guidance on supporting mental health in collegiate athletics," NCAA Chief Medical Officer Brian Hainline, who announced his retirement in March, said after a  February meeting of the Committee on Competitive Safeguards and Medical Aspects of Sports . "The NCAA recognizes the importance of promoting and protecting the mental wellness of student-athletes, who face unique challenges and pressures in their pursuit of excellence."

The document's four best practices  have been updated to recognize the importance of creating healthy environments as a first step in promoting mental health, as well as to provide membership increased flexibility in implementation. The best practices are: 

• The creation of healthy environments that support mental health and promote well-being. 
• Procedures, including mental health screening tools, for identifying student-athletes with mental health symptoms and disorders. 
• Action plans that outline referral pathways of student-athletes to qualified providers.
• Licensure of providers who oversee and manage student-athlete mental health care.

To support NCAA members in implementing mental health best practices, the NCAA Sport Science Institute recently hosted a  series of webinars  featuring membership-based examples of ways to support and promote student-athlete mental health. 

Sports betting

Protecting student-athletes from the pitfalls of sports betting, ranging from addiction to harassment, quickly became a priority of NCAA President Charlie Baker after he started his role in March 2023. Since then, the NCAA's advocacy and efforts in this space have been impactful . 

The national office is continuing to aggressively pursue advocacy in states that have or are considering legalized sports betting to incorporate antiharassment measures. This includes calling for a ban on player-specific prop bets. As a result, several states have taken positive steps to protect student-athletes from sports betting harassment. Four states have implemented restrictions on prop betting, and another four states have introduced bills that protect student-athletes from harassment. 

The NCAA has expanded its educational efforts with EPIC Global Solutions, designing specific curriculum that discusses handling abusive content. Over 50,000 student-athletes have been educated through the program, the largest of its kind globally. The NCAA also has launched a sports betting e-learning module designed to educate current and prospective student-athletes on problem gambling harms and the risks sports betting poses to the integrity of sports.

The NCAA  is also working with Signify Group  to pilot an initiative targeting social media harassment for the 2023-24 championship season. The initiative focuses on select championships with a heightened risk for harassment and abuse directed at championship participants, particularly student-athletes. This initiative is intended to further promote the mental health and well-being of the college sports community through data collection and analytics.  

In March, the NCAA launched a campaign called " Draw the Line ," prioritizing student-athlete education on the effects of sports betting. Draw the Line is aimed at college students and will run across social media channels. It will include a membership toolkit for member schools and conferences to access resources that extend the campaign to their campuses.

"Sports betting is everywhere — especially on college campuses — so it's critical student-athletes get the real story about how it can impact them and their ability to play," Baker said. "We know some bettors are harassing student-athletes and officials, so that's why we are advocating for policy changes at the state level and launching monitoring tools around championships to refer serious threats to law enforcement. The NCAA is doing more than ever to protect the integrity of the game and arm student-athletes with the truth about sports betting." 

The NCAA has continued to get direct feedback from student-athletes on their experiences, especially on mental health concerns. 

In December, the NCAA  released results  from a nationally representative survey of more than 23,000 student-athletes. The findings, drawn from the  NCAA Student-Athlete Health and Wellness Study , indicated student-athletes are reporting fewer mental health concerns than they did during the height of the COVID-19 pandemic, although the improvements are smaller in some demographics.

Similar to findings from  online studies conducted in 2020 and 2021 , self-reported mental health struggles were more common among student-athletes of color, those identifying on the queer spectrum and those identifying as transgender or nonbinary — population subgroups that commonly display higher rates of mental distress. 

"Getting an accurate understanding of what student-athletes are experiencing — directly from them — is vitally important to help member schools better serve the students on their campuses," said Tom Paskus, NCAA managing director of research. "The NCAA and our research partners, including NCAA faculty athletics representatives, devote substantial time and energy to conducting student-athlete well-being surveys because they allow us to examine important issues such as mental health trends over time. Having tens of thousands of respondents allows us to really dig deep into concerns we see in particular sports or within particular demographic groups."

In addition to sharing findings from the Health and Wellness Study, the NCAA Wagering and Social Environments Study is currently in the field, and the NCAA research team anticipates sharing preliminary results early this fall. The study represents the first comprehensive national examination of how NCAA student-athletes are being impacted by the proliferation of legal sports wagering options in the U.S. after the Supreme Court's 2018 overturning of the Professional and Amateur Sports Protection Act of 1992. Additionally, the survey examines how student-athletes interact with campus and community groups and deal with various issues that arise in their social environment. The study will expand the NCAA's understanding of the sports betting landscape and its direct impact on student-athletes, including whether rates of problem gambling behaviors in this population have changed as sports betting has become legal in many states, whether student-athletes are experiencing fan abuse related to sports betting, and how social media use is impacting student-athlete mental wellness. 

Post-eligibility insurance — mental health coverage 

In August 2023, the NCAA Board of Governors approved the creation of the  NCAA Post-Eligibility Insurance Program  for all student-athletes, which will begin Aug. 1. For up to two years (104 weeks) after student-athletes separate from school or voluntarily withdraw from athletics, the program will cover excess medical expenses for athletically related injuries sustained on or after Aug. 1 during participation in an NCAA qualifying intercollegiate sport. The coverage will provide benefits in excess of any other valid and collectible insurance. The policy will have a $90,000 excess limit per injury, with no deductible.

The program includes coverage for mental health services stemming from an eligible, documented athletic injury sustained during participation in an NCAA qualifying intercollegiate sport. Of the $90,000 available, a sublimit of up to $25,000 will be available for mental health services related to an eligible, documented athletic injury.

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Rethinking technology innovation for mental health: framework for multi-sectoral collaboration

• Sachin R. Pendse ,
• Robert Lewis ,
• Esther Howe ,
• Koustuv Saha ,
• Ebele Okoli ,
• Judith Amores ,
• Gonzalo Ramos ,
• Jenny Shen ,
• Judith Borghouts ,
• Ashish Sharma ,
• Paola Pedrelli ,
• Liz Friedman ,
• Charmain Jackman ,
• Yusra Benhalim ,
• Desmond C. Ong ,
• Sameer Segal ,
• Tim Althoff ,
• Mary Czerwinski

Nature Mental Health | May 2024

The impact of technology on mental health has become a core concern for researchers and practitioners from the clinical science, public health and technology sectors. One factor that influences this impact is the large gap between the silos of technologies explicitly designed as mental health support tools and the everyday technologies that inadvertently affect mental health. Here we ground our position on findings from a workshop that brought together over 60 experts and emphasize the importance of a multi-sectoral collaboration across these silos to address the complexities of technology’s impact on mental health. Our specific recommendations include a push to align stakeholders, incentives and governance, adopting person-centered and proactive mental health evaluation, and empowering users and clinicians (and their interactions) through mental health and technology literacy. We highlight sector-specific adaptations that can support greater collaborations, toward a future in which users have consistently positive interactions between technology use and their mental health.

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Caring for Your Mental Health

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Mental health includes emotional, psychological, and social well-being. It is more than the absence of a mental illness—it’s essential to your overall health and quality of life. Self-care can play a role in maintaining your mental health and help support your treatment and recovery if you have a mental illness.

How can I take care of my mental health?

Self-care means taking the time to do things that help you live well and improve both your physical health and mental health. This can help you manage stress, lower your risk of illness, and increase your energy. Even small acts of self-care in your daily life can have a big impact.

Here are some self-care tips:

• Get regular exercise.  Just 30 minutes of walking every day can boost your mood and improve your health. Small amounts of exercise add up, so don’t be discouraged if you can’t do 30 minutes at one time.
• Eat healthy, regular meals and stay hydrated.  A balanced diet and plenty of water can improve your energy and focus throughout the day. Pay attention to your intake of caffeine and alcohol and how they affect your mood and well-being—for some, decreasing caffeine and alcohol consumption can be helpful.
• Make sleep a priority . Stick to a schedule, and make sure you’re getting enough sleep. Blue light from devices and screens can make it harder to fall asleep, so reduce blue light exposure from your phone or computer before bedtime.
• Try a relaxing activity.  Explore relaxation or wellness programs or apps, which may incorporate meditation, muscle relaxation, or breathing exercises. Schedule regular times for these and other healthy activities you enjoy, such as listening to music, reading, spending time in nature, and engaging in low-stress hobbies.
• Set goals and priorities.  Decide what must get done now and what can wait. Learn to say “no” to new tasks if you start to feel like you’re taking on too much. Try to appreciate what you have accomplished at the end of the day.
• Practice gratitude.  Remind yourself daily of things you are grateful for. Be specific. Write them down or replay them in your mind.
• Focus on positivity . Identify and challenge your negative and unhelpful thoughts.
• Stay connected.  Reach out to friends or family members who can provide emotional support and practical help.

Self-care looks different for everyone, and it is important to find what you need and enjoy. It may take trial and error to discover what works best for you.

Learn more about  healthy practices for your mind and body  .

When should I seek professional help?

Seek professional help if you are experiencing severe or distressing symptoms that have lasted 2 weeks or more, such as:

• Difficulty sleeping
• Changes in appetite or unplanned weight changes
• Difficulty getting out of bed in the morning because of mood
• Difficulty concentrating
• Loss of interest in things you usually find enjoyable
• Inability to complete usual tasks and activities
• Feelings of irritability, frustration, or restlessness

How can I find help?

If you have concerns about your mental health, talk to a primary care provider. They can refer you to a qualified mental health professional, such as a psychologist, psychiatrist, or clinical social worker, who can help you figure out the next steps. Find  tips for talking with a health care provider about your mental health.

You can learn more about getting help on the NIMH website. You can also learn about finding support  and locating mental health services  in your area on the Substance Abuse and Mental Health Services Administration website.

If you or someone you know is struggling or having thoughts of suicide, call or text the  988 Suicide & Crisis Lifeline   at 988 or chat at 988lifeline.org   . This service is confidential, free, and available 24 hours a day, 7 days a week. In life-threatening situations, call  911.

Suicide is preventable—learn about warning signs of suicide and action steps for helping someone in emotional distress.

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Getting to Know Your Brain: Dealing with Stress:  Test your knowledge about stress and the brain. Also learn how to create and use a “ stress catcher ” to practice strategies to deal with stress.

Guided Visualization: Dealing with Stress:  Learn how the brain handles stress and practice a guided visualization activity.

Mental Health Minute: Stress and Anxiety in Adolescents: Got 60 seconds? Take a mental health minute to learn about stress and anxiety in adolescents.

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• NIH Wellness Toolkits   : NIH provides toolkits with strategies for improving your  emotional health  and  social health  .
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• CDC: Emotional Well-Being   : CDC provides information on how to cope with stress and promote social connectedness.
• SAMHSA: How to Cope   : SAMHSA offers tips for taking care of your well-being and connecting with others for support.

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• Published: 10 May 2023

Mental health awareness: uniting advocacy and research

Nature Mental Health volume  1 ,  pages 295–296 ( 2023 ) Cite this article

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Mental Health Month has been observed to reduce the stigma that is associated with mental illness and to educate the public and encourage individuals to make their mental health and wellbeing a priority. It is an important moment to bring the strengths of advocacy groups and researchers together to promote mental health awareness and to improve equity.

Observances have become a popular tool to garner media and notice for topics deserving attention, from medical conditions to public health concerns, commemoration of notable events, or celebration of cultural groups. Codifying the scope and needs connected to an issue or illness through awareness campaigns can provide opportunities for imparting useful information, reducing stigma and marshalling support for policy change. The impact of awareness campaigns can be difficult to measure beyond tallying social media mentions or news stories. Effective advocacy, however, extends beyond traffic and paves the way for the creation of knowledge and partnerships among allies and with those whose interests are being represented. When the magnitude of an issue and the potential for improvement are great and are matched by broad involvement and recognition by stakeholders, the possibility for impact is also great.

Held annually in May, Mental Health Month , also called Mental Health Awareness Month, is an observance with such reach, resonating with many people. Nearly everyone has experience with the challenges that are associated with mental health, either first-hand or through loved ones or in their community. There is a need for education, support and initiative to improve our understanding of the causes of mental health disorders and to increase the availability of resources for prevention and treatment. Mental Health Month also offers the possibility of bringing together groups who often work in parallel, such as mental health advocates and mental health research organizations, that can mutually benefit from each other’s functions and expertise.

Mental Health Month was first established in the US in 1949 by the National Mental Health Association, now known as Mental Health America . At a time more often associated with the outset of the Cold War and Marshall Plan than setting an agenda for domestic mental health and wellbeing advocacy, in the more than 70 years since, Mental Health Month has grown into an international event designed to reduce exclusion, stigma and discrimination against people with mental health conditions or disorders. Mental Health America are joined by other prominent mental health advocacy groups to sponsor related observances: Mental Health Awareness Week Canada (1–7 May, 2023) and Europe (22–28 May, 2023); and federal agencies such as the Substance Use Abuse and Mental Health Services Administration ( SAMSHA ) in the US, promoting related public education platforms, including National Prevention Week (7–13 May, 2023).

Observances and awareness campaigns also provide occasions to put mental health in context. Increasing acknowledgment of the role of social determinants, for example, as mechanisms that can increase vulnerability for developing disorders and that drive disparities in mental health are an important framework to underscore as part of promoting mental health awareness. Given the complex and broad scope of people, disorders, conditions and issues under the umbrella of mental health, observances also give us the chance to focus more closely on specific problems or experiences. The theme for Mental Health Month in 2023 is ‘Look Around, Look Within’, which emphasizes the interdependence of mental health and wellness with an individual’s internal and external experiences and environments.

“The ‘Look Around, Look Within’ theme builds on the growing recognition that all humans have mental health needs and that our available resources to build resilience and heal come in many forms — including in the natural world,” explains Jennifer Bright, Mental Health America Board Chair and President of Momentum Health Strategies. “Mental Health America’s strategic plan, focused on NextGen Prevention, carries a similar theme — that the social factors supporting mental health are essential building blocks. These encompass basic needs like healthy food, stable housing, and access to treatment and supports, but they also include spirituality, connection with peers with lived experience, and safe and natural spaces.”

Overlapping with Mental Health Month, Mental Health Foundation sponsors Mental Health Week in the UK (15–21 May, 2023), dedicating this year to raising awareness around anxiety. It shares an individual-centered approach to advocacy. In addition to providing toolkits and resources that point to how prevalent stress and anxiety can be to reduce stigma, it also promotes the accessibility of coping strategies for managing anxiety. As part of the Mental Health Awareness Week campaign, Mental Health Foundation and others use the international symbol of wearing a green ribbon or clothing to physically raise awareness around mental health. Nature Mental Health also incorporates the symbol of the green ribbon on the cover of this month’s issue and as our journal theme color. Green evokes the ideas of vitality, growth, new beginnings and hope — powerful imagery in mental health awareness.

Alongside stories, sponsorships and social media resources, mental health advocacy toolkits and strategy documents include fact sheets and messaging that are shaped and informed by research. Yet, there is often a perception that a divide exists between the mental health advocacy and research spaces, but observances such as Mental Health Month can bridge the two.

According to Lea Milligan, Chief Executive Officer of MQ: Transforming Mental Health , an international mental health research organization, there are complementary approaches and priorities in advocacy and research: “Mental health research can be used to bolster awareness by providing evidence-based information and resources that can help individuals and communities better understand mental health and the factors that contribute to mental health problems. This can include information on risk factors, prevention strategies, and available treatments.”

In addition, increased efforts to involve people with lived experience of mental illness in the research enterprise is a goal that is well-served through connection with advocacy. “While MQ is primarily focused on promoting mental health research, it also recognizes the importance of advocacy in advancing the mental health agenda” suggests Milligan. “MQ advocates for increased funding and support for mental health research, as well as policies that promote mental health and wellbeing. Additionally, MQ seeks to empower individuals with lived experience of mental health conditions to be involved in research and advocacy efforts, and to have their voices heard in the development of policies and programs that affect their lives. MQ provides resources and support for individuals with lived experience who wish to be involved in research or advocacy efforts, including training programs, research grants, and opportunities to participate in research studies.”

Involvement or engagement is certainly one of the most important metrics of advocacy. By strengthening collaboration between advocacy and research organizations and identifying the mutual areas of benefit, such as engagement and increased funding, we may find new ways to green light mental health awareness and action toward mental health equity.

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Mental Health Awareness Month Arrives Amid a Decline in Post-Pandemic Mental Health

UH Mental Health Expert Available in May to Discuss Bolstering Psychological Fortitude

By Laurie Fickman — 713-743-8454

• Health and Medicine

As Mental Health Awareness Month dawns in May, it’s a good time to review the state of mental health of our society. Since its inception in 1949, Mental Health Awareness Month has been a cornerstone of addressing the challenges faced by millions of Americans living with mental health conditions.  

“The overall mental health of our society seems to be declining, and it’s alarming,” said Rheeda Walker, University of Houston psychology professor and expert on mental health and suicide prevention. “Our nation is grappling with psychological impacts of collective post-pandemic trauma, political upheaval and daily turmoil, and the time to bolster psychological fortitude is now.”

According to the results of Stress in America™ 2023 , a nationwide survey conducted by The Harris Poll on behalf of the American Psychological Association, adults ages 35 to 44 experienced the highest increase in mental health diagnoses—45% reported a mental illness in 2023 compared with 31% in 2019—though adults ages 18 to 34 still reported the highest rate of mental illnesses at 50% in 2023.   

In Texas, where Walker is located, 1 in 3 residents experience symptoms of depression or anxiety and only a fraction of those get help.   

The rising number of suicides in the Black community led Walker to research that reveals people of color have even further risk because of discrimination they endure.    

“We must work harder to reduce the stigma associated with mental health,” said Walker. There continues to be too much resistance to understanding and addressing mental health in our broader society.”  

As society grapples with that, the best thing an individual can do is boost their own resilience or what Walker calls “psychological fortitude.”

Walker can share suggestions that might help interested individuals build greater psychological fortitude. It begins with being aware of your own mental state.  

“It is important to be mindful of our mental capacity and then make the necessary adjustments to move forward as a fully functioning people. It’s good to recognize you’re at the point of burnout. But the flex, is to stop getting to that point!” said Dr. Walker.  

About Rheeda Walker  

Rheeda Walker has published more than 60 scientific papers on African American mental health, suicide risk, and emotional resilience. She’s the author of the bestseller The Unapologetic Guide to Black Mental Health and the Unapologetic Workbook and the upcoming No Racial Elephants in the Therapy Room: An Unapologetic Approach to Providing Culturally Affirming Mental Health Care to Black and African American Clients.     

Walker debunks myths about mental health and delivers practical advice for use in everyday life. Her work has led to appearances on Good Morning America, The Breakfast Club, and NPR to name a few. Her expertise has been cited in The New York Times, Washington Post, and the Los Angeles Times, among others.     

If you are in crisis, call or text the 988 Suicide & Crisis Lifeline at 988 , available 24 hours a day, 7 days a week. The Lifeline provides confidential support to anyone in suicidal crisis or emotional distress. Support is also available via live chat .      

To book an interview with Walker, please contact Laurie Fickman at [email protected]  

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Up to 40pc of mental health conditions are linked to child abuse and neglect, study finds

In 1996, Ange McAuley was just 11 years old when ABC's Four Corners profiled her family living on Brisbane's outskirts.

At the time her mother was pregnant with her sixth child and her father had long ago moved back to Perth.

WARNING: This story contains details that may be distressing to some readers.

It was a story about child protection and the program was profiling the role of community volunteers helping her mother, who had been in and out of mental health wards.

Ange was the eldest and it fell to her to get her younger siblings ready for school.

By the time the new baby arrived, she would stay home and change nappies.

"It was pretty crazy back then — I wasn't going to school a lot," she said.

By that age she was already holding a secret — she'd been sexually abused at age six by her stepfather, who would later be convicted of the crime.

"Back in the nineties, a lot of people kept stuff hidden and it wasn't spoken about outside of the family," she said.

"I've carried all these big burdens that weren't even mine. Sexual abuse happened to me. I didn't ask for it."

She says the trauma triggered a lifetime of mental health problems from substance abuse and self-harm as a teen, right through to post-natal depression.

Hidden source of our mental health crisis

A new study from the University of Sydney's Matilda Centre has established just how much Australia's mental health crisis can be traced back to this kind of childhood abuse and neglect.

The research has found that childhood maltreatment is responsible for up to 41 per cent of common mental health conditions including anxiety, depression, substance abuse, self-harm and suicide attempts.

The research, which draws on a 2023 meta-analysis of 34 research studies covering 54,000 people, found maltreatment accounted for 41 per cent of suicide attempts in Australia, 35 per cent of self-harm cases and 21 per cent of depression episodes.

It defined childhood maltreatment as physical, sexual, emotional abuse, emotional or physical neglect and domestic violence before the age of 18.

Lead researcher Lucy Grummitt said it is the first piece of work to quantify the direct impact of child abuse on long-term mental health. 

It found if childhood maltreatment was eradicated it would avert more than 1.8 million cases of depression, anxiety and substance use disorders.

"It shows just how many people in Australia are suffering from mental health conditions that are potentially preventable," she said.

Dr Grummitt said they found in the year 2023 child maltreatment in Australia accounted for 66,143 years of life lost and 118,493 years lived with disability because of the associated mental health conditions.

"We know that when a child is exposed to this level of stress or trauma, it does trigger a lot of changes in the brain and body," Dr Grummitt said.

"Things like altering the body's stress response will make a child hyper-vigilant to threat. It can lead to difficulties with emotion regulation, being able to cope with difficult emotions."

While some areas of maltreatment are trending down, figures from the landmark Australian child maltreatment study last year show rising rates of sexual abuse by adolescents and emotional abuse.

That study found more than one in three females and one in seven males aged 16 to 24 had experienced childhood sexual abuse.

Dr Grummit says childhood trauma can affect how the brain processes emotions once children become teens.

"It could be teenagers struggling to really cope with difficult emotions and certainly trauma can play a huge role in causing those difficult emotions," she said.

Mental health scars emerge early

For Ange, the trauma of her early years first showed itself in adolescence when she started acting out — she remembers punching walls and cars, binge drinking and using drugs.

"I would get angry and just scream," she said.

"I used to talk back to the teachers. I didn't finish school. Mum kicked me out a lot as a teenager. I was back and forth between mum and dad's."

By the time she disclosed her abuse, she was self-harming and at one point tried to take her own life.

"I was just done," she said.

"I was sick of having to get up every day. I didn't want to do it anymore."

Later on, she would have inappropriate relationships with much older men and suffered from depression, including post-natal depression.

"It's definitely affected relationships, it's affected my friendships, it's affected my intimate relationships," she said.

"Flashbacks can come in at the most inappropriate times — you're back in that moment and you feel guilt and shame.

"I feel like it's held me back a lot."

Calls for mental health 'immunisation'

Dr Grummitt said childhood abuse and neglect should be treated as a national public health priority.

In Australia, suicide is the leading cause of death for young people. 

"It's critical that we are investing in prevention rather than putting all our investments into treatment of mental health problems," she said.

Her team has suggested child development and mental health check-ins become a regular feature across a person's lifetime and have proposed a mental health "immunisation schedule".

Chief executive of mental health charity Prevention United, Stephen Carbone, said they estimate that less than 1 per cent of mental health funding goes toward prevention.

"There's been a big steady increase in per capita funding for mental health over the last 30 years but that hasn't translated into reductions," Dr Carbone, a GP, said. 

"You're not going to be able to prevent mental health conditions unless you start to tackle some of these big causes, in particular child maltreatment."

He said most of Australia's child protection system was about reacting to problems rather than trying to prevent them.

"If you're not tackling the upstream risk factors or putting in place protective factors you just keep getting more and more young people experiencing problems and services being overwhelmed," he said.

Now a mother of two teens herself, Ange says she wants to break the cycle and has been going to therapy regularly to help identify and avoid destructive patterns that she's seen herself fall into.

"I love my girls so much and I want better for them."

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Why am I lonely? Lack of social connections hurts Americans' mental health.

Tens of millions of people don’t have relationships that provide meaning in daily life. no amount of federal money − no number of mental health workers or programs − will solve that problem..

We need a new way to think about mental health − one that recognizes every person’s role in tackling the crisis that surrounds us.

We all know this crisis exists. After the COVID-19 pandemic, record numbers of people have reported mental health challenges. About 20% of U.S. adults − nearly 60 million Americans − have a diagnosable mental illness. Nearly 40% of high school students − and half of high school girls − say their mental health has struggled in recent years. Anxiety, depression and suicide have soared. So has addiction , which about 1 in 5 Americans now struggle with.

Amid this crisis, government at all levels is desperately trying to make a difference, mainly through new programs and funding streams. President Joe Biden’s proposed 2024 budget, for instance, envisions a  44% increase in federal spending on the Substance Abuse and Mental Health Services Administration. In the State of the Union address, he called for funding “ more mental health workers .”

We need more than increased spending to help with the mental health problem

And states like Florida and Virginia are now spending record amounts on mental health services.

Yet more money and more workers aren’t silver bullets. It’s true that America has just one mental health professional for every 350 people who need help , but there’s no credible path to close that gap. Even if we could, more than half of  people with mental health challenges still avoid care because of social stigma.

That helps explain why  big federal funding increases  before the pandemic didn’t make much of a difference − mental health challenges continued to rise.

Clearly, some root cause is going unaddressed.

Hence the need for a new approach. The mental health advocates and substance abuse experts whom my organization has worked with over the past decade show the way. They prove that the mental health crisis isn’t just a clinical crisis. It’s really a crisis of community.

To be sure, clinical settings and clinical tools are essential for many people with mental health disorders. But it’s also true that mental health is ultimately about psychological well-being. Everyone is looking for a life of meaning, and finding that life requires a supportive community.

Americans increasingly feel isolated and lonely

The famous psychologist Abraham Maslow said it better than I can. Based on his experience treating tens of thousands of patients, he realized that mental health challenges ultimately arise when people’s deeper needs aren’t met. Most notably, when people lack relationships, belonging and love, they get lonely, leading to anxiety and depression. Left unchecked, loneliness can ruin someone’s life.

What’s happening in America supports Maslow’s theory. Last year, the U.S. surgeon general  called loneliness an “epidemic,” and an  American Psychiatric Association poll conducted this January found that a third of of adults say they have experienced feelings of loneliness at least once a week over the past year.

About  30% of millennials have zero best friends , while Generation Z has been called “the loneliest generation.” The situation is so bad that some in Gen Z have posted  “friendship applications” on social media .

My generation's isolation is real: Gen Z doesn't care about sports. That's part of a bigger problem.

No wonder mental health is plummeting. Tens of millions of people don’t have the relationships that provide meaning in daily life. No amount of federal money − no number of mental health workers or programs − will solve that problem. The real solution is communities coming together and people reaching out to one another, in a spirit of mutual support.

I’ve seen this truth play out nationwide.

The Phoenix , which promotes sobriety and fights social isolation, is helping thousands of people beat substance abuse through a supportive community that’s often focused on physical fitness.

The Confess Project is training barbers and beauty industry professionals to be sort of paraprofessional mental health counselors, forging stronger bonds with millions of people through their everyday work, particularly among communities of color that have stigmas related to mental health.

Then there’s  Give an Hour , in which mental health professionals help train people to be informal “peer supporters.”

Relationships, mental health support make a difference

It turns out that the combination of relationships and mental health support makes a remarkable difference.

These efforts are promising − but not nearly enough. Loneliness continues to soar, and with rising political polarization and social-media-driven isolation, this crisis looks set to continue getting worse.

Help fight depression and anxiety: Parents need help regulating their children's social media

As it does, more and more Americans will experience mental health challenges. While many will certainly need clinical help, let’s realize that the worst thing we can do is to expect others to solve this crisis.

The best thing we can do is to come alongside them ourselves.

Evan Feinberg is chair of the Stand Together Foundation and senior vice president of Stand Together .

FDA panel to consider MDMA for PTSD treatment

The Food and Drug Administration's panel of independent advisers will on June 4 deliberate whether they should recommend approval for the first MDMA-assisted therapy for post-traumatic stress disorder, Lykos Therapeutics said on Monday.

This would be the first FDA panel of outside experts to review a potential new PTSD treatment in 25 years.

PTSD is a disorder caused by very stressful events and can significantly disrupt patients’ lives.

Decades of studies has shown that psychoactive ingredients, whether derived from cannabis, LSD or magic mushrooms, have long captivated mental health researchers in their quest for treatments.

In support of its application, Lykos Therapeutics, formerly known as Multidisciplinary Association for Psychedelic Studies (MAPS), studied the party drug MDMA, more commonly called ecstacy or molly, in two late-stage studies.

More news on psychedelic research

• More high school students report using Delta-8 THC, also known as "weed lite."
• Effects of psychedelic drugs can last for days or weeks.
• High-potency marijuana highlights the risk of cannabis-induced psychiatric disorders.

The drug is intended to be used in combination with psychological intervention, which includes psychotherapy, or talk therapy, and other supportive services provided by a qualified healthcare provider.

No psychedelic-based therapy has been approved yet in the U.S., but MAPS and companies such as Compass Pathways are testing such drugs to find cures for a range of mental health disorders.