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1. Trajectories of Mental Distress Among U.S. Adults During the COVID-19 Pandemic

   https://doi.org/10.1093/abm/kaaa126  

   Riehm, Kira E ; Holingue, Calliope ; Smail, Emily J ; Kapteyn, Arie ; Bennett, Daniel ; Thrul, Johannes ; Kreuter, Frauke ; McGinty, Emma E ; Kalb, Luther G ; Veldhuis, Cindy B ; et al ( February 2021 , Annals of Behavioral Medicine)

   null (Ed.)

   Abstract Background Cross-sectional studies have found that the coronavirus disease 2019 (COVID-19) pandemic has negatively affected population-level mental health. Longitudinal studies are necessary to examine trajectories of change in mental health over time and identify sociodemographic groups at risk for persistent distress. Purpose To examine the trajectories of mental distress between March 10 and August 4, 2020, a key period during the COVID-19 pandemic. Methods Participants included 6,901 adults from the nationally representative Understanding America Study, surveyed at baseline between March 10 and 31, 2020, with nine follow-up assessments between April 1 and August 4, 2020. Mixed-effects logistic regression was used to examine the association between date and self-reported mental distress (measured with the four-item Patient Health Questionnaire) among U.S. adults overall and among sociodemographic subgroups defined by sex, age, race/ethnicity, household structure, federal poverty line, and census region. Results Compared to March 11, the odds of mental distress among U.S. adults overall were 1.84 (95% confidence interval [CI] = 1.65–2.07) times higher on April 1 and 1.92 (95% CI = 1.62–2.28) times higher on May 1; by August 1, the odds of mental distress had returned to levels comparable to March 11 (odds ratio [OR] = 0.80, 95% CI = 0.66–0.96). Females experienced a sharper increase in mental distress between March and May compared to males (females: OR = 2.29, 95% CI = 1.85–2.82; males: OR = 1.53, 95% CI = 1.15–2.02). Conclusions These findings highlight the trajectory of mental health symptoms during an unprecedented pandemic, including the identification of populations at risk for sustained mental distress. 

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2. Crisis Response and Suicidal Behaviors of Essential Workers and Children of Essential Workers During the COVID-19 Pandemic

   https://doi.org/10.1177/00333549221148177  

   Sugg, Margaret M. ; Runkle, Jennifer D. ; Ryan, Sophia C. ; Singh, Devyani ; Green, Shannon ; Thompson, Martie ( January 2023 , Public Health Reports)

   The COVID-19 pandemic has put unprecedented stress on essential workers and their children. Limited cross-sectional research has found increases in mental health conditions from workload, reduced income, and isolation among essential workers. Less research has been conducted on children of essential workers. We examined trends in the crisis response of essential workers and their children from April 2020 through August 2021.

   We investigated the impact during 3 periods of the pandemic on workers and their children using anonymized data from the Crisis Text Line on crisis help-seeking texts for thoughts of suicide or active suicidal ideation (desire, intent, capability, time frame), abuse (emotional, physical, sexual, unspecified), anxiety/stress, grief, depression, isolation, bullying, eating or body image, gender/sexual identity, self-harm, and substance use. We used generalized estimating equations to study the longitudinal change in crisis response across the later stages of the pandemic using adjusted odds ratios (aORs) for worker status and crisis outcomes.

   Results demonstrated higher odds of crisis outcomes for thoughts of suicide (aOR = 1.06; 95% CI, 1.00-1.12) and suicide capability (aOR = 1.14; 95% CI, 1.02-1.27) among essential workers than among nonessential workers. Children of essential workers had higher odds of substance use than children of nonessential workers (aOR = 1.33; 95% CI, 1.08-1.65), particularly for Indigenous American children (aOR = 2.76; 95% CI, 1.35-5.36). Essential workers (aOR = 1.17; 95% CI, 1.07-1.27) and their children (aOR = 1.18; 95% CI, 1.07-1.30) had higher odds of grief than nonessential workers and their children.

   Essential workers and their children had elevated crisis outcomes. Immediate and low-cost psychologically supportive interventions are needed to mitigate the mental health impacts of the COVID-19 pandemic on these populations.

    

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3. The unique nature of public stigma toward non‐medical prescription opioid use and dependence: a national study

   https://doi.org/10.1111/add.15069  

   Perry, Brea L. ; Pescosolido, Bernice A. ; Krendl, Anne C. ( April 2020 , Addiction)

   Our ability to combat the opioid epidemic depends, in part, on dismantling the stigma that surrounds drug use. However, this epidemic has been unique and, to date, we have not understood the nature of public prejudices associated with it. Here, we examine the nature and magnitude of public stigma toward prescription opioid use disorder (OUD) using the only nationally representative data available on this topic.

   General Social Survey (GSS), a cross‐sectional, nationally representative survey of public attitudes.

   United States, 2018.

   A total of 1169 US residents recruited using a probability sample.

   Respondents completed a vignette‐based survey experiment to assess public stigma toward people who develop OUD following prescription of opioid analgesics. This condition is compared with depression, schizophrenia, alcohol use disorder (AUD) and subclinical distress using multivariable logistic or linear regression.

   Adjusting for covariates (e.g. race, age, gender), US residents were significantly more likely to label symptoms of OUD a physical illness [73%, confidence interval (CI) = 66–80%;P < 0.001] relative to all other conditions, and less likely to label OUD a mental illness (40%, CI = 32–48%;P < 0.001). OUD was significantly less likely to be attributed to bad character (37%, CI = 30–44%;P < 0.001) or poor upbringing (17%, CI = 12–23%;P < 0.001) compared with AUD. Nonetheless, perceptions of competence associated with OUD (e.g. ability to manage money; 41%, CI = 33–49%;P < 0.01) were lower than AUD, depression and subclinical distress. Moreover, willingness to socially exclude people with OUD was very high (e.g. 76% of respondents do not want to work with a person with OUD), paralleling findings on traditional targets of strong stigma (i.e. AUD and schizophrenia).

   US residents do not typically hold people with prescription opioid use disorder responsible for their addiction, but they express high levels of willingness to subject them to social exclusion.

    

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4. Advancing Understanding on Greenspace and Mental Health in Young People

   https://doi.org/10.1029/2023GH000959  

   Ryan, Sophia C. ; Sugg, Margaret M. ; Runkle, Jennifer D. ; Thapa, Bhuwan ( March 2024 , GeoHealth)

   Mental distress among young people has increased in recent years. Research suggests that greenspace may benefit mental health. The objective of this exploratory study is to further understanding of place‐based differences (i.e., urbanity) in the greenspace‐mental health association. We leverage publicly available greenspace data sets to operationalize greenspace quantity, quality, and accessibility metrics at the community‐level. Emergency department visits for young people (ages 24 and under) were coded for: anxiety, depression, mood disorders, mental and behavioral disorders, and substance use disorders. Generalized linear models investigated the association between greenspace metrics and community‐level mental health burden; results are reported as prevalence rate ratios (PRR). Urban and suburban communities with the lowest quantities of greenspace had the highest prevalence of poor mental health outcomes, particularly for mood disorders in urban areas (PRR: 1.19, 95% CI: 1.16–1.21), and substance use disorders in suburban areas (PRR: 1.35, 95% CI: 1.28–1.43). In urban, micropolitan, and rural/isolated areas further distance to greenspace was associated with a higher prevalence of poor mental health outcomes; this association was most pronounced for substance use disorders (PRRUrban: 1.31, 95% CI: 1.29–1.32; PRRMicropolitan: 1.47, 95% CI: 1.43–1.51; PRRRural 2.38: 95% CI: 2.19–2.58). In small towns and rural/isolated communities, poor mental health outcomes were more prevalent in communities with the worst greenspace quality; this association was most pronounced for mental and behavioral disorders in small towns (PRR: 1.29, 95% CI: 1.24–1.35), and for anxiety disorders in rural/isolated communities (PRR: 1.61, 95% CI: 1.43–1.82). The association between greenspace metrics and mental health outcomes among young people is place‐based with variations across the rural‐urban continuum.

    

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5. A longitudinal study of psychological distress in the United States before and during the COVID-19 pandemic

   Breslau, J. ; Finucane, M.L. ; Locker, A.R. ; Baird, M.D. ; Roth, E.A. ; Collins, R.L. ( February 2021 , Preventive medicine)

   null (Ed.)

   The COVID-19 pandemic has caused financial stress and disrupted daily life more quickly than any prior economic downturn and on a scale beyond any prior natural disaster. This study aimed to assess the impact of the pandemic on psychological distress and identify vulnerable groups using longitudinal data to account for pre-pandemic mental health status. Clinically significant psychological distress was assessed with the Kessler-6 in a national probability sample of adults in the United States at two time points, February 2019 (T1) and May 2020 (T2). To identify increases in distress, psychological distress during the worst month of the past year at T1 was compared with psychological distress over the past 30-days at T2. Survey adjusted logistic regression was used to estimate associations of demographic characteristics at T1 (gender, age, race, and income) and census region at T2 with within-person increases in psychological distress. The past-month prevalence of serious psychological distress at T2 was as high as the past-year prevalence at T1 (10.9% vs. 10.2%). Psychological distress was strongly associated across assessments (X2(4) = 174.6, p < .0001). Increase in psychological distress above T1 was associated with gender, age, household income, and census region. Equal numbers of people experienced serious psychological distress in 30-days during the pandemic as did over an entire year prior to the pandemic. Mental health services and research efforts should be targeted to those with a history of mental health conditions and groups identified as at high risk for increases in distress above pre-pandemic levels. 

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