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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. Duration in Immigration Detention and Health Harms

   https://doi.org/10.1001/jamanetworkopen.2024.56164  

   Saadi, Altaf; Patler, Caitlin; Langer, Paola (January 2025, JAMA Network Open)

   IMPORTANCE Length of custody is a mechanism by which carceral systems can worsen health. However, there are fewer studies examining US immigration detention, in large part because US immigration detention is largely privately operated and opaque by design. OBJECTIVES To examine the association between duration spent in US immigration detention with subsequent health outcomes. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used a referral sample of recently detained immigrants who were released from Immigrations and Customs Enforcement (ICE) under a series of court orders in 2020 and 2021. Data were analyzed from June 2023 to October 2024. EXPOSURE Detention duration less than 6 months vs 6 months or longer. MAIN OUTCOMES AND MEASURES We used multivariable regression analysis to assess the association of detention duration and several variables: (1) self-rated health, (2) mental illness (Kessler 6-item psychological distress scale), and (3) posttraumatic stress disorder (PTSD) (Primary Care-PTSD-5 Screen).We then calculated the likelihood of experiencing each outcome, controlling for covariates. As a robustness check, we conducted sensitivity analyses with detention duration as a continuous measure. RESULTS The study included 200 respondents (mean [SD] age, 40.3 [10.1] years; 175 male [87.5%]; 149 Hispanic or Latino ethnicity [74.5%]). Results revealed a high prevalence of poor self-rated health, mental illness, and PTSD for all respondents, but especially among those who had been detained for 6 months or longer, who had significantly higher likelihood of poor or fair self-rated health (49.1% [95%CI, 40.5%-57.6%] vs 30.4%[95%CI, 21.8%-39.1%]; P < .001), mental illness (37.0%[95%CI, 28.2%-45.8%] vs 20.7%[95%CI, 12.6%-28.7%]; P < .001), and PTSD (59.3%[95% CI, 50.3%-68.3%] vs 34.8%[95%CI, 25.3%-44.3%]; P < .001). Sensitivity analysis confirmed the general robustness of these findings, with longer detention duration significantly associated with mental illness (OR, 1.11 [95%CI, 1.02-1.20]; P = .01) and PTSD (OR, 1.11 [95%CI, 1.03-1.20]; P = .005) in our adjusted models. CONCLUSIONS AND RELEVANCE In this cross-sectional study, detained immigrants experienced a high prevalence of poor health, mental illness, and PTSD, with detention periods of 6 months or more associated with higher rates compared with those detained less than 6 months. Duration of custody is one mechanism by which immigration detention might be a catalyst for worsening health. 

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3. 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)

   Abstract 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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4. 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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5. Distress among undergraduates: Marginality, stressors and resilience resources

   Nurius, P. S. (January 2021, Journal of American college health)

   null (Ed.)

   Objective: This study addresses mental health concerns among university students, examining cumulative stress exposure as well as resilience resources. Participants: Participants were 253 first- and second-year undergraduate students (age = 18.76; 49.80% male, 69% students of color) enrolled at a large western US university. Methods: Data were obtained from a cross-sectional online survey examining marginalized statuses and multiple stressors alongside coping responses, adaptive self-concept, and social support as predictors of stress, anxiety, and depression. Results: Multivariate regressions demonstrated significant associations between stress exposures and lower levels of resilience resources with each mental health indicator (with substantial R2 of.49-.60). Although stressor exposures accounted for significant increases in mental health concerns, their exploratory power was attenuated by resilience resources (e.g., beta decreases from.25 to.16). Conclusions: Better understanding cumulative adversity/resilience resource profiles, particularly among marginalized students, can help universities in prioritizing institutional support responses toward prevention and mitigating psychological distress. 

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