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1. Crisis response among essential workers and their children during the COVID-19 pandemic

   https://doi.org/10.1016/j.ypmed.2021.106852  

   Sugg, M.M. (February 2022, Preventive medicine)

   Limited research has been conducted on the mental health concerns of frontline and essential workers and their children during the COVID-19 pandemic in the United States (U.S.). This study examined the association between working on the frontlines in the U.S. during the COVID-19 pandemic (March to July 2020) and personal crisis text concerns (e.g., self-harm, suicidal thoughts, anxiety/stress, and substance abuse) for frontline essential workers and the children of frontline workers. We used a novel data set from a crisis texting service, Crisis Text Line (CTL), that is widely used throughout the U.S. Generalized Estimating Equations examined the individual association between eight specific crisis types (Depression, Stress/Anxiety, Self-Harm, Suicidal Thoughts, Substance Abuse, Isolation, Relationship Issues, and Abuse) and being in frontline work or being a child of a frontline worker during the early phase of the pandemic. Using CTL concerns as a proxy for the prevalence of mental health issues, we found that children of workers, specifically the youngest demographic (13 years and under), females, and non-conforming youth had a higher risk of specific crisis events during the COVID-19 pandemic. Additionally, Hispanic children of workers reported higher rates of stress/anxiety, whereas African American children of workers had higher rates of abuse and depression. Frontline workers had a higher risk of suicidal thoughts, and the risk of crisis events was generally highest for non-binary, transgender, and male users. Increases in CTL usage among frontline workers were noted across 7–28 days after spikes in local COVID-19 cases. The research to date has focused on the mental health of frontline essential workers, but our study highlights troubling trends in psychological stress among children of these workers. Supportive interventions and mental health resources are needed not only for frontline essential workers but for their children too. 

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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®)

   Objective: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. Methods: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: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. Conclusion: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. Mental health during the COVID-19 pandemic: Impacts of disease, social isolation, and financial stressors

   https://doi.org/10.1371/journal.pone.0277562  

   Kraut, Robert E.; Li, Han; Zhu, Haiyi (November 2022, PLOS ONE)

   Nabi, Mohammad Hayatun (Ed.)

   BackgroundAlthough research shows that the Covid-19 pandemic has led to declines in mental health, the existing research has not identified the pathways through which this decline happens. AimsThe current study identifies the distinct pathways through which COVID-induced stressors (i.e., social distancing, disease risk, and financial stressors) trigger mental distress and examines the causal impact of these stressors on mental distress. MethodsWe combined evidence of objective pandemic-related stressors collected at the county level (e.g., lack of social contact, infection rates, and unemployment rates) with self-reported survey data from over 11.5 million adult respondents in the United States collected daily for eight months. We used mediation analysis to examine the extent to which the objective stressors influenced mental health by influencing individual respondents’ behavior and fears. ResultsCounty-level, day-to-day social distancing predicted significantly greater mental distress, both directly and indirectly through its effects on individual social contacts, worries about getting ill, and concerns about finances. Economic hardships were indirectly linked to increased mental distress by elevating people’s concerns about their household’s finances. Disease threats were both directly linked to mental distress and indirectly through its effects on individual worries about getting ill. Although one might expect that social distancing from people outside the home would have a greater influence on people who live alone, sub-analyses based on household composition do not support this expectation. ConclusionThis research provides evidence consistent with the thesis that the COVID-19 pandemic harmed the mental well-being of adults in the United States and identifies specific stressors associated with the pandemic that are responsible for increasing mental distress. 

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4. Investigating COVID-19’s Impact on Mental Health: Trend and Thematic Analysis of Reddit Users’ Discourse

   https://doi.org/10.2196/46867  

   Zhu, Jianfeng; Yalamanchi, Neha; Jin, Ruoming; Kenne, Deric R; Phan, NhatHai (January 2023, Journal of Medical Internet Research)

   BackgroundThe COVID-19 pandemic has resulted in heightened levels of depression, anxiety, and other mental health issues due to sudden changes in daily life, such as economic stress, social isolation, and educational irregularity. Accurately assessing emotional and behavioral changes in response to the pandemic can be challenging, but it is essential to understand the evolving emotions, themes, and discussions surrounding the impact of COVID-19 on mental health. ObjectiveThis study aims to understand the evolving emotions and themes associated with the impact of COVID-19 on mental health support groups (eg, r/Depression and r/Anxiety) on Reddit (Reddit Inc) during the initial phase and after the peak of the pandemic using natural language processing techniques and statistical methods. MethodsThis study used data from the r/Depression and r/Anxiety Reddit communities, which consisted of posts contributed by 351,409 distinct users over a period spanning from 2019 to 2022. Topic modeling and Word2Vec embedding models were used to identify key terms associated with the targeted themes within the data set. A range of trend and thematic analysis techniques, including time-to-event analysis, heat map analysis, factor analysis, regression analysis, and k-means clustering analysis, were used to analyze the data. ResultsThe time-to-event analysis revealed that the first 28 days following a major event could be considered a critical window for mental health concerns to become more prominent. The theme trend analysis revealed key themes such as economic stress, social stress, suicide, and substance use, with varying trends and impacts in each community. The factor analysis highlighted pandemic-related stress, economic concerns, and social factors as primary themes during the analyzed period. Regression analysis showed that economic stress consistently demonstrated the strongest association with the suicide theme, whereas the substance theme had a notable association in both data sets. Finally, the k-means clustering analysis showed that in r/Depression, the number of posts related to the “depression, anxiety, and medication” cluster decreased after 2020, whereas the “social relationships and friendship” cluster showed a steady decrease. In r/Anxiety, the “general anxiety and feelings of unease” cluster peaked in April 2020 and remained high, whereas the “physical symptoms of anxiety” cluster showed a slight increase. ConclusionsThis study sheds light on the impact of COVID-19 on mental health and the related themes discussed in 2 web-based communities during the pandemic. The results offer valuable insights for developing targeted interventions and policies to support individuals and communities in similar crises. 

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5. Effects of COVID-19 on Stress and Mental Health of Community College Pre-Engineering Students

   https://doi.org/10.1109/FIE56618.2022.9962570  

   Danowitz, Andrew; Beddoes, Kacey (January 2022, Frontiers in Education Annual Conference)

   This research full paper presents screening rates for mental health issues and life-stress events in engineering-focused community college students during the initial phases of the COVID-19 pandemic in the US. Specifically, it attempts to answer the following research questions: 1) What is the overall rate of various mental health conditions among engineering-focused community college students, 2) What effects has the pandemic had on baseline stress levels engineering-focused community college, and 3) What effects has the pandemic had on quality of life, such as sleep habits and financial security of engineering- focused community college students? Data for this paper was collected via survey from May–July 2020 and includes responses from 84 students at 24 community colleges. The survey itself was a compilation of several widely- used instruments for measuring overall mental health and stress levels in a population. These instruments include the Kessler-6 for psychological distress, the PHQ for anxiety, depression, and eating disorders, the PC-PTSD for PTSD-like symptoms, and the SRRS for inventorying stressful life events. Among the major findings, 32% of respondents reported a major change in financial situation, 27% reported loss of employment, and 13% reported ceasing formal schooling because of the COVID-19 pandemic. Additionally, 32% of respondents reported that the COVID-19 pandemic worsened their housing security situation, 38% reported that COVID-19 has worsened their food security situation, and 36% report that COVID-19 has decreased their ability to access instruction, course materials, or course supplies. Finally, of respondents who completed at least one mental health screening instrument, 70% screened positive for at least one potentially diagnosable condition, while only 9% reported ever receiving a mental health diagnosis. Index Terms—Community College, Mental Health, Disability, Accessibility, Equity, Inclusion, Wellness 

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