Trends in mental health symptoms, service use, and unmet need for services among US adults through the first 8 months of the COVID-19 pandemic.

The COVID-19 pandemic has led to rising morbidity, mortality, and social and economic disruption, likely impairing mental health. The purpose of this study was to track trends in mental health symptoms, use of services, and unmet need for services among US adults, and to delineate variation across demographic strata. Data were drawn from the 2020 US Household Pulse Survey from repeated cross-sectional online surveys collected between April 23 and November 23, 2020 from 1,302,455 US adults, weighted to represent the US population. Survey respondents self-reported their symptoms of anxiety and depression, use of medication and counseling services, and unmet need for services. Reports of probable anxiety and depression rose significantly through the study period, to prevalence rates of 37% and 29%, respectively, by November, 2020, rates more than four times higher than early 2019 US norms. Use of prescription medication, counseling services, and unmet need for mental health services also rose significantly. Prevalence rates of probable mental health disorders were highest among young, less educated, single parent, female, Black and multi-racial respondents, with some vacillation in such disparities over cohorts. Young, female, and moderately educated respondents also reported higher unmet needs for services. Disparities in estimates of mental health disorders and mental health treatment indicate a striking disequilibrium between the potential need for and the use of mental health services during the COVID-19 pandemic. Rising mental health challenges are being borne largely by young, less advantaged people of color and women, with the potential for expanded interruptions to optimal functioning and societal recovery from COVID-19.