COVID-19: CDC Reports Increased Suicidal Thoughts Among Young Adults, Caregivers, Essential Workers

One-quarter of young adults aged between 18 and 24 years say they have contemplated suicide in the past 30 days as a result of the coronavirus disease 2019 (COVID-19) pandemic, according to new data from the Centers for Disease Control and Prevention (CDC) published today in Morbidity and Mortality Weekly Report. 

Among the 5412 adults aged ≥18 years completing a web-based survey between June 24–30, 2020, more than two-thirds (40.9%) reported at least one adverse mental or behavioral health condition:

• 30.9% reported symptoms of anxiety or depressive disorder
• 26.3% reported symptoms of a trauma- and stressor-related disorder (TSRD) related to the pandemic
• 13.3% reported having started or increased substance use (eg, alcohol, prescription or illicit drugs) to cope with stress or emotions related to COVID-19

Approximately 10% reported seriously considering suicide in the preceding 30 days.

Mental health challenges related to the COVID-19 pandemic are linked to the infection’s widespread morbidity and mortality, to mitigation efforts that include social distancing and stay-at-home orders, loss of job security or employment, and many other severe disrupters. 

Data from the National Center for Health Statistics on symptoms of anxiety and depressive disorder during April-June of 2020 found a significant increase over the same period in 2019.

The survey authors note that the prevalence of symptoms of anxiety disorder between April and June 2020 was approximately 3 times that reported in the second quarter of 2019 (25.5% vs 8.1%); prevalence of depressive disorder in the 2020 report was approximately 4 times that reported in the second quarter of 2019 (24.3% versus 6.5%). (Note that methodologic differences and potential unknown bias in survey design may limit direct comparison between the two data sets.)

Groups experiencing the greatest burden include young adults, unpaid caregivers of adults, essential workers, and minorities. While 10.7% of all respondents reported considering suicide in the past 30 days, 25.5% of young adults between ages 18 to 24 reported having such thoughts. Approximately 31% of self-reported unpaid caregivers and 22% percent of essential workers reported thoughts of suicide. Among racial/ethnic groups 18.6% of Hispanic respondents and 15.1% of black respondents had considered taking their own lives.

At least one adverse mental or behavioral health symptom was reported by more than one-half of those:

• aged 18–24 years (74.9%)
• aged 25–44 years (51.9%)
• of Hispanic ethnicity (52.1%)
• who held less than a high school diploma (66.2%)
• self-identified as essential workers (54.0%)
• self identified as unpaid caregivers for adults (66.6%)
• who reported treatment for diagnosed anxiety (72.7%), depression (68.8%), or PTSD (88.0%) at the time of the survey

The survey's findings, the authors note, indicate the broad impact of the COIVD-19 pandemic on mental health across populations and underscore the need to treat the current manifestations and just as critically, to prevent future mental and behavioral distress.

Among the suggestions for action:

• Use identification of populations at increased risk for psychological distress/unhealthy coping to inform policies to address health inequity, including increasing access to resources for clinical diagnoses and treatment options.
• Expand use of telehealth, shown to be an effective delivery method for treatment of mental health conditions including depression, substance use disorder, and suicidal ideation.
• Focus future research on the impact of drivers of COIVD-19-related adverse mental/behavioral health and the contribution of specific pandemic-related stressors, ie, social isolation, absence of school structure, unemployment and other financial worries, and various forms of violence (e.g., physical, emotional, mental, or sexual abuse)
• Develop/implement COVID-19–specific screening instruments for early identification of related TSRD symptoms to allow early clinical intervention.

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