Study: Majority of those screened for depression in 2020 had severe, moderately severe symptoms

mental health
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A new analysis from Mental Health America finds that 62 percent of people scored with symptoms of severe or moderately severe depression.

The numbers come from a new MHA brief, Severe Depression and COVID-19: Communities in Need Across the U.S., analyzing data collected from 725,949 individuals who took a depression screen (PHQ-9) as part of the MHA Screening Program in 2020.

Of those who scored with symptoms of severe depression, 70 percent had never been diagnosed with a mental health condition and 67 percent had never received any kind of mental health treatment or support.

This is the second analysis of a four-part series from MHA and Lundbeck identifying communities hardest-hit by the rapid escalation of mental health impacts emerging from the COVID-19 pandemic. The series examines suicidal ideation (released May 30, 2021), severe depression, psychosis, and trauma, and will ultimately provide publicly available data to help community and public health leaders make informed decisions about resourcing and expanding access to mental health care.

The depression report focuses on individuals severely impacted, meaning those who report experiencing symptoms of depression at least half the days over a two-week period and have the highest need for imminent support.

The brief further analyzes this data and breaks it down to the state and county level, a rarity in data collection. County-level data in particular is difficult to find. National government data on depression typically does not include county-level results, and is often delayed one to two years. This analysis is unique in that it can quickly identify local areas with the greatest need for a fast and coordinated response amid the mental health crisis exacerbated by COVID-19.

“Providing real-time and public, local information from MHA Screening to policymakers, public health officials and community leaders will help us more quickly identify unmet need and respond with the appropriate resources,” said Schroeder Stribling, President and CEO of Mental Health America, “We are putting a spotlight on the places that desperately need more support.”

“Each data point represents someone’s life, which is humbling — especially when these numbers are so significant,” said Ann Hartry, PhD, Vice President of US and Global Value Evidence at Lundbeck, and an advisor to the initiative. “Untreated depression can result in lost time at work and school, difficulty with relationships, higher risk for suicide attempts, and longer-term poor health care outcomes – not to mention the profound economic and societal impacts. Lundbeck is proud to support this important work to help community leaders identify those with the greatest need for mental health support.”

Key findings

  • States: Alaska had the highest percentage of individuals at-risk for severe depression, compared to the overall state population. Indiana, Alabama, Wyoming and Arizona followed.
  • Counties: Among large counties, Bexar County, TX, had the highest percentage of individuals at-risk for severe depression. Clark County, NV; Maricopa County, AZ; San Bernardino County, CA; and Riverside County, CA followed. Among small and mid-sized counties, Carol County, KY, scored highest. Baraga County, MI; Unicoi County, TN; Dearborn County, IN; and Richland County, MT followed.
  • Demographics: Respondents who identified as non-binary were most likely in the Gender category to score with symptoms of severe depression. Native Americans were the Race/Ethnicity category with the highest risk. Individuals ages 11-17 were the Age category scoring highest, and households reporting less than $20K annual income screened most at-risk.

These state and county-level findings are the result of an analysis of the largest dataset ever collected from a help-seeking population, meaning users accessed mental health screening tools while searching for mental health resources and support online.

Users in this help-seeking population are more likely to screen at-risk or with moderate- to-severe symptoms of mental health conditions than the general population. This convenience sample allows MHA to understand the experiences of the nearly one million individuals with the highest need who were actively seeking help for depression in 2020. Therefore, the results can be interpreted as a minimum unmet need for immediate resources and support across the United States.

The goal of this analysis is to identify communities in need of greater mental health supports, generate a better understanding of mental health concerns in the U.S., generate new resources to address unmet need, create an environment that promotes mental wellness at the population level, and create long-term systemic policy change to prevent future mental health concerns.

The analysis was made possible by the support of Lundbeck US.

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