Dramatic increase
The screen also showed a “dramatic increase” in the number of people who reported being at risk for psychosis, with 18,000 participants screening positive. This represented more than four times the baseline figures recorded through March.
“We were not surprised to see a spike in depression and anxiety, but why were we seeing a spike in psychosis in May/June?” Mr. Gionfriddo asked. He suggested that stress may play a role in driving this increased risk.
“These data, we hope, will get policymakers to pay attention, take it seriously, and intervene to prevent psychosis at an earlier stage before signs and symptoms emerge,” said Mr. Gionfriddo.
One of the most alarming findings was that in June, 25,498 participants who screened positive for depression reported thinking of suicide or self-harm on “more than half of days to nearly every day.” A total of 14,607 participants said they had these thoughts every day.
Overall, the results should reinforce the recommendations of the US Preventive Services Task Force to routinely screen for depression in any clinical setting on a regular basis, Mr. Gionfriddo said.
In addition, policymakers “need to balance reopening vs. quarantining and isolating, and we need to think about what the next 2-4 years look like in terms of balancing physical health risks and mental health risks,” he noted.
“We’ve been treating the pandemic like a sprint and now, 4 or 5 months into it, perhaps as a middle-distance run, when in fact it’s a marathon,” he added.
Advocates needed
Dr. Elspeth Cameron Ritchie
Commenting on the report in an interview, Elspeth Cameron Ritchie, MD, chair of the Department of Psychiatry, Medstar Washington (D.C.) Hospital Center, said her experience in clinical practice corroborates the increased levels of anxiety and depression in general, especially among young people.
Dr. Elspeth Cameron Ritchie
The increase in anxiety and depression often centers on the changes and uncertainties in the college experience, such as whether classes will be held in person, online, or a hybrid of the two, said Dr. Ritchie, who was not involved with the research.
Additionally, some college students who have “left the nest” have been forced to “return to the nest,” which compounds stress, she said.
LGBTQ youngsters may be particularly affected because some have “come out of the closet” while away from home and now must negotiate going back to their home of record. They are uncertain whether or not “to go back into the closet,” added Dr. Ritchie, who is also vice chair of psychiatry at Georgetown University, Washington.
Psychiatrists and other mental health professionals should be advocates for “getting services to more people for the greatest good,” she noted.
For example, the MHA data “might be useful in advocating for keeping telehealth accessible and even promoting it,” she said.
The full report is available on MHA’s website.
Mr. Gionfriddo and Dr. Ritchie report no relevant financial relationships.
A version of this article originally appeared on Medscape.com.