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Cited by 83COVID-19 and Mental HealthEmployment and Welfare StudiesMental Health Treatment and Access

Mental Health During the First Weeks of the COVID-19 Pandemic in the United States

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Killgore, William D. S., Cloonan, Sara A., Taylor, Emily C., Dailey, Natalie S.·2021·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2021.561898PMC PMC8100184
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Abstract

Background: By March 2020, the World Health Organization declared the COVID-19 crisis as a worldwide pandemic and many local governments instituted stay-at-home orders and closed non-essential businesses. Within the United States, tens of millions of workers lost their jobs and financial security during the first few weeks of the national response, in an attempt to slow the global pandemic. Because of the enormity of the pandemic and its potential impact on mental health, the objective of the present study was to document the prevalence of mental health problems and their association with pandemic-related job loss during the third week of the nationwide shutdown. Methods: Mental health was assessed via online questionnaires among a representative sample of 1,013 U.S. adults on April 9–10, 2020. Rates of clinically significant mental health outcomes were compared between participants who lost their job as a result of COVID-19 restrictions (17.4%) vs. those who did not (82.6%). Bivariate multiple logistic regression identified factors that were predictive of, and protective against, mental health problems. Results: The prevalence of clinically significant symptoms was significantly higher than prior population estimates, ranging from 27 to 32% for depression, 30 to 46% for anxiety disorders, 15 to 18% for acute/post-traumatic stress, 25% for insomnia, and 18% for suicidal ideation. Prevalence estimates were 1.5–1.7 times higher for those who reported job loss due to COVID-19 restrictions than those who did not. Mental health problems were predicted by worry over financial instability, insomnia, social isolation, and alcohol consumption, while getting outside more often, perceived social support, and older age were protective against these problems. Conclusions: During the first 3 weeks of lockdowns/stay-at-home restrictions, mental health problems, including depression, anxiety, insomnia, and acute stress reactions were notably elevated relative to prior population estimates. Job loss related to the nationwide shutdown was particularly associated with poorer mental health. These findings provide a baseline of mental health functioning during the first weeks of the national emergency and lockdown orders in response to COVID-19.

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  • During the COVID-19 pandemic, uncertainty and government restrictions contributed to increased mental health problems, including stress and anxiety.

    “Beyond the impact on physical health, the ongoing uncertainty related to the pandemic and the restrictions imposed by the governments of the world has also led to increased mental health related problems, including increased rates of stress and anxiety (Killgore et al., 2021; Magalhaes et al., 2021; Raihan, 2021).”

    From The association between facets of mindfulness and COVID-19 related distress: A cross-sectional study (2023) · cites this paper as Killgore et al., 2021

    The Abstract reports elevated anxiety and acute stress during the first three weeks of U.S. lockdowns, and the Introduction links pandemic uncertainty and restrictions to mental-health concerns. The paper does not establish that restrictions caused the increases worldwide or over the ongoing course of the pandemic; its findings concern the United States in the first weeks and are largely associational. (LLM, conf=0.84)

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Authors
Killgore, W. D. S., Cloonan, S. A., Taylor, E. C., & Dailey, N. S.
Affiliations
University of Arizona (US)
Corresponding author
Killgore, William D. S.
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2021-04-22
Volume
12
Pages
561898-561898
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2021.561898
PMC
PMC8100184
OpenAlex
W3153465157
Cited by
83
References
14
Citations by year
2026: 3 · 2025: 8 · 2024: 17 · 2023: 19 · 2022: 20 · 2021: 16
FWCI
12.28
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
University of Arizona
Topics
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
  • Health Sciences › Health Professions › General Health Professions › Employment and Welfare Studies
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
COVID-19 pandemic, mental health, job loss, lockdown, stay-at-home orders, depression, anxiety disorders, post-traumatic stress, insomnia, suicidal ideation, financial instability, social isolation, alcohol consumption, social support, protective factors

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