A new report suggests that the pandemic only minimally impacted people’s mental health.
Authors and professionals urge readers not to undermine mental health complications that arise due to the results, which may be biased.
A new report suggests the pandemic only minimally impacted people’s mental health. Its results have drawn out skepticism from some mental health experts and caused others to rethink the impact of COVID-19.
“My initial reaction to the study was shock,” says Alisa Ruby Bash, PsyD, LMFT, who runs a private marriage counseling practice and works part-time at a university in the counseling center. “That definitely has not been my experience in my practice.”
The research compiles 137 studies that look at people’s general mental health, anxiety symptoms, and depression symptoms in 2018, 2019, and 2020. On average among all participants, the results showed participants experienced no changes in general mental health and anxiety symptoms from 2019 to 2020, and minimal deterioration in depression symptoms.
On average among women and female participants, some studies showed no to minimal deterioration in the three categories, while others showed no to slight improvement.
Of those included in the report, only three studies looked at changes in mental health from March 2020 to April 2020. These showed that people’s mental health was either unchanged during the timespan or temporarily worsened and then increased to starting levels.
“There's just a scale of people's ability to cope; of how much they were affected by it,” Bash says of the results. “But I can't imagine anybody being unaffected with their mental health.”
In a linked editorial, the authors of the report note high risks of bias, including that the majority of studies were conducted in high-income or upper-middle-income countries, and that the results relied on an average value rather than evaluating outliers. 
Further, they say that report does not account for individual factors that could have impacted the changes—or lack thereof—in participants' mental health statuses.
“While the present study clearly shows that we need not be overly concerned about the general population’s mental health in relation to the COVID-19 pandemic…Pandemic or not, there is a strong need to provide preventive mental health interventions for those most at risk of poor mental health outcomes,” they write.
Mental health vs illness
To properly interpret the results of the study, it may be important to understand and distinguish between definitions of mental health and mental illness, says Mayra Mendez, Ph.D., a licensed psychotherapist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John's Child and Family Development Center in Santa Monica, CA
“A disorder is the product of functional interference,” says Mendez. “It's usually much more pervasive, and it's not just associated with and having an experience that is distressing, but will pass. It's more of a permanent state of being.”
The current study looks at mental health status, and anxiety and depression symptoms, which may or may not fall under anxiety and depression diagnoses per the DSM.
Mendez said her practice did not experience a large change in their numbers of new patients—they typically have a full list of clients, with an about 10-person waitlist, which stayed relatively consistent over the last few years, she says—but they did experience an increase in appointments for some returning patients.
In the peak of the pandemic, many of her patient’s symptoms escalated, largely for people with anxiety, Mendez says.
“If I had been seeing them once a week, those sessions either became more intense or increased to twice a week for a period of time because their anxiety was so high,” she adds. “That anxiety was mostly driven by the unknown, listening to the news too much, catastrophizing that information.”
Clients with depression tended to experience increases in confusion and a need for reassurance, she says.
What does mental health look like in a partially post-pandemic society
In her personal and professional life, Bash has seen people’s social anxieties plummet and then slowly rise since March 2020. If she could chart what she’s noticed as a trend on a graph, the time before the pandemic might be plotted on the top left of a U-shaped parabola, and losses and lockdowns during 2020 at the inflection point.
“It really got very low during the peak of the pandemic—really, really low. Now, we’re not quite at where we were pre-pandemic, but we're getting there,” explains Bash.
Mendez too notes that social reopenings have positively impacted her clients' health. For many, peak-pandemic escalations have dribbled closer to starting levels, she adds.
“Talk of death has decreased very significantly, and clients are seeing that the support that they need is still there,” says Mendez.
Are we mentally okay, really?
While it’s important to recognize the mental health progress we’ve made, it’s also important to recognize how much farther we still need to go, Bash says. (For example, “We've not had mask mandates for over a year, but people are affected,” she adds.)
This impact is understandable—natural even—due to the chemical impact isolation, loss, and lockdowns had on the mind, she says.
“We carved out these neural pathways of isolating ourselves—sitting at home if you're feeling a little bit off,” explains Bash. “People are much more prone now to revert to old behaviors.”
Reversing the revert could take more time still. But exactly how much will depend on the individual.
“It's an individual thing—it always has been,” says Mendez of not only ridding ourselves of pandemic behaviors but tackling any kind of mental health complication. “What the takeaway should be, is that if you have concerns and you're noticing something different in the way you are living your life, thinking through problem-solving, interacting with your world, then you need to seek help—pandemic related or not.”
What this means for you
A new report reveals that the pandemic may not have had a large impact on people’s mental health in comparison to years prior. Both study authors and mental health practitioners warn not to take the results out of context and not to undermine functional problems that your patients bring up. Assessing patients for a mental health diagnosis can be important in determining if symptoms are temporary occurrences or a disorder.