Bouncing Back: New Yorkers’ Mental Health Progress and Remaining Challenges

Methods in Brief

This data brief analyzes trends in mental health status for adults ages 18 and older in New York State from 2020 through the first half of 2024. Data are from the Household Pulse Survey, an experimental data product by the U.S. Census Bureau. The brief examines self-reported symptoms of anxiety and/or depression by income, age, and race/ethnicity. It also compares symptoms among New Yorkers who did and did not experience food insufficiency.

“Poor mental health” is defined as having reported anxiety and/or depression symptoms within a specified period.

Until July 2021, the period assessed was “the last 7 days.” From July 2021 to July 2024, the period assessed was “the last two weeks.”^[1]

^[1] Centers for Disease Control and Prevention. Anxiety and Depression Household Pulse Survey, https://www.cdc.gov/nchs/covid19/pulse/mental-health.htm, accessed August 2024.

Key Takeaways

• The prevalence of poor mental health plunged by 40% between July 2023 (31.9%) and July 2024 (18.9%).
• Nearly one in five New Yorkers currently experience poor mental health.
• Rates of poor mental health peaked in the first year of the COVID-19 pandemic and have fluctuated over time. In February 2021, two in five New Yorkers (40.2%) experienced poor mental health. The most recent spike was in October 2023, when one in three New Yorkers (30.5%) reported symptoms of anxiety and/or depression.
• Improvements in mental health are universal. Across all population groups, rates of anxiety and/or depression fell between 2023 and the first half of 2024.
• However, some groups of New Yorkers are still more likely to experience symptoms of anxiety and/or depression:
  • Younger adults reported higher rates of poor mental health than any other age group. In the first half of 2024, nearly one in four (24.4%) younger adults between the ages of 18 and 34 reported anxiety and/or depression.
  • Hispanic New Yorkers have consistently reported higher rates of poor mental health compared with other racial/ethnic groups from 2020 to 2024. One in four Hispanic New Yorkers (25.3%) reported poor mental health in the first half of 2024.
  • New Yorkers experiencing food insufficiency were more likely to report poor mental health than their food-sufficient peers. Two in five (39.5%) food–insufficient New Yorkers reported anxiety and/or depression symptoms in the first half of 2024, a rate more than double that reported by food–sufficient New Yorkers (15.7%).

Anxiety and/or Depression Among New Yorkers 2020–2024

Overall 

One in five (18.9%) adult New Yorkers reported symptoms of depression and/or anxiety in July 2024. Reported anxiety and/or depression in New York State has been gradually decreasing since early 2021, with a sharper decrease since the beginning of 2024.

Anxiety and/or Depression Among New Yorkers 2020–2024

By Income Group

Compared to 2023, anxiety and/or depression symptoms decreased across all income groups in the first half of 2024. But disparities persist, with the lowest income groups (those earning <$25,000) experiencing the highest rates of anxiety and/or depression. Nearly one in three (32.1%) New Yorkers with very low income reported anxiety and/or depression in the first half of 2024, more than twice the rate of New Yorkers within the highest income bracket (16.9%).

Between 2023 and 2024, anxiety and/or depression decreased by half for New Yorkers with household incomes between $50,000 and $99,999—the largest decline of any income bracket (32.3% to 13.5%).

Anxiety and/or Depression Among New Yorkers 2020–2024

By Age Group

Across all survey years, age has been closely related to mental health status. Reported anxiety and/or depression rates remain highest for adult New Yorkers ages 18–34. While reported rates of poor mental health among this group have been slowly improving since 2020, approximately one in four (24.4%) younger adults reported anxiety and/or depression in the first half of 2024—twice the rate among New Yorkers ages 65 and older (12.3%).

After a slight increase in reported poor mental health between 2022 and 2023, anxiety and/or depression symptoms for older adults (ages 65 and older) decreased by almost half (from 20.1% to 12.3%) between 2023 and the first half of 2024.

Anxiety and/or Depression Among New Yorkers 2020–2024

By Race/Ethnicity

Reported rates of anxiety and/or depression symptoms decreased for all race and ethnicity groups between 2023 and 2024, following slight increases among Asian and Hispanic New Yorkers during the prior year. Asian New Yorkers experienced the largest improvements, with half as many reporting poor mental health in 2024 compared to 2023 (12.2% vs. 26.7%). Hispanic New Yorkers also saw substantial improvements (25.3% vs. 36.8%) during this period.

However, racial and ethnic disparities in mental health persist. Hispanic New Yorkers continue to report the highest rates, with one in four Hispanic New Yorkers (25.3%) reporting poor mental health in the first half of 2024. Approximately one in six white (17.2%) and Black New Yorkers (15.3%) reported poor mental health in 2024, compared with 12.2% of Asian New Yorkers.

Anxiety and/or Depression Among New Yorkers 2020–2024

By Food Sufficiency Status

Food insufficiency is closely linked with worse mental health for New Yorkers. Food insufficiency is defined by the United States Department of Agriculture as a household sometimes or often not having enough to eat within the last seven days.^[1]

While rates of anxiety and/or depression have improved among food-insufficient New Yorkers since 2023, they report poor mental health at more than twice the rate of food-sufficient New Yorkers (39.5% and 15.7%, respectively). New Yorkers experiencing food insufficiency reported the highest rates of poor mental health of any group in the survey.

^[1] United States Department of Agriculture Economic Research Service, “Food Insecurity in the US,” https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/measurement/#:~:text=Food%20insufficiency%20is%20a%20more,than%20to%20overall%20food%20insecurity, accessed August 2024.

Discussion

New Yorkers’ mental health appears to be bouncing back. The occurrence of poor mental health peaked during the early years of the COVID pandemic. The rates started to fall consistently beginning in 2023 through the first half of 2024. Across all population groups, rates of anxiety and/or depression fell between 2023 and the first half of 2024.

Yet disparities remain, with younger, Black, Hispanic, low-income, and food-insufficient New Yorkers consistently having the highest rates of poor mental health across the study periods. New Yorkers who have the lowest income and/or food insufficiency reported the highest rates of poor mental health of any group. These groups of New Yorkers can overlap; previous research shows that Black, Hispanic, and low-income New Yorkers have higher levels of food insufficiency.^[1]

There has been considerable State and local investment in and attention to mental health services. For Fiscal Year 2023–2024, the State budget included $1 billion for mental health services and New York City funded multiple new mental health initiatives.^[2],[3],[4]  For Fiscal Year 2024–2025, the State budget built on these previous investments, increasing commercial insurance rates for outpatient mental health visits and school-based mental health satellites.^[5]

New York City’s Fiscal Year 2024–2025 budget safeguarded mental health services, including by continued funding of developmental, psychological, and behavioral health services, as well as neighborhood-based centers for residents with serious mental illness.^[6] In 2024, the City’s Department of Health and Mental Hygiene also released its first ever “The State of Mental Health of New Yorkers,” which highlighted the diverse needs of its residents and provided policy recommendations to support them.^[7]

^[1] Cobbs, E. Ford, MM. McCarthy, J. Barrett, A. Havusha, A. Sandman, D. 2024. “Still Hungry: Food Insufficiency in New York State 2020-2023,” New York Health Foundation, New York, NY. https://nyhealthfoundation.org/resource/food-insufficiency-in-new-york-state-2020-2023/.

^[2] The Office of the Governor of New York. “Transforming New York State’s Continuum of Mental Health Care,” https://www.governor.ny.gov/programs/transforming-new-york-states-continuum-mental-health-care, accessed August 2024.

^[3] New York City Council, “Mental Health Roadmap,” https://council.nyc.gov/mental-health-road-map/, accessed August 2024.

^[4] The City of New York, “Care, Community, Action: A Mental Health Plan for NYC,” https://www.nyc.gov/assets/doh/care-community-action-mental-health-plan/index.html, accessed August 2024.

^[5] Division of The Budget, State of New York, “Governor Hochul Announces Historic Investments of FY 2025 New York State Budget,” https://www.budget.ny.gov/pubs/press/2024/fy25-enacted-budget-mental-health.html, accessed August 2024.

^[6] Fiscal Year 2025 Adopted Expense Budget Adjustment Summary/ Schedule C, Res. 0489, The Council of the City of New York (2024).

^[7] New York City Department of Health and Mental Hygiene. (2024). “The State of Mental Health of New Yorkers.” https://www.nyc.gov/assets/doh/downloads/pdf/mh/state-of-mental-health-new-yorkers.pdf.

Promising Approaches for Improving Mental Health in New York

Policymakers must continue to support strengthening and expanding mental health services with a focus on reducing inequities. Community-based organizations, schools, health care providers, behavioral health organizations, public health organizations, and foundations also have roles to play. A multi-pronged approach that engages a wide range of stakeholders is needed to address the complexity of mental health needs in New York.

New York Health Foundation grantees and partners are leading a number of efforts to support New Yorkers’ mental health needs and advocate for sustained progress. Some promising examples include:

• Strengthening behavioral health service providers through capacity building and payment reform. NYHealth grantee InUnity Alliance, a new organization formed from the merger of two membership associations (the Coalition for Behavioral Health and the Alcoholism and Substance Abuse Providers of New York State), amplifies statewide policy initiatives and provider training to integrate care delivery for individuals with mental health and substance use disorders.^[1],[2] Citizen’s Committee for Children leads the Campaign for Healthy Minds, Healthy Kids, which advocates for insurance payment reform and increased investment in school-based mental health services to improve access to behavioral health support for youth and teens.^[3]
• Using credible messengers to promote awareness of  youth mental health and connections to community-based services. The Institute for Human Services, Inc.’s NYHealth-funded project Mental Health First Aid trains community members (including teenagers, family members, and school staff) to spot and respond to adolescents who may be experiencing mental health and/or substance use issues in Chemung and Steuben counties.^[4] And Delphi Rise, based in the Finger Lakes region, will collaborate with the Wayne County Partnership—a regional consortium of more than 48 government agencies, community-based organizations, and school districts—to launch a culturally-tailored Youth Mental Health First Aid initiative to support young people of color in Wayne County and neighboring rural counties.^[5]
• Increasing culturally and linguistically appropriate care for immigrant communities. Asian American Federation launched a Mental Health Directory, New York City’s first online mental health directory for the Asian American/Pacific Islanders where individuals can search for therapeutic care offered in their native language.^[6] The Organización Latino Americana (OLA) of Eastern Long Island launched “Youth Connect,” to connect Latino youth in Suffolk County with an anonymous helpline. Participants can speak with bilingual counselors and be referred to care if needed.^[7]
• Investing in the mental health workforce. Mental health service access cannot happen without a robust workforce. The pandemic created and exacerbated widespread shortages in the health workforce, including in behavioral health. With funding from NYHealth, Project Renewal has partnered with NYC Health + Hospitals to develop and launch a new psychiatric technician training program. Psychiatric technicians provide support in caring for people with mental illnesses and/or developmental disabilities; they may assist patients with activities or conduct wellness checks. The program also creates a career pathway for New Yorkers who have experiences with homelessness, substance use disorders, justice system involvement and/or mental illness.^[8]
• Expanding peer-based mental health services for veterans. Some new veterans struggle to transition back to civilian life. However, they often do not ask for help until a crisis occurs and struggle to share with people who do not understand their experiences. NYHealth has supported veterans’ peer-to-peer services for many years in the State. In 2024, the Foundation awarded Clear Path for Veterans funding to expand these services and to formalize a statewide peer mentor coalition to promote best practices.^[9]

^[1] InUnity Alliance, “InUnity Alliance,” https://iuany.org/, accessed September 2024.

^[2] New York Health Foundation, “The Coalition for Behavioral Health,” https://nyhealthfoundation.org/grantee/the-coalition-for-behavioral-health/, accessed September 2024.

^[3] Campaign for Healthy Minds, Healthy Kids, “About the Campaign,” https://healthymindshealthykids.org/about-the-campaign/, accessed September 2024.

^[4] Institute for Mental Services, “Youth Mental Health First Aid,” https://ihsnet.org/mental-health-first-aid/, accessed August 2024.

^[5] Wayne County Partnership, “Youth Mental Health First Aid,” https://www.waynepartnership.org/mental-health-first-aid, accessed September 2024.

^[6] Asian American Federation, “Mental Health Directory,’ https://mhd.aafederation.org/, accessed September 2024.

^[7] New York Health Foundation, “Organización Latino Americana (OLA) of Eastern Long Island,” https://nyhealthfoundation.org/grantee/organizacion-latino-americana-ola-of-eastern-long-island/, accessed August 2024.

^[8] New York Health Foundation, “Project Renewal Inc.,” https://nyhealthfoundation.org/grantee/project-renewal-inc/, accessed August 2024.

^[9] New York Health Foundation, “Clear Path for Veterans,” https://nyhealthfoundation.org/grantee/clear-path-for-veterans-2/, accessed August 2024.

Methods and Limitations

The data used for the analysis are part of the COVID-19 Household Pulse Survey, an experimental data project designed by the U.S. Census Bureau in collaboration with multiple federal agencies. The data are available from:

U.S. Census Bureau. “Household Pulse Survey Public Use File.” Accessed August 2024. https://www.census.gov/programs-surveys/household-pulse-survey/data/datasets.html.

The survey is designed to provide near-real-time data on household experiences during the COVID-19 pandemic throughout the United States to inform state and federal responses.

• Phase 1 of data collection started on April 23, 2020, and was generally conducted on a weekly basis until July 1, 2020;
• Phase 2 of data collection began on August 19, 2020, and was generally conducted every two weeks on October 26, 2020;
• Phase 3 of data collection started on October 28, 2020, and was conducted every two weeks until March 29, 2021;
• Phase 3.1 collected responses from April 14, 2021, until July 5, 2021;
• Phase 3.2 collected responses from July 21, 2021, until October 11, 2021;
• Phase 3.3 collected responses from December 1, 2021, until February 7, 2022;
• Phase 3.4 collected data from March 2, 2022, until May 9, 2022;
• Phase 3.5 collected responses from June 1, 2022, until August 8, 2022;
• Phase 3.6 collected responses from September 14, 2022, until November 14, 2022;
• Phase 3.7 collected responses from December 9, 2022, until February 13, 2023;
• Phase 3.8 collected responses from March 1, 2023, until May 8, 2023.
• Phase 3.9 collected responses from June 7, 2023, until August 7, 2023.
• Phase 3.10 collected responses from August 23, 2023, until October 30, 2023.
• Phase 4.0 Cycle 1 collected responses from January 9, 2024, until February 5, 2024.
• Phase 4.0 Cycle 2 collected responses from February 6, 2024, until March 4, 2024.
• Phase 4.0 Cycle 3 collected responses from March 5, 2024, until April 1, 2024.
• Phase 4.1 Cycle 4 collected responses from April 2, 2024, until April 29, 2024.
• Phase 4.1 Cycle 5 collected responses from April 30, 2024, until April 29, 2024.
• Phase 4.1 Cycle 6 collected responses from May 28, 2024, until June 24, 2024.
• Phase 4.1 Cycle 7 collected responses from June 25, 2024, until July 22, 2024.

Each phase had updated questionnaires, which were administered through e-mail or mobile phone to complete an internet questionnaire. The questionnaires were only available in English and Spanish.

The Household Pulse Survey included questions to measure the frequency of anxiety and depression symptoms. These questions were developed based on the Patient Health Questionnaire (PHQ-2) and the Generalized Anxiety Disorder (GAD-2) scale. One difference is that from Phases 1 to 3.1 the Household Pulse Survey measured symptoms over the last 7 days, as opposed to the typical 14 days. From 3.2 to 4.1, the questionnaire was updated to measure symptoms over the past two weeks, matching the PHQ-2 and GAD-2 questions.

Earlier NYHealth reports on mental health included findings on loss of employment income. These findings were omitted from this report as the question changed duration. Phases 1. to 3.0 asked “Have you, or has anyone in your household experienced a loss of employment income since March 13, 2020?” Phases 3.1 and onward asked “Have you, or has anyone in your household experienced a loss of employment income in the last 4 weeks?”

While the Household Pulse Survey did not track mental health data for youth and teens, it is important to note that experts have pointed to an enduring mental health crisis among youth across the country. The latest national data show that, among high school students, more than 40% felt persistently sad or hopeless, nearly 30% experienced poor mental health, and 20% considered attempting suicide. Between 2021 and 2023, there were small improvements in the number of young people who felt persistently sad or hopeless, but some disparities continued, and many rates remained high.