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Introduction
The mental health impact of the COVID-19 pandemic has been widespread and enduring. The World Health Organization (WHO) reported a 25% increase in the global prevalence of anxiety and depression in the first year of the pandemic.[1] And although both the WHO and the United States government have declared the end of COVID as a public health emergency, people are still experiencing mental health strain that may be exacerbated by economic instability, social isolation, and Long COVID.
This data brief analyzes data on mental health in New York State during the pandemic. It uses 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 a loss in household employment income during the pandemic, and those 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. Through July 21, 2021, the duration was the past 7 days. From July 2021 to March 13, 2023, the duration was the last two weeks.[2]
Data in the brief are from the COVID-19 Household Pulse Survey, an experimental data product by the U.S. Census Bureau in collaboration with multiple federal agencies. The survey is designed to provide near-real-time data on household experiences during the COVID-19 pandemic from April 23, 2020, until March 13, 2023. These results are largely based on the first quarter of calendar year 2023.
[1] Brunier A, Drysdale C. (2022) COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. World Health Organization, https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide, accessed Jun 2023.
[2] Centers for Disease Control and Prevention. Anxiety and Depression Household Pulse Survey, https://www.cdc.gov/nchs/covid19/pulse/mental-health.htm, accessed June 2023.
Key Findings
- More than three in ten (31.5%) New Yorkers reported poor mental health in March 2023, the most recent date for which data are available. That proportion shows no improvement from May 2021, when 32% of New Yorkers reported poor mental health.
- Rates of poor mental health among New Yorkers have fluctuated throughout the pandemic. They peaked in February 2021, when two in five (40.2%) New Yorkers said they experienced anxiety and/or depression. The most recent spike (37.2%) occurred in September 2022.
- Some groups of New Yorkers were more likely to experience depression and/or anxiety in the first quarter of 2023:
- One in two (50.0%) New Yorkers with very low incomes (less than $25,000 per year) reported anxiety and/or depression, more than twice the rate of those with annual household incomes of $100,000 or more (22.1%).
- Younger adults had poorer mental health rates than other age groups; two in five (40.0%) New Yorkers between the ages of 18 and 34 reported poor mental health.
- Poor mental health increased most for Asian New Yorkers and Hispanic New Yorkers; two out of five (41.0%) Hispanic New Yorkers reported anxiety and/or depression.
- One in two (50.7%) New Yorkers who lost employment income since the onset of the pandemic reported anxiety and/or depression.
- New Yorkers experiencing food insufficiency had worse mental health than their food-sufficient peers. More than half (57.4%) of food-insufficient New Yorkers had poor mental health—nearly twice the rate of food-sufficient New Yorkers (29.2%).
Anxiety and/or Depression in New York State
Overall
One in three adult New Yorkers are experiencing depression and/or anxiety. Reported anxiety and/or depression in New York State most recently spiked in September 2022 (37.2%) and has remained high. Throughout the first quarter of 2023, rates remained higher than they were for much of 2022.
Anxiety and/or Depression in New York State
By Income Group
Household income is closely related to mental health outcomes in New York State. Half (50.0%) of New Yorkers with very low income reported anxiety and/or depression in the first quarter 2023, more than twice the rate of New Yorkers with the highest incomes (22.1%).
Comparing calendar year 2022 to the first quarter of 2023, poor mental health increased by 21.5% for New Yorkers with household incomes between $50,000 and $99,999—the largest jump of any income band.
Anxiety and/or Depression in New York State
By Age Group
Age and mental health are also linked. Younger New Yorkers (ages 18–34) continue to report the highest rates of anxiety and/or depression. While rates for this group have improved each year between 2020 and 2023, they remain stubbornly high: two in five (40.0%) younger adults still experience poor mental health.
Anxiety and/or depression symptoms increased for older adults by more than 35% in the first quarter of 2023, compared with calendar year 2022.
Anxiety and/or Depression in New York State
By Race and Ethnicity
Reported rates of anxiety and/or depression increased among Hispanic and Asian New Yorkers in the first quarter of 2023, compared to calendar year 2022. More than two out of five (41.0%) Hispanic New Yorkers and one-third (29%) of Asian New Yorkers reported poor mental health in the first quarter of 2023.
Anxiety and/or Depression in New York State
By Household Employment Income Loss
Loss of employment income is associated with anxiety and depression.
One in two (50.7%) New Yorkers with household employment income loss during the pandemic reported anxiety and/or depression, compared with one in three (29.8%) New Yorkers in households that did not lose employment income.
Anxiety and/or Depression in New York State
By Food Sufficiency Status
Food sufficiency is closely associated with worse mental health for New Yorkers. Food insufficiency is defined by the United States Department of Agriculture (USDA) as a household sometimes or often not having enough to eat within the last seven days.[1] While anxiety and/or depression rates have declined slightly among this group each year since the onset of the pandemic, more than half (57.4%) of food–insufficient New Yorkers reported anxiety and/or depression. In comparison, fewer than one in three (29.2%) food–sufficient New Yorkers reported anxiety and/or depression for the same period.
[1] USDA. Food Insecurity in the US, https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/measurement/#insufficiency, accessed April 2023.
Discussion
In New York State, mental health is stagnating following a period of improvement. Following a dip in the reported prevalence of anxiety and/or depression in summer 2022, rates have remained stubbornly high, with one in three New Yorkers experiencing one or both conditions. Mental health distress is more common among some groups of New Yorkers than others.
There are several possible reasons for persistently high rates of depression and anxiety among New Yorkers, even three years after the onset of the pandemic. Ongoing economic uncertainty, stagnant wages, inflation, food insecurity, social isolation, the loss of loved ones during the pandemic, and the effects of Long COVID could all be contributing factors.
In response to worsening mental health following the COVID-19 pandemic, New York State, City, and local government agencies have been mobilizing to address mental health through multiple new programs and community efforts:
- New York State’s FY 2024 budget provides $1 billion to expand mental health throughout the State, focusing on New Yorkers with serious mental health needs.[1] The plan includes new residential units, increased inpatient capacity, and expanded outpatient services. It also invests in peer-based outreach, expands school-based mental health services, and addresses gaps in insurance coverage for behavioral health services.[2],[3] The budget also provides an increase over the prior budget to support the 988 Suicide and Crisis Lifeline.
- New York City Mayor Adams and the New York City Department of Health and Mental Hygiene unveiled a $20 million plan called “Care, Community, Action: A Mental Health Plan for NYC” that takes a public health approach to address the mental health needs of children, youth, and families; people with serious mental illness; and those at risk of drug overdose.[4]
- The New York City Council released a “Mental Health Roadmap” that proposes to expand preventive and supportive services, including school-based screenings, mental health services in family shelters, and other youth mental health programs. It also addresses the mental health workforce shortage, the intersections between mental health and the criminal justice system, public awareness, and coordination among agencies.[5]
Focused government attention and funding will be critical to improving mental health in New York State, but other sectors also have important roles to play. Foundations, advocates, community-based organizations, schools, health care providers, and others are working to support New Yorkers’ mental health. No one program, no one organization, no one government entity alone can solve the substantial mental health challenges New York is facing. Making meaningful and sustainable progress will require long-term investments, collaboration, and focused attention among a range of stakeholders across the State.
[1] New York State Office of State Governor. (2023) Governor Hochul Announces Passage of $1 Billion Plan to Overhaul New York State’s Continuum of Mental Health Care, https://www.governor.ny.gov/news/governor-hochul-announces-passage-1-billion-plan-overhaul-new-york-states-continuum-mental, accessed June 2023.
[2] Mental Health Association in New York State. (2023) Governor Hochul Highlights New York’s Mental Health Budget Plan, https://mhanys.org/mh_update/governor-hochul-highlights-new-yorks-mental-health-budget-plan/#:~:text=The%20FY%202024%20Budget%20provides,those%20with%20mental%20health%20challenges, accessed June 2023.
[3] New York State Office of State Governor. (2023) Governor Hochul Announces Passage of $1 Billion Plan to Overhaul New York State’s Continuum of Mental Health Care, https://www.governor.ny.gov/news/governor-hochul-announces-passage-1-billion-plan-overhaul-new-york-states-continuum-mental, accessed June 2023.
[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 June 2023.
[5] New York City Council. Mental Health Roadmap, https://council.nyc.gov/mental-health-road-map/, accessed April 2023.
Methods
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 April 2023. https://www.census.gov/programs-surveys/household-pulse-survey/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 April 26, 2023. This analysis includes Phase 3.8 data only from March 1 to March 13, 2023.
Each phase had updated questionnaires, which were administered through e-mail or mobile phone to complete an internet questionnaire.
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 3.8, the questionnaire was updated to measure symptoms over the past two weeks, matching the PHQ-2 and GAD-2 questions.