Mental Health Repercussions of Virtual Interactions and Quarantine
The COVID-19 pandemic has upended nearly every aspect of everyday life, canceling large events, shuttering non-essential businesses, and effectively forcing the majority of interpersonal interactions into the virtual space. While the pandemic has occasioned widespread job loss, economic instability, and food and housing insecurity for vulnerable members of American society, some of its most pervasive and acute impacts are difficult to quantify and even harder to see, especially through a Zoom meeting or virtual event. The COVID-19 pandemic and its associated periods of government-mandated lockdown, quarantine, and social isolation have had a profound and deleterious impact on mental health across a variety of demographic groups—its adverse effects on mental health and suicide rates so profound they have been deemed an “echo pandemic.”
On April 3, 2020, less than a month after much of the world entered a period of lockdown in an attempt to control the wildfire spread of the coronavirus, the BBC ran the story of Daniel Furniss, a thirty-four year old British man who committed suicide after the United Kingdom imposed a social isolation order in March. Classified as a high-risk individual, the isolation “pushed [Furniss] over the edge.” Meanwhile, a man in the Bronx attempted to commit “suicide by cop,”[2] believing he was going to die after receiving a diagnosis of COVID-19 given his comorbidities of diabetes and obesity. Deaths by suicide, even those directly linked to COVID-19, are not included in the COVID death toll.
These anecdotes are, sadly, only two examples culled from a host of similar stories. And even those do not complete the picture. Just as the national coronavirus death toll—which stood at around 570,000 victims at the time of this writing—does not include those who, whether unexpectedly or for lack of sufficient resources to seek treatment, succumb uncounted to the virus at home, the stories of the dire mental health consequences of the global pandemic reflect merely the surface of an issue that is, in fact, far more ubiquitous.
A report published by the Centers for Disease Control and Prevention (CDC) in August, 2020 noted that the incidence of symptoms of anxiety was triple that of the 2019 survey, rising from 8.1% to 25.5%. Additionally, the same report found that the prevalence of symptoms of depression was four times the previous year’s results, rising to 24.3% from 2019’s 6.1%. A study measuring the incidence of depression before and after the pandemic began found that “[d]epression symptom prevalence was higher in every category during COVID-19 compared with before,” with a nearly sevenfold increase in respondents reporting “severe depression” (5.1% up from .7%) and nearly a tripling in reports of moderate depression (14.8% as compared to 5.7%). A study from Johns Hopkins University of Americans’ mental wellbeing during the month of April 2020 found that 13.6% of adults reported experiencing “serious psychological distress,” an increase of nearly ten percentage points from the previous iteration of the survey, conducted in April 2018, when 3.9% of respondents reported similar symptoms.
Though unsurprising, the mental health impact of the coronavirus pandemic has been devastating, with local resources unable to meet increased need and some of the nation’s most vulnerable demographics experiencing these challenges most acutely. Municipal officials in Portland, Oregon reported a 41% spike in suicide and self-harm-related calls after the city declared a state of emergency related to the virus on March 20, 2020. Thankfully, vitally needed mental health resources were able to adapt to the virtual environment, moving swiftly to telehealth models to continue providing therapy and counseling. However, the model, and the circumstantial conditions that precipitated its use, threatened to overtax mental healthcare providers attempting to guide clients through a moment of collective societal upheaval that impacted professionals alongside those seeking their services. And despite the continued availability of mental health counseling on virtual platforms, the pandemic limited its accessibility: some clients who paid out of pocket for therapy sessions were forced to stop treatment after being laid off from their jobs, while inconsistent access to broadband in lower income communities left financially under-resourced Americans unable to access remote mental healthcare. But while the COVID-19 pandemic has had far-reaching and significant mental health consequences nationwide, some groups have felt its impact more profoundly than others.
Highest Risk for the Echo Pandemic: COVID-19’s Intensified Toll on College Students
The psychological toll taken by the pandemic has been neither unanticipated, nor, sadly, surprising. Researchers have identified external factors that compound the mental health challenges posed by the COVID environment, including increased consumption of coverage of the pandemic in the mainstream news and media, particularly when this engagement is gleaned from sources presenting conflicting information, and so-called “touch deprivation” as a result of social distancing and lockdowns. However, results from several recent studies aimed at determining the pandemic’s impact on mental health evinced one consistent trend: COVID-19 is taking a particular mental toll on young adults, particularly college students. The CDC study found that young adults, along with racial/ethnic minorities, essential workers, and unpaid adult caregivers experienced “disproportionately worse mental health outcomes, increased substance use, and elevated suicidal ideation” as a result of the pandemic and associated social isolation and economic uncertainty. Specifically, 62.9% of young adults (ages 18-24) surveyed reported an anxiety or depressive disorder, 24.7% of the group had “started or increased substance use to cope with pandemic-related stress or emotions,” and 25.5% had “seriously considered” suicide in the preceding month.
The pandemic’s outsized impact on the mental health of young adults should not be surprising: even before COVID-19 hit the United States, college students were already disproportionately impacted by mental health concerns. A study conducted by Boston University’s School of Public Health found that “[h]igher risk of depression symptoms during COVID-19 was associated with having lower income. . . having less than $5000 in savings . . . and exposure to more stressors.” With 70% of college students reporting worry about their finances, according to a 2015 study, it comes as no shock that the increased financial uncertainty occasioned by the pandemic, combined with a newly volatile and transforming job market, should have aggravated the extant financial concerns plaguing young adults across the country. As college campuses and dorms closed, students lost their current source of stable housing, which precipitated a number of challenges for those in precarious situations. Some were forced to confront abusive home situations, food insecurity, and other adversities such as losing on-campus jobs, all while adapting to the unfamiliar and unprecedented demands of an educational program that had suddenly gone virtual. All in all, nearly three out of every five college students ended the spring 2020 semester feeling insecure about their ability to meet their basic needs, such as housing and food, according to a report by the HOPE Center for College, Community, and Justice at Temple University.
Financial instability and stress, both academic and environmental, are not the only factors exacerbating the mental health impact of COVID-19 on college students. While the pandemic has proved disruptive for everyone, whether by canceling events, keeping families apart, or requiring dependence on Zoom to approximate face-to-face social interactions, college students and other young adults have arguably experienced unique degrees of disruption even in such unprecedented circumstances. Roxane Cohen Silver, a psychologist at the University of California-Irvine, posits that the pandemic has had such a significant impact on young adults because of its interference with life events typical of the late teens and early twenties: “graduations, weddings, the senior year of college and of high school,” in addition to the “school and social connections” upon which young adults particularly rely. A 2020 study by Active Minds found that of the ~2,000 students surveyed, 80% reported that COVID-19 had negatively impacted their mental health, increasing feelings of stress or anxiety (91%), disappointment or sadness (81%), and loneliness or isolation (80%).
A PBS NewsHour story in which University of Texas at Austin student Victoria Canales recounts the ways in which COVID-19 impacted her mental health exemplifies many of the stressors that compound to negatively impact young adults: leaving her family hundreds of miles away across the state, she moved back to her college apartment to begin the fall 2020 semester although none of her roommates or friends had returned to attend in-person classes. Alone and experiencing severe emotional distress, she stopped taking her prescribed antidepressants and soon spiraled into depression and thoughts of suicide. Other students report Zoom fatigue, isolation, and disappointment with the reality of their pandemic-era college experience. Rates of suicide have increased so dramatically in some areas that schools have chosen to reopen: the school district of Clark County, Nevada, which contains Las Vegas, has begun to reopen in-person classrooms after 18 students took their own lives during 2020.
College is a difficult experience under normal circumstances: a cornucopia of stress, anxiety, and uncertainty brought on by academic obligations, employment instability, distance from family, substance use, and innumerable other contributing factors. Post-pandemic mental health interventions must therefore account for the coronavirus’s disruptive impact on young adults. Above all, the COVID-19 crisis is exposing the weaknesses of America’s patchwork healthcare system, which often does not provide for easily accessible, comprehensive, and affordable mental health coverage. The mental health ramifications of COVID-19 will likely stay with us for years after social distancing and mask mandates have become a thing of the past. Any long-term recovery must therefore include systemic changes to democratize and expand access to mental health treatment for all.
[1] Hari Sreenivasan & Alison Thoet, How the pandemic is impacting college students’ mental health, https://www.pbs.org/newshour/show/how-the-pandemic-is-impacting-college-students-mental-health?fbclid=IwAR3yod0EsIbQ3zMLJ34FHztWcOaJMfaE5Uju2Zz_e7eVCwi_et-eSICLEZ0.
[2] “Suicide by cop” is a term, often used by law enforcement, to describe incidents where suicidal persons engage with law enforcement in ways calculated to provoke the officers to shoot the suicidal person in self-defense or to protect others. See Hutson et al., Suicide by Cop, PubMed.org., https://pubmed.ncbi.nlm.nih.gov/9832661/ (last visited Apr. 24, 2021).