The COVID-19 Pandemic and Its Effects on Mental Health-A before, during, and after Comparison Using the U.S. Census Bureau's Household Pulse Survey.

Background: Although significantly increased mental health concerns were noted globally during the first year of the COVID-19 pandemic, much less is known about the mental health trends during the COVID-19 recovery period. We aimed to compare current anxiety or depression rates to those before and during the first year of the pandemic and to evaluate demographic differences.

Methods: We analyzed Household Pulse Survey data prospectively collected from a representative U.S. population sample. We compared the anxiety or depression rates from the first pandemic year (04/2020-05/2021) and recovery period (06/2023-03/2024) from the national cohort and demographic subgroups using two-sided paired t-tests and regression analyses and compared these to pre-pandemic (01/2019-12/2019) rates using one-sided t-tests.

Results: The national estimates for anxiety or depression improved during the recent COVID-19 recovery period as compared to the first year (29.5 ± 5.5 vs. 37.6 ± 3.1; p < 0.0001) but did not return to the pre-pandemic benchmark (29.5% vs. 10.8%; p < 0.001). Higher rates were noted in younger individuals aged 18-29 years (p < 0.0001), in individuals with less than a high school diploma (p < 0.0001), or with disabilities (p < 0.0001). Non-Hispanic Asians reported the lowest rates (p < 0.0001), and no significant gender differences were noted.

Conclusion: The U.S. population's mental health concerns have improved since the first year of the pandemic but remain above pre-pandemic benchmarks. Certain demographic subgroups are at higher risk, indicating the need for targeted health care and economic policy interventions to address these disparities.