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Adults with Mental and Behavioral Health Disorders Describe COVID-19’s Impact and Resilience-Building Strategies Through Social Support, Emotion Management, and Self-Care

A study funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).

The onset of the COVID-19 pandemic appears to have increased emotional distress nationwide, with national surveys showing anxiety and depression symptoms levels among the general population three times higher than pre-pandemic levels. Studies show that people with mental and behavioral health disorders have a higher risk for physical and emotional health disparities than the general population. Despite these disparities, there’s been very little investigation of how the pandemic has impacted people with mental and behavioral health disorders. In a recent NIDILRR-funded study, researchers sought to determine the impact of the pandemic on people with mental and behavioral health disorders, from changes in their lifestyle to access to health care. The researchers wanted to know if these lifestyle changes, COVID-19 exposure, and barriers to healthcare were related to increases in anxiety and depression symptoms. Lastly, they were interested to know what resilience and positive coping strategies these individuals used to cope in response to the pandemic.

Researchers from the Rehabilitation Research and Training Center (RRTC) on Health and Function of People with Psychiatric Disabilities surveyed 272 individuals who received mental and behavioral health support services from statewide service providers in New York and New Jersey.  All of the participants were at least 21 years old, able to read/understand English, and reported a current mental health or substance abuse disorder and/or being a mental health peer specialist. The participants were asked whether they experienced any symptoms of anxiety or depression during the previous two weeks and, if so, how long those symptoms lasted. Additionally, the participants answered closed- and open-ended survey questions about how the COVID-19 pandemic had affected them. They were asked whether they experienced changes in eating habits, sleeping habits, living situation, and access to healthcare and medications, and, if so, to describe those changes. They were also asked whether their daily activities and routines put them at risk of exposure to COVID-19. Finally, they were asked to describe, in their own words, the effect of the pandemic on their lives.

When reviewing the results, the researchers found that the participants had slightly higher levels of anxiety and depression symptoms, generally, when compared to surveys of the general population. About a third (35%) of the participants reported symptoms of anxiety compared to about a quarter of the general population. Slightly fewer (30%) participants reported symptoms of depression, but this was still higher than the general population at about 25%.

When the researchers looked at the results for changes among the participants, they found that

  • More than half of all participants reported some change to eating or sleeping habits.
  • About 8% reported a change in their living situation.
  • About 9% of participants reported trouble getting medications and about 19% reported not being able to obtain health care.
  • More than half reported that their activities and routines put them at risk for exposure to COVID-19.

The researchers found that the participants who reported more anxiety or depression symptoms were much more likely to also report changes in eating habits, altered sleep patterns, and unmet needs for health care. This was true regardless of gender, age, or state of residence.

The researchers analyzed the participants’ descriptions of the effects of COVID-19 on their lives. They described the negative impact of being diagnosed with or having family or friends diagnosed with the virus, disrupted routines, feelings of anxiety and sadness, stress of financial and job losses, being overwhelmed with negative information and news about the pandemic, and feelings of social isolation. They also described some positive impacts, such as being able to stay at home to avoid anxiety-inducing crowds, time to take care of the home and be with family, and the benefits of virtual communication to connect with family and friends or to schedule telemedicine visits. Some participants also described improvements in their ability to manage upsetting feelings and emotions and build resilience. They expressed gratitude for relationships, rewarding jobs, food security, and access to medications to help them cope. Among the wellness and self-care strategies, participants mentioned mindfulness, journaling, meditating, and videoconferencing, including leading virtual support groups and offering wellness assistance to others.

The authors noted that all of the participants received services and supports through community mental health programs and suggested that the participants’ ability to cope may be related to their access to wellness services and peer support through these programs. The researchers also added that the participants who were peer leaders may have found meaning and purpose associated with helping others, and therefore strengthened their own resilience.

The authors noted that the participants of this study were all from one region and all participated in community mental health programs, so they may not represent the general population of adults with mental and behavioral health challenges. However, they suggested that the results of this study may provide valuable insight into the potential benefits of adding peer support and wellness services, either in person or virtual, to traditional mental health services to help people manage their emotional distress and cope over the long term. Psychiatric rehabilitation services may also help those impacted by the pandemic to find and maintain housing, find employment or return to work, and find safe ways to participate in community life. These solutions may help the general population of people with mental and behavioral health disorders manage the long-term mental health effects of the COVID-19 pandemic.

To Learn More

The Center for Integrated Health Care and Self-Directed Recovery offers a suite of guides, tools, and resources to help people with psychiatric and behavioral disorders manage their physical and mental health and wellness, including the following COVID-related resources:

The Transitions to Adulthood Center for Research is curating a large collection of resources to help people with mental health conditions, especially young people, cope during the COVID-19 pandemic. This includes articles and factsheets produced by the center and its peer researchers.

To Learn More About this Study

Jonikas, J.A., et al. (2021) The impact of the COVID-19 pandemic on the mental health and daily life of adults with behavioral health disorders. Translational Behavioral Medicine, 2021. This article is available from the NARIC collection under Accession Number J86100 and free in full text from the publisher.

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