NHIS Data Set Pre-Pandemic Anxiety, Depression Benchmarks

Before the COVID-19 pandemic, 15% of U.S. adults had anxiety symptoms and 18.5% had depressive symptoms, data from the 2019 National Health Interview Survey indicated.

Women were more likely than men to report signs of anxiety (19% vs 11.9%, P<0.05) and depression (21.8% vs 15%, P<0.05) in the two weeks prior to the survey. Women were also more likely than men to have received mental health treatment in the past year (24.7% vs 13.4%, P<0.05), reported Emily P. Terlizzi, MPH, of the National Center for Health Statistics (NCHS) in Bethesda, Maryland, and colleagues.

The youngest adults surveyed (age 18-29) had the highest rates of anxiety and depression at 19.5% and 21%, respectively, yet they were also less likely to take medication for their mental health compared to adults 45 and up (13.6% vs 17.6%-17.7%). However, young adults did receive counseling at a higher rate than adults 45 and older (11.6% vs 5.7%-9.1%), they wrote in an NCHS Data Brief.

"While the percentage of adults who had taken medication for their mental health increased with age, the percentage who had received counseling or therapy decreased with age," the authors wrote.

This data was collected before the pandemic but more recent evidence suggests the prevalence of mental health conditions is even higher today. In a CDC survey conducted in June 2020, 30.9% of adults reported anxiety or depression.

Altogether, 19.2% of adults and 13.6% of children in the survey had received either pharmacologic therapy or counseling in the past 12 months. Although the prevalence of mental health conditions among children was not reported, prior estimates suggest about 16.5% of school-age children have been diagnosed with a mental health disorder.

In the survey, boys were more likely than girls to have taken medication for their mental health compared to girls (9.8% vs 7%, P<0.05), but the rate at which boys and girls received counseling was similar (10.3% vs 9.7%).

Black and white adults reported experiencing depression at the same rate (19.3%), but Black people were less likely to have accessed treatment for mental health than white people in the past year (13.6% vs 23%, P<0.05), researchers reported. Hispanic respondents also reported relatively high rates of depression (16.9%), but received mental health treatment at a significantly lower rate compared to white people (12.9% vs 23%, P<0.05).

White children were also more likely than Hispanic and Black children to receive mental health treatment for their conditions (17.7% vs 9.2% and 8.7%, respectively), the authors noted.

The NHIS relies on self-reported answers from household members, collected through in-person interviews. Depression and anxiety symptoms were assessed through the Patient Health Questionnaire depression scale (PHQ–8) and the Generalized Anxiety Disorder scale (GAD–7), respectively. This year's survey is ongoing, although some data are now collected by telephone instead, due to the pandemic.

In 2019 data, a higher percentage of adult respondents received mental health treatment in rural areas than in small or large metropolitan areas (17.9% vs 10.6% and 21.5%, respectively). Among children, mental health treatment rates increased as residential areas became less urban as well.

"Past research has shown that nonmetropolitan, or more rural, counties have a lower supply of mental health professionals per capita but a higher prevalence of adults who had experienced a mental illness compared with metropolitan, or more urban, counties," the investigators wrote.

Finally, teens between 12-17 years were more likely to have received mental health treatment in the prior year compared to younger adolescents between 5-11 years (16.8% vs 10.8%), "which is consistent with a higher prevalence of mental health conditions seen among older children," they noted.