This article is part of a series in which OECD experts and thought leaders — from around the world and all parts of society — address the COVID-19 crisis, discussing and developing solutions now and for the future. Aiming to foster the fruitful exchange of expertise and perspectives across fields to help us rise to this critical challenge, opinions expressed do not necessarily represent the views of the OECD.

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The onset of the coronavirus pandemic upended life for many individuals around the world. In addition to the impact on health care systems, businesses and schools shut down, and offices shifted to remote work. Much of the past two years has been spent in varying degrees of lockdown across many countries, disrupting mental health services in 93% of countries according to a 2020 World Health Organization survey. Research by the OECD suggests that the prevalence of anxiety and depression increased across many member countries in 2020.

Though the United States accounts for only about 4% of the world’s total population, it has experienced approximately 19% of all COVID-19 cases and 15% of deaths attributed to the disease. The pandemic has imposed significant economic and social challenges across the country, though Americans are not impacted equally. For example, Hispanic women, immigrants, young adults and those with less education were more likely to suffer employment losses. About half (52%) of employed parents with children younger than 12 in the household said it has been difficult to manage childcare during the pandemic. And the share of young adults living with at least one parent increased sharply in 2020.

A Pew Research Center survey conducted in February 2021 found that about one in five United States adults (21%) were experiencing a high level of psychological distress. Respondents were sorted into high, medium or low distress groups based on their responses to a set of questions assessing the frequency of trouble sleeping, anxiety, depression, loneliness and physical distress. Barring the item on physical reactions, none of the questions asked specifically about the COVID-19 pandemic. (For more information on this methodology, see Many Americans continue to experience mental health difficulties as pandemic enters second year.)

The share of Americans in the high distress group decreased slightly from when this set of questions was first asked in March 2020. In the earliest weeks of the pandemic, about a quarter (24%) of United States adults could be categorised as experiencing high levels of distress.

Levels of psychological distress varied across demographic groups, aligning with previous research from mental health experts. Differences in gender, age, income and disability status were linked to a high level of psychological distress. For example, about a quarter (24%) of women fell into the high distress category, compared with 16% of men. Roughly a third (32%) of young adults ages 18 to 29 were placed in the high distress group, compared with 13% of those 65 and older. A similar share (31%) of those with lower family incomes belonged to the high psychological distress group, compared with 13% of those with the highest incomes. These patterns across gender, age and income were also observed in the March 2020 survey. One particularly large difference was between those who have a disability or health condition that keeps them from participating fully in work and those who do not: 36% of those with a disability fell into the high distress group, compared with 17% of those who do not have a disability.

Unsurprisingly, psychological distress was higher among those who were broadly worried about the pandemic’s impact on society and themselves. Those who viewed the coronavirus outbreak as a major threat to public health (24%) were more likely to be in the high distress group than those who considered COVID-19 to be a minor threat or not a threat at all (16%). Americans who were very or somewhat concerned they would get the coronavirus and require hospitalisation were more likely to be in the high distress group than those who were less concerned. (This survey was fielded as vaccines were becoming more widely available across the country.) And those who said they have had COVID-19 were more likely to experience a high level of distress than those who said they have not experienced the disease (26% vs. 19%, respectively).

The pandemic has particularly impacted young adults, both in the United States and across the world, disrupting school and early career opportunities. Americans ages 18 to 29 were also particularly likely to score highly on this measure of distress: 32% fell into the high distress category, compared with 21% of all United States adults. Among young adults, subgroups that were more likely to be sorted into the high distress group included women, those with a lower income and those who are unmarried.

Young people were also more likely than their older counterparts to say they have felt anxious, depressed or lonely, or had trouble sleeping occasionally, most or all of the time. For example, 45% of those ages 18 to 29 reported feeling anxious at least occasionally, about double the share who said the same among those 65 and older (22%). Young adults were also more likely than older adults to say they had physical reactions, such as sweating, trouble breathing, nausea or a pounding heart, when thinking about their experience with the coronavirus outbreak, though this phenomenon was less widespread than emotional responses.

Potentially compounding distress among Americans is the sense that life will not return to normal anytime soon. A March 2021 Pew Research Center survey found that 57% believe it will be one year or more before public activities operate as they did before the COVID-19 outbreak, including 14% who say it will take more than two years.

Note: Here are the mental health questions used for this analysis, along with responses, and the detailed survey methodology statements for March 2020, late April 2020 and February 2021.

As part of an OECD Forum series, the virtual event Working it Out: Mental Health & Employment will take place on 4 November 2021, 14:30–16:00 CET—register now!

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