The COVID-19 pandemic has exacerbated unmet mental health needs among adults in the U.S and resulted in significant strains on the U.S. healthcare system. This descriptive, quantitative study aims to investigate reports of unmet mental health needs among adults in the U.S. prior to, and after the onset of the COVID-19 (SARS-CoV-2) pandemic. The purpose of this study is to critically examine state level characteristics and public health response approaches to better understand the contributing factors to mental illness and unmet mental health needs in the U.S. The specific objectives of this study include 1) To create a comprehensive national, longitudinal dataset; 2) To investigate state level variability in regards to mental health outcomes, contrasting states with better and worse mental health indicators; 3) To examine COVID-19 response legislation on mental illness (depression), contrasting states with more restrictive and less restrictive COVID-19 response measures, and 4) To provide an in-depth comparison of the best and worst ranked states.
A major component of this dissertation is the development of a comprehensive state-level dataset that links key state characteristics related to mental illness and COVID-19 response measures to aggregate individual self-report mental health data. The dataset (n=50) consists of 206 total variables sourced from 8 data sources. Descriptive statistics, frequencies, and bivariate analyses were run in SPSS Statistics 28 to determine if there were any correlations among state level characteristics, COVID-19 response measures, and unmet mental health needs. Findings suggest slight correlations among meso- and macrosystem level variables which could be indicative of the impacts of the COVID-19 pandemic on economic and mental health outcomes. Economic characteristics at the macro-system level, such as household income and healthcare spending, look to be associated with better mental health rankings.
This dissertation research provides an original contribution to the field of public health as there is minimal existing literature pertaining to the influence of state level variability on mental illness and unmet mental health needs. This research also provides the groundwork for future studies to build upon the data collected on state level factors which influence mental health outcomes, and to explore the inter-relationships between the U.S. healthcare and economic systems. In terms of health policy, this data and subsequent research will provide guidance for improvements regarding mental health advocacy and reform efforts.