Americans were already struggling with historic levels of mental health problems amid the coronavirus pandemic. Then came the video of George Floyd’s death at the hands of police.
Within a week, anxiety and depression among African Americans shot to higher rates than experienced by any other racial or ethnic group, with 41% screening positive for at least one of those symptoms, data from the Census Bureau shows.
The findings — from a survey launched by the federal government originally intended to study the effects of the novel coronavirus — indicate that the recent unrest, demonstrations and debate have exacted a disproportionate emotional and mental toll on black and Asian Americans, even as rates of anxiety and depression remain relatively flat among white Americans and decreased among Latino Americans.
The rate of black Americans showing clinically significant signs of anxiety or depressive disorders jumped from 36% to 41% in the week after the video of Floyd's death became public. That represents roughly 1.4 million more people.
Among Asian Americans, those symptoms increased from 28% to 34%, a change that represents an increase of about 800,000 people.
The new data comes from an emergency weekly survey of U.S. households launched by the Census Bureau at the end of April to measure the pandemic's effects on finances, housing, education and health. In the most recent data release, more than 1 million households were contacted through email and text, and more than 100,000 responded, creating a robust sample size for the findings. Analysis of the data was conducted by multiple federal agencies including the Census Bureau and the Centers for Disease Control and Prevention's National Center for Health Statistics.
Included in the 20-minute survey — called the 2020 Household Pulse Survey — were questions from two screening tools used by doctors to help determine whether patients might have major depressive disorder or generalized anxiety disorder. The results provide a real-time window into the country’s collective mental health.
Data collected in 2019, released two weeks ago by the CDC, allows for the most accurate comparison to date of America's mental health from before the pandemic to after.
And that comparison is stark: Rates of depression and anxiety symptoms have more than tripled since the coronavirus hit.
But the increases have hit black Americans especially hard.
"When we think about the impact of covid-19 among black Americans and other underserved populations - they have had to remain in the workforce or they have felt the effect of unemployment," said Erlanger Turner, a licensed psychologist and assistant professor of psychology at Pepperdine University. "When you add the police killings from the last couple of weeks, it makes sense that you would see additional stress among the black community."
The census survey collects data over a six-day period weekly, from Thursday to the following Tuesday. The video of George Floyd's death began circulating widely online May 26, the last day of data collection for week four. The following week, May 28 to June 2, mass protests spread across the country.
In the wake of such incidents — as footage keeps replaying and debates ignite throughout the country — “it can feel like it’s happening to you over and over,” said Wizdom Powell, director of the University of Connecticut’s Health Disparities Institute. “You start seeing symptoms of hyper vigilance, emotional numbing and secondary trauma.”
A 2018 study in the journal Lancet found that following police shootings, African Americans suffer higher levels of psychological distress than white people even when they live in the same community.
"It's hard for others outside of the community to understand the level to which we feel each others' pain," said Turner, author of "Mental Health among African Americans." "With the George Floyd killing and other killings, we don't have a personal connection to those individuals. But it could have been us or someone we know, and that does lead to additional stress and anxiety around these incidents."
One surprising finding in the new census data was that Asian Americans experienced the largest one-week change in anxiety and depression symptoms of any racial or ethnic group. Asians had the lowest rates of depression in 2019 — just 3% screened positive — but that rate has soared sevenfold during the pandemic.
For months, since the emergence of the coronavirus in Wuhan, China, Asian Americans have experienced marked racism.
"Given how this pandemic started, with discrimination against Asian Americans, it's not hard to imagine that as the national conversation started turning back to race and racial violence, you see anxiety and depression start resurfacing," Powell said.
Asian Americans have seen a rise in hate crimes and harassment, their businesses have been targeted by vandals and looters, and Asian doctors and nurses have been abused and physically attacked even as they help the United States fight the coronavirus.
"In my private practice, I've seen a huge uptick," said Michi Fu, a psychologist in Los Angeles with expertise in working with Asian American families. "What worries me about this increase in trauma and stress are all those who aren't seeking help because Asian Americans are especially less likely to do that when it comes to mental health. Compared to other ethnic groups, the stigma is just incredibly strong."
Latino Americans began the pandemic with higher rates of symptoms than all other groups, but those symptoms decreased during the past week. Experts say this may be a reflection of some measure of relief that after three years of intense focus on immigration and their community during the Trump administration, the attention is turning toward other groups.
"I remember when 9/11 happened, there was such a focus on Middle Eastern communities, and there were a lot of ethno-cultural communities that were relieved that the focus was no longer on them," said Miguel Gallardo, psychology professor at Pepperdine University and a director of the Aliento Center for Latino communities. "Now, we're talking about Black Lives Matter, and for some community members, it represents a shift from the focus on immigrants and the LatinX community."
Gallardo said that for some members of the Hispanic community, symptoms of anxiety and depression may also have been alleviated by joining campaigns that are pushing for changes in policing.
Experts say the disproportionate effect of the pandemic and racial unrest on black and Asian Americans highlights the need for improving mental health support for those groups — with better access to health care, awareness campaigns and encouragement to seek help.
Minority communities, experts said, often have the greatest need but the least access to the country's mental health-care system.
“We also need to think beyond just patching up the wounds,” Powell said. “You can’t just address the trauma. You need to address the cause of the trauma, and that is the structural and systemic racism in the first place that sparked these protests and everything else we’re seeing now.”