In 2019, the Massachusetts Behavioral Risk Factor Surveillance System survey found that 11 percent of respondents reported poor mental health. More recently, the Department of Public Health (DPH) conducted the COVID-19 Community Impact Survey (CCIS); the findings of this survey revealed poor mental health rates three times higher than the 2019 survey.
The survey was conducted between September and November 2020 and had more than 35,000 responses. Any Massachusetts resident 14 years old and older was eligible to respond.
Initial results were released February 17, 2021; updated findings were reported May 12, 2021.
According to Sanouri Ursprung, director, Office of Statistics and Evaluation, Bureau of Community Health and Prevention, Massachusetts Department of Public Health, the broad goals of the survey were to: identify the most pressing immediate and long-term needs created by the pandemic, including its social and economic consequences, and to determine who was most impacted in order to inform and prioritize the department’s resource deployment and policy actions. It is also to help inform and prioritize their partners’ pandemic response.
DPH intentionally reached out to populations often not captured in traditional data systems by conducting community engagement during recruitment and provided the survey in 11 languages, including English, Spanish, Portuguese, Traditional Chinese, Simplified Chinese, Haitian Creole, and Vietnamese.
DPH aims to share the data with communities for their own use and with DPH-specific and external stakeholders; DPH will track policies and efforts put in place to address the most urgent findings.
DPH hopes to engage communities in interpreting and framing the data to challenge dominant false narratives about health and to highlight how the pandemic has exacerbated existing structural and systemic causes of inequities.
Furthermore, DPH plans to identify the best opportunities for collaboration with its stakeholders to address inequities together.
The findings showed that while one in three adults reported having 15 or more days of poor mental health, people with disabilities were impacted most and caregivers or parents/guardians of individuals with special needs also experienced poor mental health.
Individuals who identify as LGBQT+; those who are multiracial; American Indian/Alaska Native and Hispanic/Latinx; between 25 and 34 years of age; and people with incomes below $35,000 also cited elevated rates of poor mental health that lasted 15 or more days.
Access and/or delays to appropriate routine and/or urgent mental health care proved to be problematic for many respondents. Overall, 27 percent reported delays in urgent mental health care, while 17 percent cited delays in routine mental health care.
The reasons for delayed care varied. More than half the respondents canceled or delayed an appointment. Another 27 percent expressed fear of contracting COVID-19 from a medical caregiver and eight percent feared their insurance would not cover the cost of services. Seven percent did not have safe transportation to keep an appointment.
Telehealth services were available, but seven percent said they did not have access to a private phone or computer for this type of appointment.
According to Ursprung, DPH intentionally conducted every step of the survey in direct coordination with its community partners. “These ranged from population-specific groups like Cambodian Mutual Assistance, the Massachusetts Commission for the Deaf and Hard of Hearing, and the Mashpee Wampanoag Tribe, to geographic-based groups like the Chinatown Neighborhood Association of Boston or the Lawrence/Methuen Coalition,” she said.
Ursprung added that there was participation across sectors, including grant giving organizations, youth-serving organizations, community centers, and municipal partners that included Springfield, Fitchburg, Leominster, Lowell, Chelsea, Boston, and others.
Ursprung said, “DPH hopes to do more surveys like this and is planning to use the successes of the CCIS to build up additional health equity data infrastructure that allows us to better reach populations who are often excluded and to elevate their stories and experiences.”