An analysis of 8 million mental health helpline calls from 19 countries early in the pandemic reveals a 35% jump in calls related to fear and loneliness rather than to problems with relationships, finances, domestic violence, and suicidal thoughts that dominated before COVID-19 emerged.
The study, published yesterday in Nature, suggests that concerns related directly to the pandemic replaced, rather than aggravated, common underlying anxieties, the researchers said.
The study team, led by researchers from the University of Lausanne in Switzerland, said they used helpline call data because they provide a real-time picture of the state of public mental health, unaffected by the design and framing of a study.
The researchers evaluated data from 23 helplines in 14 European countries, the United States, China, Hong Kong, Israel, and Lebanon from 2019 to early 2021, taking into account differences in the timing of local COVID-19 waves and pandemic-related policy measures.
Fear, loneliness amid lockdowns
Of calls to the 21 helplines for which daily data were available, volume rose 13.5% above prepandemic levels. After peaking at week 6 at 35% above pre–COVID-19 levels, call volumes began to decline, reaching 6.2% above prepandemic levels in week 11.
When the investigators defined the beginning of the pandemic as the time when stay-at-home orders were first issued, call volumes rose to 11.2% above prepandemic levels by week 2, climbed to 27% by week 3 until week 8, and then declined. The authors attributed the differences in time profiles to variations in implementation of stay-at-home orders, which typically occurred 2 or 3 weeks after local outbreaks.
Call volumes could have been limited owing to helpline capacity; at first, some helplines were unable to answer all calls and then gradually increased capacity to meet demand, the researchers said. As a result, total call numbers in the study should be interpreted as a low estimate of the true increase in calls.
“However, unanswered calls are not pre-screened, and call answering is thus a random process unrelated to the motives of the caller,” the authors wrote. “Thus our data provide representative information on the reasons for calling even if some calls were left unanswered because of capacity constraints.”