Short-term changes in mental health help-seeking behaviors following exposure to multiple social stressors and a natural disaster

Abstract

In 2020, unprecedented circumstances led to significant mental health consequences. Individuals faced mental health stressors that extended beyond the devastating impact of the COVID-19 pandemic, including widespread social unrest following the murder of George Floyd, an intense hurricane season in the Atlantic, and the politically divisive 2020 election. The objective of this analysis was to consider changes in help-seeking behavior following exposure to multiple social stressors and a natural disaster. Data from Crisis Text Line (CTL), a national text-based mental health crisis counseling service, was used to determine how help-seeking behavior changed in the wake of each event. Wilcoxon rank sum tests assessed changes in help-seeking behavior for each event in 2020 as compared to the same period in 2019. AutoRegressive Integrated Moving Average (ARIMA) models examined if changes in crisis conversation volumes following each event differed. Higher median conversation volumes noted for the COVID-19 pandemic (+1 to +5 conversations), Hurricane Laura (+1 to +7 conversations) and the 2020 Election (+1 to +26 conversations). ARIMA models show substantial increases in help-seeking behavior following the declaration of a national emergency for the COVID-19 pandemic (+4.3 to +38.2%) and following the 2020 election (+3 to +24.44%). Our analysis found that the mental health response following social stressors may be distinct from natural events, especially when natural disasters occur in the context of multiple social stressors. This analysis adds to the growing body of literature considering the mental health impact of exposure to multiple co-occurring societal stressors, like police violence and a global pandemic.

Keywords: 2020 election; ARIMA modeling; COVID-19 pandemic; George Floyd; Hurricane laura.

Figure 1.

Wilcoxon-Rank Sum Box Plots illustrating changes in median crisis conversation volume for the COVID-19 pandemic (March 13th - April 10th, 2019 and March 13th - April 10th, 2020), the murder of George Floyd (May 25th - June 22nd, 2019 and May 25th - June 22nd, 2020), Hurricane Laura (August 27th - September 24th, 2019 and August 27th - September 24th, 2020) and the election (November 3rd - December 1st, 2019 and November 3rd - December 1st, 2020).

Figure 2.

Forecast total crisis conversation volume for each event. The forecast volume is indicated with the dotted red line, and the light blue illustrates the 95% Confidence Interval.