Associations among state-level physical distancing measures and mental health outcomes among U.S. adults during the early COVID-19 pandemic

Purpose: The purpose of this study was to identify leading sources of stress, describe rates of mental health outcomes, and examine their associations among U.S. adults during the first months of the COVID-19 pandemic. Method: In a cross-sectional, general population survey conducted from March 18 to April 4, 2020, U.S. adults (n=10,625) were recruited through Qualtrics Panels using quota sampling methods. Results: Life stressors, probable depression, past-month suicide ideation, and past-month suicide attempts were not elevated among participants subject to state-level stay-at-home orders and/or large gatherings bans. Multiple life stressors were associated with increased rates of probable depression. Past-month suicide ideation was significantly higher among participants reporting ongoing arguments with a partner and serious legal problems. Past-month suicide attempt was significantly higher among participants reporting concerns about a life-threatening illness or injury, but was significantly lower among participants reporting an unexpected bill or expense. Conclusions: Results failed to support the conclusion that physical distancing measures are correlated with worse mental health outcomes. Concerns about life-threatening illness or injury was uniquely associated with increased risk of suicide attempt.