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55 research questions about mental health

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Research in the mental health space helps fill knowledge gaps and create a fuller picture for patients, healthcare professionals, and policymakers. Over time, these efforts result in better quality care and more accessible treatment options for those who need them.

Use this list of mental health research questions to kickstart your next project or assignment and give yourself the best chance of producing successful and fulfilling research.

• Why does mental health research matter?

Mental health research is an essential area of study. It includes any research that focuses on topics related to people’s mental and emotional well-being.

As a complex health topic that, despite the prevalence of mental health conditions, still has an unending number of unanswered questions, the need for thorough research into causes, triggers, and treatment options is clear.

Research into this heavily stigmatized and often misunderstood topic is needed to find better ways to support people struggling with mental health conditions. Understanding what causes them is another crucial area of study, as it enables individuals, companies, and policymakers to make well-informed choices that can help prevent illnesses like anxiety and depression.

• How to choose a strong mental health research topic

As one of the most important parts of beginning a new research project, picking a topic that is intriguing, unique, and in demand is a great way to get the best results from your efforts.

Mental health is a blanket term with many niches and specific areas to explore. But, no matter which direction you choose, follow the tips below to ensure you pick the right topic.

Prioritize your interests and skills

While a big part of research is exploring a new and exciting topic, this exploration is best done within a topic or niche in which you are interested and experienced.

Research is tough, even at the best of times. To combat fatigue and increase your chances of pushing through to the finish line, we recommend choosing a topic that aligns with your personal interests, training, or skill set.

Consider emerging trends

Topical and current research questions are hot commodities because they offer solutions and insights into culturally and socially relevant problems.

Depending on the scope and level of freedom you have with your upcoming research project, choosing a topic that’s trending in your area of study is one way to get support and funding (if you need it).

Not every study can be based on a cutting-edge topic, but this can be a great way to explore a new space and create baseline research data for future studies.

Assess your resources and timeline

Before choosing a super ambitious and exciting research topic, consider your project restrictions.

You’ll need to think about things like your research timeline, access to resources and funding, and expected project scope when deciding how broad your research topic will be. In most cases, it’s better to start small and focus on a specific area of study.

Broad research projects are expensive and labor and resource-intensive. They can take years or even decades to complete. Before biting off more than you can chew, consider your scope and find a research question that fits within it.

Read up on the latest research

Finally, once you have narrowed in on a specific topic, you need to read up on the latest studies and published research. A thorough research assessment is a great way to gain some background context on your chosen topic and stops you from repeating a study design. Using the existing work as your guide, you can explore more specific and niche questions to provide highly beneficial answers and insights.

• Trending research questions for post-secondary students

As a post-secondary student, finding interesting research questions that fit within the scope of your classes or resources can be challenging. But, with a little bit of effort and pre-planning, you can find unique mental health research topics that will meet your class or project requirements.

Examples of research topics for post-secondary students include the following:

How does school-related stress impact a person’s mental health?

To what extent does burnout impact mental health in medical students?

How does chronic school stress impact a student’s physical health?

How does exam season affect the severity of mental health symptoms?

Is mental health counseling effective for students in an acute mental crisis?

• Research questions about anxiety and depression

Anxiety and depression are two of the most commonly spoken about mental health conditions. You might assume that research about these conditions has already been exhausted or that it’s no longer in demand. That’s not the case at all.

According to a 2022 survey by Centers for Disease Control and Prevention (CDC), 12.5% of American adults struggle with regular feelings of worry, nervousness, and anxiety, and 5% struggle with regular feelings of depression. These percentages amount to millions of lives affected, meaning new research into these conditions is essential.

If either of these topics interests you, here are a few trending research questions you could consider:

Does gender play a role in the early diagnosis of anxiety?

How does untreated anxiety impact quality of life?

What are the most common symptoms of anxiety in working professionals aged 20–29?

To what extent do treatment delays impact quality of life in patients with undiagnosed anxiety?

To what extent does stigma affect the quality of care received by people with anxiety?

Here are some examples of research questions about depression:

Does diet play a role in the severity of depression symptoms?

Can people have a genetic predisposition to developing depression?

How common is depression in work-from-home employees?

Does mood journaling help manage depression symptoms?

What role does exercise play in the management of depression symptoms?

• Research questions about personality disorders

Personality disorders are complex mental health conditions tied to a person’s behaviors, sense of self, and how they interact with the world around them. Without a diagnosis and treatment, people with personality disorders are more likely to develop negative coping strategies during periods of stress and adversity, which can impact their quality of life and relationships.

There’s no shortage of specific research questions in this category. Here are some examples of research questions about personality disorders that you could explore:

What environments are more likely to trigger the development of a personality disorder?

What barriers impact access to care for people with personality disorders?

To what extent does undiagnosed borderline personality disorder impact a person’s ability to build relationships?

How does group therapy impact symptom severity in people with schizotypal personality disorder?

What is the treatment compliance rate of people with paranoid personality disorder?

• Research questions about substance use disorders

“Substance use disorders” is a blanket term for treatable behaviors and patterns within a person’s brain that lead them to become dependent on illicit drugs, alcohol, or prescription medications. It’s one of the most stigmatized mental health categories.

The severity of a person’s symptoms and how they impact their ability to participate in their regular daily life can vary significantly from person to person. But, even in less severe cases, people with a substance use disorder display some level of loss of control due to their need to use the substance they are dependent on.

This is an ever-evolving topic where research is in hot demand. Here are some example research questions:

To what extent do meditation practices help with craving management?

How effective are detox centers in treating acute substance use disorder?

Are there genetic factors that increase a person’s chances of developing a substance use disorder?

How prevalent are substance use disorders in immigrant populations?

To what extent do prescription medications play a role in developing substance use disorders?

• Research questions about mental health treatments

Treatments for mental health, pharmaceutical therapies in particular, are a common topic for research and exploration in this space.

Besides the clinical trials required for a drug to receive FDA approval, studies into the efficacy, risks, and patient experiences are essential to better understand mental health therapies.

These types of studies can easily become large in scope, but it’s possible to conduct small cohort research on mental health therapies that can provide helpful insights into the actual experiences of the people receiving these treatments.

Here are some questions you might consider:

What are the long-term effects of electroconvulsive therapy (ECT) for patients with severe depression?

How common is insomnia as a side effect of oral mental health medications?

What are the most common causes of non-compliance for mental health treatments?

How long does it take for patients to report noticeable changes in symptom severity after starting injectable mental health medications?

What issues are most common when weaning a patient off of an anxiety medication?

• Controversial mental health research questions

If you’re interested in exploring more cutting-edge research topics, you might consider one that’s “controversial.”

Depending on your own personal values, you might not think many of these topics are controversial. In the context of the research environment, this depends on the perspectives of your project lead and the desires of your sponsors. These topics may not align with the preferred subject matter.

That being said, that doesn’t make them any less worth exploring. In many cases, it makes them more worthwhile, as they encourage people to ask questions and think critically.

Here are just a few examples of “controversial” mental health research questions:

To what extent do financial crises impact mental health in young adults?

How have climate concerns impacted anxiety levels in young adults?

To what extent do psychotropic drugs help patients struggling with anxiety and depression?

To what extent does political reform impact the mental health of LGBTQ+ people?

What mental health supports should be available for the families of people who opt for medically assisted dying?

• Research questions about socioeconomic factors & mental health

Socioeconomic factors—like where a person grew up, their annual income, the communities they are exposed to, and the amount, type, and quality of mental health resources they have access to—significantly impact overall health.

This is a complex and multifaceted issue. Choosing a research question that addresses these topics can help researchers, experts, and policymakers provide more equitable and accessible care over time.

Examples of questions that tackle socioeconomic factors and mental health include the following:

How does sliding scale pricing for therapy increase retention rates?

What is the average cost to access acute mental health crisis care in [a specific region]?

To what extent does a person’s environment impact their risk of developing a mental health condition?

How does mental health stigma impact early detection of mental health conditions?

To what extent does discrimination affect the mental health of LGBTQ+ people?

• Research questions about the benefits of therapy

Therapy, whether that’s in groups or one-to-one sessions, is one of the most commonly utilized resources for managing mental health conditions. It can help support long-term healing and the development of coping mechanisms.

Yet, despite its popularity, more research is needed to properly understand its benefits and limitations.

Here are some therapy-based questions you could consider to inspire your own research:

In what instances does group therapy benefit people more than solo sessions?

How effective is cognitive behavioral therapy for patients with severe anxiety?

After how many therapy sessions do people report feeling a better sense of self?

Does including meditation reminders during therapy improve patient outcomes?

To what extent has virtual therapy improved access to mental health resources in rural areas?

• Research questions about mental health trends in teens

Adolescents are a particularly interesting group for mental health research due to the prevalence of early-onset mental health symptoms in this age group.

As a time of self-discovery and change, puberty brings plenty of stress, anxiety, and hardships, all of which can contribute to worsening mental health symptoms.

If you’re looking to learn more about how to support this age group with mental health, here are some examples of questions you could explore:

Does parenting style impact anxiety rates in teens?

How early should teenagers receive mental health treatment?

To what extent does cyberbullying impact adolescent mental health?

What are the most common harmful coping mechanisms explored by teens?

How have smartphones affected teenagers’ self-worth and sense of self?

• Research questions about social media and mental health

Social media platforms like TikTok, Instagram, YouTube, Facebook, and X (formerly Twitter) have significantly impacted day-to-day communication. However, despite their numerous benefits and uses, they have also become a significant source of stress, anxiety, and self-worth issues for those who use them.

These platforms have been around for a while now, but research on their impact is still in its infancy. Are you interested in building knowledge about this ever-changing topic? Here are some examples of social media research questions you could consider:

To what extent does TikTok’s mental health content impact people’s perception of their health?

How much non-professional mental health content is created on social media platforms?

How has social media content increased the likelihood of a teen self-identifying themselves with ADHD or autism?

To what extent do social media photoshopped images impact body image and self-worth?

Has social media access increased feelings of anxiety and dread in young adults?

• Mental health research is incredibly important

As you have seen, there are so many unique mental health research questions worth exploring. Which options are piquing your interest?

Whether you are a university student considering your next paper topic or a professional looking to explore a new area of study, mental health is an exciting and ever-changing area of research to get involved with.

Your research will be valuable, no matter how big or small. As a niche area of healthcare still shrouded in stigma, any insights you gain into new ways to support, treat, or identify mental health triggers and trends are a net positive for millions of people worldwide.

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Mental health

Mental disorders are among the top 10 leading causes of health loss worldwide, with anxiety and depressive disorders ranked as the most common across all age groups and locations.

Photo by Ashley Batz, Unsplash.

On this page:

Where are mental disorders most common.

The countries with the highest age-standardized prevalence rates of mental disorders in the world are Portugal, Iran, and Lebanon. We also see high prevalence and disability in Australia, Western Europe, and parts of the Americas, including the US and Brazil.

Some of the lowest age-standardized prevalence rates in the world are in parts of Asia, like Viet Nam, Taiwan, and Brunei. 

Some of the variation detected in our prevalence estimates is due to differences in the risk factors for mental disorders and their treatment across countries. However, the quality and availability of epidemiological data vary substantially by country, and this too may bias some of the variation in prevalence detected.  

How can we respond to the burden imposed by mental disorders globally?

There are a number of proven actions governments can take to reduce the burden of mental disorders in their region.

• Work to reduce contributing factors, like financial stress and domestic violence . There are many known risk factors for mental disorders, such as childhood maltreatment, bullying victimization, conflict, and interpersonal violence. Addressing the causes of mental disorders and taking steps to mitigate them is a proactive approach to reducing the burden on the population.  These preventive strategies can take different forms. For instance, we have seen success in the implementation of learning programs in schools to support the social and emotional development of children and youth, build their resilience, and discourage risky behaviors.   
• Increase awareness and reduce stigma. In many regions of the world, mental health can still be a taboo topic. Breaking the stigma can encourage more people to seek care and treatment. Read more about this neglected health challenge in Latin America and the Caribbean.  
• Improve access to effective treatment for mental health. Considerable research has been done to demonstrate the success and cost-effectiveness of a range of pharmacological and psychosocial treatments for mental disorders. The focus now needs to turn to improving the uptake of these treatments within the population and preventive intervention strategies to slow down the emergence of new mental disorder cases.

Dr. Alize Ferrari, Affiliate Associate Professor at IHME

“ It’s important for us to learn from [COVID-19] so we’re better prepared for the next population shock that comes along, whether it’s an economic shock or a shock around conflict, war, and violence – all these things that we already know do impact the prevalence of mental disorders. ”

Are the prevalence and burden of mental disorders increasing over time?

Since 1990, mental disorders have jumped up in the ranking of top causes of health loss worldwide – from 9th to 6th place . 

While the age-standardized prevalence of these conditions has not increased by much, we’re seeing an even greater impact on the overall health of the population. This reflects a general change in the landscape of global health: as we see fewer deaths from infectious diseases like malaria, more people are now living to an age when they’re more likely to be impacted by mental disorders.

Explore the data

How did COVID-19 impact the prevalence and burden of mental disorders?

Before 2020, anxiety and depressive disorders were already significant causes of health loss worldwide, and the COVID-19 pandemic only increased that burden. There were an additional 53 million cases of depressive disorders and 76 million cases of anxiety disorders due to the pandemic, a 28% increase.

We estimated particularly significant increases of mental disorders in women and young people. In 2020, depressive and anxiety disorders were highest in the 20 – 35-year-old age group , and women experienced nearly twice as many new cases as men.

Global burden of depression and anxiety by age and sex in 2020

A few reasons women were uniquely impacted may include: 

• Higher rates of job loss from mandates and lockdowns, resulting in financial insecurity
• Increases in domestic violence during stay-at-home orders
• Greater likelihood for women to take on additional care responsibilities in the home

While there are many known treatments and preventive interventions for mental disorders, large numbers of people around the world still face barriers in accessing those treatments. 

Dr. Alize Ferrari and Dr. Damian Santomauro discuss mental health in our Global Health Insights podcast.

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• Open access
• Published: 13 May 2021

Global prevalence of mental health issues among the general population during the coronavirus disease-2019 pandemic: a systematic review and meta-analysis

• Surapon Nochaiwong   ORCID: orcid.org/0000-0003-1100-7171 1 , 2 ,
• Chidchanok Ruengorn   ORCID: orcid.org/0000-0001-7927-1425 1 , 2 ,
• Kednapa Thavorn   ORCID: orcid.org/0000-0003-4738-8447 2 , 3 , 4 , 5 ,
• Brian Hutton   ORCID: orcid.org/0000-0001-5662-8647 3 , 4 , 5 ,
• Ratanaporn Awiphan   ORCID: orcid.org/0000-0003-3628-0596 1 , 2 ,
• Chabaphai Phosuya 1 ,
• Yongyuth Ruanta   ORCID: orcid.org/0000-0003-4184-0308 1 , 2 ,
• Nahathai Wongpakaran   ORCID: orcid.org/0000-0001-8365-2474 6 &
• Tinakon Wongpakaran   ORCID: orcid.org/0000-0002-9062-3468 6  

Scientific Reports volume  11 , Article number:  10173 ( 2021 ) Cite this article

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• Post-traumatic stress disorder

To provide a contemporary global prevalence of mental health issues among the general population amid the coronavirus disease-2019 (COVID-19) pandemic. We searched electronic databases, preprint databases, grey literature, and unpublished studies from January 1, 2020, to June 16, 2020 (updated on July 11, 2020), with no language restrictions. Observational studies using validated measurement tools and reporting data on mental health issues among the general population were screened to identify all relevant studies. We have included information from 32 different countries and 398,771 participants. The pooled prevalence of mental health issues amid the COVID-19 pandemic varied widely across countries and regions and was higher than previous reports before the COVID-19 outbreak began. The global prevalence estimate was 28.0% for depression; 26.9% for anxiety; 24.1% for post-traumatic stress symptoms; 36.5% for stress; 50.0% for psychological distress; and 27.6% for sleep problems. Data are limited for other aspects of mental health issues. Our findings highlight the disparities between countries in terms of the poverty impacts of COVID-19, preparedness of countries to respond, and economic vulnerabilities that impact the prevalence of mental health problems. Research on the social and economic burden is needed to better manage mental health problems during and after epidemics or pandemics. Systematic review registration : PROSPERO CRD 42020177120.

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Introduction.

After the World Health Organisation (WHO) declared the rapid worldwide spread of coronavirus disease-2019 (COVID-19) to be a pandemic, there has been a dramatic rise in the prevalence of mental health problems both nationally and globally 1 , 2 , 3 . Early international evidence and reviews have reported the psychological effects of the COVID-19 outbreak on patients and healthcare workers, particularly those in direct contact with affected patients 4 , 5 , 6 , 7 , 8 . Besides patients with COVID-19, negative emotions and psychosocial distress may occur among the general population due to the wider social impact and public health and governmental response, including strict infection control, quarantine, physical distancing, and national lockdowns 2 , 9 , 10 .

Amid the COVID-19 pandemic, several mental health and psychosocial problems, for instance, depressive symptoms, anxiety, stress, post-traumatic stress symptoms (PTSS), sleep problems, and other psychological conditions are of increasing concern and likely to be significant 5 , 10 , 11 . Public psychological consequences can arise through direct effects of the COVID-19 pandemic that are sequelae related to fear of contagion and perception of danger 2 . However, financial and economic issues also contribute to mental health problems among the general population in terms of indirect effects 12 , 13 . Indeed, economic shutdowns have disrupted economies worldwide, particularly in countries with larger domestic outbreaks, low health system preparedness, and high economic vulnerability 14 , 15 , 16 .

The COVID-19 pandemic may affect the mental health of the general population differently based on national health and governmental policies implemented and the public resilience and social norms of each country. Unfortunately, little is known about the global prevalence of mental health problems in the general population during the COVID-19 pandemic. Previous systematic reviews have been limited by the number of participants included, and attention has been focussed on particular conditions and countries, with the majority of studies being conducted in mainland China 5 , 8 , 11 , 17 , 18 . To the best of our knowledge, evidence on mental health problems among the general population worldwide has not been comprehensively documented in the current COVID-19 pandemic. Therefore, a systematic review and meta-analysis at a global level is needed to provide robust and contemporary evidence to inform public health policies and long-term responses to the COVID-19 pandemic.

As such, we have performed a rigorous systematic review and meta-analysis of all available observational studies to shed light on the effects of the global COVID-19 pandemic on mental health problems among the general population. We aimed to: (1) summarise the prevalence of mental health problems nationally and globally, and (2) describe the prevalence of mental health problems by each WHO region, World Bank income group, and the global index and economic indices responses to the COVID-19 pandemic.

This systematic review and meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines 19 and reported in line with the Meta-analysis of Observational Studies in Epidemiology statement (Appendix, Table S1 ) 20 . The pre-specified protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020177120).

Search strategy

We searched electronic databases in collaboration with an experienced medical librarian using an iterative process. PubMed, Medline, Embase, PsycINFO, Web of Science, Scopus, CINAHL, and the Cochrane Library were used to identify all relevant abstracts. As the WHO declared the COVID-19 outbreak to be a public health emergency of international concern on January 30, 2020, we limited the search from January 1, 2020, to June 16, 2020, without any language restrictions. The main keywords used in the search strategy included “coronavirus” or “COVID-19” or “SARS-CoV-2”, AND “mental health” or “psychosocial problems” or “depression” or “anxiety” or “stress” or “distress” or “post-traumatic stress symptoms” or “suicide” or “insomnia” or “sleep problems” (search strategy for each database is provided in the Appendix, Table S2 ). Relevant articles were also identified from the reference lists of the included studies and previous systematic reviews. To updated and provide comprehensive, evidence-based data during the COVID-19 pandemic, grey literature from Google Scholar and the preprint reports from medRxiv, bioRxiv, and PsyArXiv were supplemented to the bibliographic database searches. A targeted manual search of grey literature and unpublished studies was performed through to July 11, 2020.

Study selection and data screening

We included observational studies (cross-sectional, case–control, or cohort) that (1) reported the occurrence or provided sufficient data to estimate the prevalence of mental health problems among the general population, and (2) used validated measurement tools for mental health assessment. The pre-specified protocol was amended to permit the inclusion of studies the recruited participants aged 12 years or older and college students as many colleges and universities were closed due to national lockdowns. We excluded studies that (1) were case series/case reports, reviews, or studies with small sample sizes (less than 50 participants); (2) included participants who had currently confirmed with the COVID-19 infection; and (3) surveyed individuals under hospital-based settings. If studies had overlapping participants and survey periods, then the study with the most detailed and relevant information was used.

Eligible titles and abstracts of articles identified by the literature search were screened independently by two reviewers (SN and CR). Then, potentially relevant full-text articles were assessed against the selection criteria for the final set of included studies. Potentially eligible articles that were not written in English were translated before the full-text appraisal. Any disagreement was resolved by discussion.

The primary outcomes were key parameters that reflect the global mental health status during the COVID-19 pandemic, including depression, anxiety, PTSS, stress, psychological distress, and sleep problems (insomnia or poor sleep). To deliver more evidence regarding the psychological consequences, secondary outcomes of interest included psychological symptoms, suicidal ideation, suicide attempts, loneliness, somatic symptoms, wellbeing, alcohol drinking problems, obsessive–compulsive symptoms, panic disorder, phobia anxiety, and adjustment disorder.

Data extraction and risk of bias assessment

Two reviewers (SN and YR) independently extracted the pre-specified data using a standardised approach to gather information on the study characteristics (the first author’s name, study design [cross-sectional survey, longitudinal survey, case–control, or cohort], study country, article type [published article, short report/letters/correspondence, or preprint reporting data], the data collection period), participant characteristics (mean or median age of the study population, the proportion of females, proportion of unemployment, history of mental illness, financial problems, and quarantine status [never, past, or current]), and predefined outcomes of interest (including assessment outcome definitions, measurement tool, and diagnostic cut-off criteria). For international studies, data were extracted based on the estimates within each country. For studies that had incomplete data or unclear information, the corresponding author was contacted by email for further clarification. The final set of data was cross-checked by the two reviewers (RA and CP), and discrepancies were addressed through a discussion.

Two reviewers (SN and CR) independently assessed and appraised the methodological quality of the included studies using the Hoy and colleagues Risk of Bias Tool-10 items 21 . A score of 1 (no) or 0 (yes) was assigned to each item. The higher the score, the greater the overall risk of bias of the study, with scores ranging from 0 to 10. The included studies were then categorised as having a low (0–3 points), moderate (4–6 points), or high (7 or 10 points) risk of bias. A pair of reviewers (RA and CP) assessed the risk of bias of each study. Any disagreements were resolved by discussion.

Data synthesis and statistical methods

A two-tailed P value of less than 0.05 was considered statistically significant. We used Stata software version 16.0 (StataCorp, College Station, TX, USA) for all analyses and generated forest plots of the summary pooled prevalence. Inter-rater agreements between reviewers for the study selection and risk of bias assessment were tested using the kappa (κ) coefficient of agreement 22 . Based on the crude information data, we recalculated and estimated the unadjusted prevalence of mental health and psychological problems using the crude numerators and denominators reported by each of the included studies. Unadjusted pooled prevalence with corresponding 95% confidence intervals (CIs) was reported for each WHO regions (Africa, America, South-East Asia, Europe, Eastern Mediterranean, and Western Pacific) and World Bank income group (low-, lower-middle-, upper-middle-, and high-income).

We employed the variance of the study-specific prevalence using the Freeman–Tukey double arcsine methods for transforming the crude data before pooling the effect estimates with a random-effect model to account for the effects of studies with extreme (small or large) prevalence estimates 23 . Heterogeneity was evaluated using the Cochran’s Q test, with a p value of less than 0.10 24 . The degree of inconsistency was quantified using I 2 values, in which a value greater than 60–70% indicated the presence of substantial heterogeneity 25 .

Pre-planned subgroup analyses were performed based on the participant (i.e., age, the proportion of female sex, the proportion of unemployment, history of mental illness, financial problems, and quarantine status) and study characteristics (article type, study design, data collection, and sample size). To explore the inequality and poverty impacts across countries, subgroup analyses based on the global index and economic indices responses to the COVID-19 pandemic were performed, including (1) human development index (HDI) 2018 (low, medium, high, and very high) 26 ; (2) gender inequality index 2018 (below vs above world average [0.439]) 27 ; (3) the COVID-19-government response stringency index during the survey (less- [less than 75%], moderate- [75–85%], and very stringent [more than 85%]) according to the Oxford COVID-19 Government Response Tracker reports 28 ; (4) the preparedness of countries in terms of hospital beds per 10,000 people, 2010–2018 (low, medium–low, medium, medium–high, and high) 15 ; (5) the preparedness of countries in terms of current health expenditure (% of gross domestic product [GDP] 2016; low, medium–low, medium, medium–high, and high) 15 ; (6) estimated percent change of real GDP growth based on the International Monetary Fund, April 2020 (below vs above world average [− 3.0]) 29 ; (7) the resilience of countries’ business environment based on the 2020 global resilience index reports (first-, second-, third-, and fourth-quartile) 30 ; and (8) immediate economic vulnerability in terms of inbound tourism expenditure (% of GDP 2016–2018; low, medium–low, medium, medium–high, and high) 15 .

To address the robustness of our findings, we conducted a sensitivity analysis by restricting the analysis to studies with a low risk of bias (Hoy and Colleagues-Tool, 0–3 points). Furthermore, a random-effects univariate meta-regression analysis was used to explore the effect of participant and study characteristics, and the global index and economic indices responses to the COVID-19 pandemic as described above on the prevalence estimates.

The visual inspection of funnel plots was performed when there was sufficient data and tested for asymmetry using the Begg’s and Egger’s tests for each specific. A P value of less than 0.10 was considered to indicate statistical publication bias 31 , 32 . If the publication bias was detected by the Begg’s and Egger’s regression test, the trim and fill method was then performed to calibrate for publication bias 33 .

Initially, the search strategy retrieved 4642 records. From these, 2682 duplicate records were removed, and 1960 records remained. Based on the title and abstract screening, we identified 498 articles that seemed to be relevant to the study question (the κ statistic for agreement between reviewers was 0.81). Of these, 107 studies fulfilled the study selection criteria and were included in the meta-analysis (Appendix, Figure S1 ). The inter-rater agreement between reviewers on the study selection and data extraction was 0.86 and 0.75, respectively. The reference list of all included studies in this review is provided in the Appendix, Table S3 .

Characteristics of included studies

In total, 398,771 participants from 32 different countries were included. The mean age was 33.5 ± 9.5 years, and the proportion of female sex was 60.9% (range, 16.0–51.6%). Table 1 summarises the characteristics of all the included studies according to World Bank income group, the global index of COVID-19 pandemic preparedness, and economic vulnerability indices. The included studies were conducted in the Africa (2 studies 34 , 35 [1.9%], n = 723), America (12 studies 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 [11.2%], n = 18,440), South-East Asia (10 studies 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 [9.4%], n = 11,953), Europe (27 studies 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 [25.2%], n = 148,430), Eastern Mediterranean (12 studies 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 [11.2%], n = 23,396), and Western Pacific WHO regions (44 studies 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 [41.1%], n = 195,829). Most of the included studies were cross-sectional (96 studies, 89.7%), used an online-based survey (101 studies, 95.3%), conducted in mainland China (34 studies, 31.8%), and were conducted in countries with upper-middle (49 studies, 45.8%) and high-incomes (44 studies, 41.1%). Detailed characteristics of the 107 included studies, measurement tools for evaluating the mental health status and psychological consequences, and the diagnostic cut-off criteria are described in Appendix, Table S4 . Of the 107 included studies, 76 (71.0%) had a low risk, 31 (29.0%) had a moderate risk, and no studies had a high risk of bias (Appendix, Table S5 ).

Global prevalence of mental health issues among the general population amid the COVID-19 pandemic

Table 2 presents a summary of the results of the prevalence of mental health problems among the general population amid the COVID-19 pandemic by WHO region and World Bank country groups. With substantial heterogeneity, the global prevalence was 28.0% (95% CI 25.0–31.2) for depression (75 studies 34 , 35 , 36 , 37 , 38 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 57 , 58 , 60 , 61 , 64 , 66 , 67 , 68 , 69 , 70 , 71 , 73 , 74 , 75 , 76 , 77 , 80 , 81 , 82 , 83 , 87 , 88 , 91 , 93 , 96 , 97 , 99 , 101 , 104 , 105 , 106 , 107 , 108 , 109 , 112 , 113 , 114 , 116 , 117 , 119 , 120 , 122 , 124 , 125 , 126 , 127 , 129 , 130 , 131 , 132 , 133 , 134 , 136 , 138 , 139 , 140 , n = 280,607, Fig.  1 ); 26.9% (95% CI 24.0–30.0) for anxiety (75 studies 35 , 37 , 38 , 40 , 42 , 43 , 44 , 46 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 57 , 58 , 60 , 61 , 64 , 66 , 67 , 68 , 69 , 71 , 73 , 74 , 75 , 76 , 77 , 80 , 81 , 82 , 83 , 87 , 88 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 104 , 105 , 107 , 108 , 109 , 112 , 113 , 114 , 115 , 116 , 117 , 119 , 120 , 122 , 124 , 125 , 126 , 129 , 130 , 131 , 132 , 133 , 134 , 136 , 138 , 139 , 140 , n = 284,813, Fig.  2 ); 24.1% (95% CI 17.0–32.0) for PTSS (28 studies 35 , 44 , 56 , 59 , 62 , 64 , 66 , 69 , 75 , 78 , 80 , 81 , 82 , 89 , 90 , 91 , 106 , 109 , 110 , 111 , 119 , 123 , 124 , 125 , 127 , 131 , 135 , 138 , n = 56,447, Fig.  3 ); 36.5% (95% CI 30.0–43.3) for stress (22 studies 37 , 50 , 51 , 52 , 53 , 54 , 57 , 58 , 71 , 73 , 75 , 76 , 80 , 114 , 117 , 119 , 120 , 122 , 125 , 129 , 131 , 136 , n = 110,849, Fig.  4 ); 50.0% (95% CI 41.8–58.2) for psychological distress (18 studies 39 , 47 , 52 , 59 , 63 , 65 , 70 , 72 , 78 , 79 , 85 , 86 , 88 , 102 , 110 , 118 , 121 , 128 , n = 81,815, Fig.  5 ); and 27.6% (95% CI 19.8–36.1) for sleep problems (15 studies 35 , 53 , 58 , 80 , 84 , 103 , 106 , 107 , 109 , 119 , 120 , 125 , 134 , 136 , 137 , n = 99,534, Fig.  6 ). The prevalence of mental health problems based on different countries varied (Appendix, Table S6 ), from 14.5% (South Africa) to 63.3% (Brazil) for depressive symptoms; from 7.7% (Vietnam) to 49.9% (Mexico) for anxiety; from 10.5% (United Kingdom) to 52.0% (Egypt) for PTSS; from 19.7% (Portugal) to 72.8% (Thailand) for stress; from 23.9% (China) to Jordan (92.9%) for psychological distress; from 9.2% (Italy) to 53.9% (Thailand) for sleep problems.

Pooled prevalence of depression among the general population amid the COVID-19 pandemic. COVID-19 coronavirus disease 2019, CI confidence interval, df degree of freedom, NA not applicable. References are listed according to WHO region in the appendix, Table S3 .

Pooled prevalence of anxiety among the general population amid the COVID-19 pandemic. COVID-19 coronavirus disease 2019, CI confidence interval, df degree of freedom, NA not applicable. References are listed according to WHO region in the appendix, Table S3 .

Pooled prevalence of PTSS among the general population amid the COVID-19 pandemic. COVID-19 coronavirus disease 2019, CI confidence interval, df degree of freedom, NA not applicable, PTSS post-traumatic stress symptoms. References are listed according to WHO region in the appendix, Table S3 .

Pooled prevalence of stress among the general population amid the COVID-19 pandemic. COVID-19 coronavirus disease 2019, CI confidence interval, df degree of freedom, NA not applicable. References are listed according to WHO region in the appendix, Table S3 .

Pooled prevalence of psychological distress among the general population amid the COVID-19 pandemic. COVID-19 coronavirus disease 2019, CI confidence interval, df degree of freedom, NA not applicable. References are listed according to WHO region in the appendix, Table S3 .

Pooled prevalence of sleep problems among the general population amid the COVID-19 pandemic. COVID-19 coronavirus disease 2019, CI confidence interval, df degree of freedom, NA not applicable. References are listed according to WHO region in the appendix, Table S3 .

With respect to the small number of included studies and high degree of heterogeneity, the pooled secondary outcome prevalence estimates are presented in Appendix, Table S7 . The global prevalence was 16.4% (95% CI 4.8–33.1) for suicide ideation (4 studies 36 , 41 , 53 , 124 , n = 17,554); 53.8% (95% CI 42.4–63.2) for loneliness (3 studies 41 , 44 , 45 , n = 2921); 30.7% (95% CI 2.1–73.3) for somatic symptoms (3 studies 53 , 69 , 134 , n = 7230); 28.6% (95% CI 9.2–53.6) for low wellbeing (3 studies 53 , 68 , 97 , n = 15,737); 50.5% (95% CI 49.2–51.7) for alcohol drinking problems (2 studies 97 , 114 , n = 6145); 6.4% (95% CI 5.5–7.4) for obsessive–compulsive symptoms (2 studies 73 , 134 , n = 2535); 25.7% (95% CI 23.7–27.8) for panic disorder (1 study 74 , n = 1753); 2.4% (95% CI 1.6–3.4) for phobia anxiety (1 study 134 , n = 1255); 22.8% (95% CI 22.1–23.4) for adjustment disorder (1 study 80 , n = 18,147); and 1.2% (95% CI 1.0–1.4) for suicide attempts (1 study 36 , n = 10,625).

Subgroup analyses, sensitivity analyses, meta-regression analyses, and publication bias

In the subgroup analyses (Appendix, Table S8 , Table S9 , Table S10 , Table S1 , Table S12 ), the prevalence of mental health problems was higher in countries with a low to medium HDI (for depression, anxiety, PTSS, and psychological distress), high HDI (for sleep problems), high gender inequality index (for depression and PTSS), very stringent government response index (for PTSS and stress), less stringent government response index (for sleep problems), low to medium hospital beds per 10,000 people (for depression, anxiety, PTSS, stress, psychological distress, and sleep problems), low to medium current health expenditure (for depression, PTSS, and psychological distress), estimated percent change of real GDP growth 2020 below − 3.0 (for psychological distress), low resilience (fourth-quartile) of business environment (for depression, anxiety, and PTSS), medium resilience (second-quartile) of business environment (for psychological distress, and sleep problems), high economic vulnerability-inbound tourism expenditure (for psychological distress, sleep problems), article type-short communication/letter/correspondence (for stress), cross-sectional survey (for PTSS and psychological distress), longitudinal survey (for anxiety and stress), non-mainland China (for depression, anxiety, and psychological distress), sample size of less than 1000 (for psychological distress), sample size of more than 5000 (for PTSS), proportion of females more than 60% (for stress and sleep problems), and measurement tools (for depression, anxiety, stress, and sleep problems). However, several pre-planned subgroup analyses based on participant characteristics and secondary outcomes reported could not be performed due to limited data in the included studies.

Findings from the sensitivity analysis were almost identical to the main analysis (Appendix, Table S14 ). The pooled prevalence by restricting the analysis to studies with a low risk of bias was 28.6% (95% CI 25.1–32.3) for depression, 27.4% (95% CI 24.1–30.8) for anxiety, 30.2% (95% CI 20.3–41.1) for PTSS, 40.1% (95% CI 32.5–47.9) for stress, 45.4% (95% CI 32.0–59.2) for psychological distress, and 27.7% (95% CI 19.4–36.9) for sleep problems.

On the basis of univariate meta-regression, the analysis was suitable for the primary outcomes (Appendix, Table S15 ). The increased prevalence of mental health problems was associated with the WHO region (for depression, anxiety, and psychological distress), female gender inequality index (for depression and anxiety), the COVID-19-government response stringency index during the survey (for sleep problems), hospital beds per 10,000 people (for depression and anxiety), immediate economic vulnerability-inbound tourism expenditure (for sleep problems), study design (cross-sectional vs longitudinal survey; for stress), surveyed country (mainland China vs non-mainland China; for depression and psychological distress), and risk of bias (for PTSS).

The visual inspection of the funnel plots, and the p values tested for asymmetry using the Begg’s and Egger’s tests for each prevalence outcome, indicated no evidence of publication bias related to the sample size (Appendix, Table S16 , and Figure S2 ).

This study is, to the best of our knowledge, the first systematic review and meta-analysis on the overall global prevalence of mental health problems and psychosocial consequences among the general population amid the COVID-19 pandemic. Overall, our findings indicate wide variability in the prevalence of mental health problems and psychosocial consequences across countries, particularly in relation to different regions, the global index of COVID-19 pandemic preparedness, inequalities, and economic vulnerabilities indices.

Two reports examined the global prevalence of common mental health disorders among adults prior to the COVID-19 outbreak. The first study was based on 174 surveys across 63 countries from 1980 to 2013. The estimated lifetime prevalence was 29.1% for all mental disorders, 9.6% for mood disorders, 12.9% for anxiety disorders, and 3.4% for substance use disorder 141 . Another report which was conducted as part of the Global Health Estimates by WHO in 2015, showed that the global estimates of depression and anxiety were 4.4% and 3.6% (more common among females than males), respectively 142 . Despite the different methodological methods used, our findings show that the pooled prevalence of mental health problems during the COVID-19 pandemic is higher than before the outbreak.

Previous studies on the prevalence of mental health problems during the COVID-19 pandemic have had substantial heterogeneity. Three systematic reviews reported the prevalence of depression, anxiety, and stress among the general population (mainly in mainland China). The first of these by Salari et al. 11 , was based on 17 included studies (from ten different countries in Asia, Europe, and the Middle East), the pooled prevalence of depression, anxiety, and stress were 33.7% (95% CI 27.5–40.6), 31.9% (95% CI 27.5–36.7), and 29.6% (95% CI 24.3–35.4), respectively. A review by Luo et al. 8 , which included 36 studies from seven different countries, reported a similar overall prevalence of 27% (95% CI 22–33) for depression and 32% (95% CI 25–39) for anxiety. However, a review by Ren et al. 17 , which focussed on only the Chinese population (8 included studies), found that the pooled prevalence was 29% (95% CI 16–42) and 24% (95% CI 16–32), respectively. Nevertheless, previous systematic reviews have been mainly on investigating the prevalence of PTSS, psychological distress, and sleep problems among the patients or healthcare workers that are limited to the general population during the COVID-19 pandemic. With regard to the general population, a review by Cénat et al. 143 , found that the pooled prevalence of PTSS, psychological distress, and insomnia were 22.4% (95% CI 7.6–50.3; 9 included studies), 10.2% (95% CI 4.6–21.0; 10 included studies), and 16.5% (95% CI 8.4–29.7; 8 included studies), respectively.

In this systematic review and meta-analysis, we updated and summarised the global prevalence of mental health problems and psychosocial consequences during the COVID-19 pandemic using information from 32 different countries, and 398,771 participants. A range of problems, including depression, anxiety, PTSS, stress, psychological distress, and sleep problems were reported. The global prevalence of our findings was in line with the previous reviews mentioned above in terms of depression (28.0%; 95% CI 25.0–31.2), anxiety (26.9%; 95% CI 24.0–30.0), and stress (36.5%; 95% CI 30.0–43.3). Interestingly, our findings highlight the poverty impacts of COVID-19 in terms of inequalities, the preparedness of countries to respond, and economic vulnerabilities on the prevalence of mental health problems across countries. For instance, our results suggest that countries with a low or medium HDI had a higher prevalence of depression and anxiety compared to countries with a high or very high HDI (Appendix, Table S8 , and Table S9 ). The prevalence of depression was higher among countries with a gender inequality index of 0.439 or greater (39.6% [95% CI 30.3–49.3] vs 26.2% [95% CI 23.1–29.3]; P  = 0.020; Appendix, Table S8 ). Likewise, the prevalence of depression and anxiety was higher among countries with low hospital beds per 10,000 people (Appendix, Table S8 , and Table S9 ). Our findings suggest that the poverty impacts of COVID-19 are likely to be quite significant and related to the subsequent risk of mental health problems and psychosocial consequences. Although we performed a comprehensive review by incorporating articles published together with preprint reports, there was only limited data available on Africa, low-income groups, and secondary outcomes of interest (psychological distress, suicide ideation, suicide attempts, loneliness, somatic symptoms, wellbeing, alcohol drinking problems, obsessive–compulsive symptoms, panic disorder, phobia anxiety, and adjustment disorder).

Strengths and limitations of this review

From a methodological point of view, we used a rigorous and comprehensive approach to establish an up-to-date overview of the evidence-based information on the global prevalence of mental health problems amid the COVID-19 pandemic, with no language restrictions. The systematic literature search was extensive, comprising published peer-reviewed articles and preprints reporting data to present all relevant literature, minimise bias, and up to date evidence. Our findings expanded and addressed the limitations of the previous systematic reviews, such as having a small sample size and number of included studies, considered more aspects of mental health circumstance, and the generalisability of evidence at a global level 5 , 6 , 11 , 17 , 18 . To address biases from different measurement tools of assessment and the cultural norms across countries, we summarised the prevalence of mental health problems and psychosocial consequences using a random-effects model to estimate the pooled data with a more conservative approach. Lastly, the sensitivity analyses were consistent with the main findings, suggesting the robustness of our findings. As such, our data can be generalised to individuals in the countries where the included studies were conducted.

There were several limitations to this systematic review and meta-analysis. First, despite an advanced comprehensive search approach, data for some geographical regions according to the WHO regions and World Bank income groups, for instance, the Africa region, as well as the countries in the low-income group, were limited. Moreover, the reporting of key specific outcomes, such as suicide attempts and ideation, alcohol drinking or drug-dependence problems, and stigma towards COVID-19 infection were also limited. Second, a subgroup analysis based on participant characteristics (that is, age, sex, unemployment, history of mental illness, financial problems, and quarantine status), could not be performed as not all of the included studies reported this data. Therefore, the global prevalence of mental health problems and psychosocial consequences amid the COVID-19 pandemic cannot be established. Third, it should be noted that different methods, for example, face-to-face interviews or paper-based questionnaires, may lead to different prevalence estimates across the general population. Due to physical distancing, the included studies in this review mostly used online surveys, which can be prone to information bias and might affect the prevalence estimates of our findings. Fourth, a high degree of heterogeneity between the included studies was found in all outcomes of interest. Even though we performed a set of subgroup analyses concerning the participant characteristics, study characteristics, the global index, and economic indices responses to the COVID-19 pandemic, substantial heterogeneity persisted. However, the univariate meta-regression analysis suggested that the WHO region, gender inequality index, COVID-19-government response stringency index during the survey, hospital beds, immediate economic vulnerability (inbound tourism expenditure), study design, surveyed country (mainland China vs non-mainland China), and risk of bias were associated with an increased prevalence of mental health problems and psychosocial consequences amid the COVID-19 pandemic. Finally, we underline that the diagnostic cut-off criteria used were not uniform across the measurement tools in this review, and misclassification remains possible. The genuine variation in global mental health circumstances across countries cannot be explained by our analyses. Indeed, such variation might be predisposed by social and cultural norms, public resilience, education, ethnic differences, and environmental differences among individual study populations.

Implications for public health and research

Despite the limitations of our findings, this review provides the best available evidence that can inform the epidemiology of public mental health, implement targeted initiatives, improving screening, and reduce the long-term consequences of the COVID-19 pandemic, particularly among low-income countries, or those with high inequalities, low preparedness, and high economic vulnerability. Our findings could be improved by further standardised methods and measurement tools of assessment. There is a need for individual country-level data on the mental health problems and psychosocial consequences after the COVID-19 pandemic to track and monitor public health responses. There are a number network longitudinal surveys being conducted in different countries that aim to improve our understanding of the long-term effects of the COVID-19 pandemic 144 . To promote mental wellbeing, such initiatives could also be advocated for by public health officials and governments to increase awareness and provide timely proactive interventions in routine practice.

Conclusions

In conclusion, this systematic review and meta-analysis provides a more comprehensive global overview and evidence of the prevalence of mental health problems among the general population amid the COVID-19 pandemic. The results of this study reveal that the mental health problems and psychosocial consequences amid the COVID-19 pandemic are a global burden, with differences between countries and regions observed. Moreover, equality and poverty impacts were found to be factors in the prevalence of mental health problems. Studies on the long-term effects of the COVID-19 pandemic on the mental health status among the general population at a global level is needed. Given the high burden of mental health problems during the COVID-19 pandemic, an improvement of screening systems and prevention, prompt multidisciplinary management, and research on the social and economic burden of the pandemic, are crucial.

Data sharing

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors thank the research assistances and all staff of Pharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai, Thailand. This work reported in this manuscript was partially supported by a grant by the Chiang Mai University, Thailand. The funder of the study had no role in the study design collection, analysis, or interpretation of the data, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit it for publication.

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S.N. conceived the study and, together with C.R., K.T., R.A., C.P., and Y.R. developed the protocol. S.N. and C.R. did the literature search, selected the studies. S.N. and Y.R. extracted the relevant information. S.N. synthesised the data. S.N. wrote the first draft of the paper. K.T., B.H., N.W., and T.W. critically revised successive drafts of the paper. All authors approved the final draft of the manuscript. SN is the guarantor of the study.

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Nochaiwong, S., Ruengorn, C., Thavorn, K. et al. Global prevalence of mental health issues among the general population during the coronavirus disease-2019 pandemic: a systematic review and meta-analysis. Sci Rep 11 , 10173 (2021). https://doi.org/10.1038/s41598-021-89700-8

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Mental health and the pandemic: What U.S. surveys have found

The coronavirus pandemic has been associated with worsening mental health among people in the United States and around the world . In the U.S, the COVID-19 outbreak in early 2020 caused widespread lockdowns and disruptions in daily life while triggering a short but severe economic recession that resulted in widespread unemployment. Three years later, Americans have largely returned to normal activities, but challenges with mental health remain.

Here’s a look at what surveys by Pew Research Center and other organizations have found about Americans’ mental health during the pandemic. These findings reflect a snapshot in time, and it’s possible that attitudes and experiences may have changed since these surveys were fielded. It’s also important to note that concerns about mental health were common in the U.S. long before the arrival of COVID-19 .

Three years into the COVID-19 outbreak in the United States , Pew Research Center published this collection of survey findings about Americans’ challenges with mental health during the pandemic. All findings are previously published. Methodological information about each survey cited here, including the sample sizes and field dates, can be found by following the links in the text.

The research behind the first item in this analysis, examining Americans’ experiences with psychological distress, benefited from the advice and counsel of the COVID-19 and mental health measurement group at Johns Hopkins Bloomberg School of Public Health.

At least four-in-ten U.S. adults (41%) have experienced high levels of psychological distress at some point during the pandemic, according to four Pew Research Center surveys conducted between March 2020 and September 2022.

Young adults are especially likely to have faced high levels of psychological distress since the COVID-19 outbreak began: 58% of Americans ages 18 to 29 fall into this category, based on their answers in at least one of these four surveys.

Women are much more likely than men to have experienced high psychological distress (48% vs. 32%), as are people in lower-income households (53%) when compared with those in middle-income (38%) or upper-income (30%) households.

In addition, roughly two-thirds (66%) of adults who have a disability or health condition that prevents them from participating fully in work, school, housework or other activities have experienced a high level of distress during the pandemic.

The Center measured Americans’ psychological distress by asking them a series of five questions on subjects including loneliness, anxiety and trouble sleeping in the past week. The questions are not a clinical measure, nor a diagnostic tool. Instead, they describe people’s emotional experiences during the week before being surveyed.

While these questions did not ask specifically about the pandemic, a sixth question did, inquiring whether respondents had “had physical reactions, such as sweating, trouble breathing, nausea, or a pounding heart” when thinking about their experience with the coronavirus outbreak. In September 2022, the most recent time this question was asked, 14% of Americans said they’d experienced this at least some or a little of the time in the past seven days.

More than a third of high school students have reported mental health challenges during the pandemic. In a survey conducted by the Centers for Disease Control and Prevention from January to June 2021, 37% of students at public and private high schools said their mental health was not good most or all of the time during the pandemic. That included roughly half of girls (49%) and about a quarter of boys (24%).

In the same survey, an even larger share of high school students (44%) said that at some point during the previous 12 months, they had felt sad or hopeless almost every day for two or more weeks in a row – to the point where they had stopped doing some usual activities. Roughly six-in-ten high school girls (57%) said this, as did 31% of boys.

On both questions, high school students who identify as lesbian, gay, bisexual, other or questioning were far more likely than heterosexual students to report negative experiences related to their mental health.

Mental health tops the list of worries that U.S. parents express about their kids’ well-being, according to a fall 2022 Pew Research Center survey of parents with children younger than 18. In that survey, four-in-ten U.S. parents said they’re extremely or very worried about their children struggling with anxiety or depression. That was greater than the share of parents who expressed high levels of concern over seven other dangers asked about.

While the fall 2022 survey was fielded amid the coronavirus outbreak, it did not ask about parental worries in the specific context of the pandemic. It’s also important to note that parental concerns about their kids struggling with anxiety and depression were common long before the pandemic, too . (Due to changes in question wording, the results from the fall 2022 survey of parents are not directly comparable with those from an earlier Center survey of parents, conducted in 2015.)

Among parents of teenagers, roughly three-in-ten (28%) are extremely or very worried that their teen’s use of social media could lead to problems with anxiety or depression, according to a spring 2022 survey of parents with children ages 13 to 17 . Parents of teen girls were more likely than parents of teen boys to be extremely or very worried on this front (32% vs. 24%). And Hispanic parents (37%) were more likely than those who are Black or White (26% each) to express a great deal of concern about this. (There were not enough Asian American parents in the sample to analyze separately. This survey also did not ask about parental concerns specifically in the context of the pandemic.)

Looking back, many K-12 parents say the first year of the coronavirus pandemic had a negative effect on their children’s emotional health. In a fall 2022 survey of parents with K-12 children , 48% said the first year of the pandemic had a very or somewhat negative impact on their children’s emotional well-being, while 39% said it had neither a positive nor negative effect. A small share of parents (7%) said the first year of the pandemic had a very or somewhat positive effect in this regard.

White parents and those from upper-income households were especially likely to say the first year of the pandemic had a negative emotional impact on their K-12 children.

While around half of K-12 parents said the first year of the pandemic had a negative emotional impact on their kids, a larger share (61%) said it had a negative effect on their children’s education.

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John Gramlich is an associate director at Pew Research Center .

How Americans View the Coronavirus, COVID-19 Vaccines Amid Declining Levels of Concern

Online religious services appeal to many americans, but going in person remains more popular, about a third of u.s. workers who can work from home now do so all the time, how the pandemic has affected attendance at u.s. religious services, economy remains the public’s top policy priority; covid-19 concerns decline again, most popular.

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Student mental health is in crisis. Campuses are rethinking their approach

Amid massive increases in demand for care, psychologists are helping colleges and universities embrace a broader culture of well-being and better equipping faculty to support students in need

Vol. 53 No. 7 Print version: page 60

• Mental Health

By nearly every metric, student mental health is worsening. During the 2020–2021 school year, more than 60% of college students met the criteria for at least one mental health problem, according to the Healthy Minds Study, which collects data from 373 campuses nationwide ( Lipson, S. K., et al., Journal of Affective Disorders , Vol. 306, 2022 ). In another national survey, almost three quarters of students reported moderate or severe psychological distress ( National College Health Assessment , American College Health Association, 2021).

Even before the pandemic, schools were facing a surge in demand for care that far outpaced capacity, and it has become increasingly clear that the traditional counseling center model is ill-equipped to solve the problem.

“Counseling centers have seen extraordinary increases in demand over the past decade,” said Michael Gerard Mason, PhD, associate dean of African American Affairs at the University of Virginia (UVA) and a longtime college counselor. “[At UVA], our counseling staff has almost tripled in size, but even if we continue hiring, I don’t think we could ever staff our way out of this challenge.”

Some of the reasons for that increase are positive. Compared with past generations, more students on campus today have accessed mental health treatment before college, suggesting that higher education is now an option for a larger segment of society, said Micky Sharma, PsyD, who directs student life’s counseling and consultation service at The Ohio State University (OSU). Stigma around mental health issues also continues to drop, leading more people to seek help instead of suffering in silence.

But college students today are also juggling a dizzying array of challenges, from coursework, relationships, and adjustment to campus life to economic strain, social injustice, mass violence, and various forms of loss related to Covid -19.

As a result, school leaders are starting to think outside the box about how to help. Institutions across the country are embracing approaches such as group therapy, peer counseling, and telehealth. They’re also better equipping faculty and staff to spot—and support—students in distress, and rethinking how to respond when a crisis occurs. And many schools are finding ways to incorporate a broader culture of wellness into their policies, systems, and day-to-day campus life.

“This increase in demand has challenged institutions to think holistically and take a multifaceted approach to supporting students,” said Kevin Shollenberger, the vice provost for student health and well-being at Johns Hopkins University. “It really has to be everyone’s responsibility at the university to create a culture of well-being.”

Higher caseloads, creative solutions

The number of students seeking help at campus counseling centers increased almost 40% between 2009 and 2015 and continued to rise until the pandemic began, according to data from Penn State University’s Center for Collegiate Mental Health (CCMH), a research-practice network of more than 700 college and university counseling centers ( CCMH Annual Report , 2015 ).

That rising demand hasn’t been matched by a corresponding rise in funding, which has led to higher caseloads. Nationwide, the average annual caseload for a typical full-time college counselor is about 120 students, with some centers averaging more than 300 students per counselor ( CCMH Annual Report , 2021 ).

“We find that high-caseload centers tend to provide less care to students experiencing a wide range of problems, including those with safety concerns and critical issues—such as suicidality and trauma—that are often prioritized by institutions,” said psychologist Brett Scofield, PhD, executive director of CCMH.

To minimize students slipping through the cracks, schools are dedicating more resources to rapid access and assessment, where students can walk in for a same-day intake or single counseling session, rather than languishing on a waitlist for weeks or months. Following an evaluation, many schools employ a stepped-care model, where the students who are most in need receive the most intensive care.

Given the wide range of concerns students are facing, experts say this approach makes more sense than offering traditional therapy to everyone.

“Early on, it was just about more, more, more clinicians,” said counseling psychologist Carla McCowan, PhD, director of the counseling center at the University of Illinois at Urbana-Champaign. “In the past few years, more centers are thinking creatively about how to meet the demand. Not every student needs individual therapy, but many need opportunities to increase their resilience, build new skills, and connect with one another.”

Students who are struggling with academic demands, for instance, may benefit from workshops on stress, sleep, time management, and goal-setting. Those who are mourning the loss of a typical college experience because of the pandemic—or facing adjustment issues such as loneliness, low self-esteem, or interpersonal conflict—are good candidates for peer counseling. Meanwhile, students with more acute concerns, including disordered eating, trauma following a sexual assault, or depression, can still access one-on-one sessions with professional counselors.

As they move away from a sole reliance on individual therapy, schools are also working to shift the narrative about what mental health care on campus looks like. Scofield said it’s crucial to manage expectations among students and their families, ideally shortly after (or even before) enrollment. For example, most counseling centers won’t be able to offer unlimited weekly sessions throughout a student’s college career—and those who require that level of support will likely be better served with a referral to a community provider.

“We really want to encourage institutions to be transparent about the services they can realistically provide based on the current staffing levels at a counseling center,” Scofield said.

The first line of defense

Faculty may be hired to teach, but schools are also starting to rely on them as “first responders” who can help identify students in distress, said psychologist Hideko Sera, PsyD, director of the Office of Equity, Inclusion, and Belonging at Morehouse College, a historically Black men’s college in Atlanta. During the pandemic, that trend accelerated.

“Throughout the remote learning phase of the pandemic, faculty really became students’ main points of contact with the university,” said Bridgette Hard, PhD, an associate professor and director of undergraduate studies in psychology and neuroscience at Duke University. “It became more important than ever for faculty to be able to detect when a student might be struggling.”

Many felt ill-equipped to do so, though, with some wondering if it was even in their scope of practice to approach students about their mental health without specialized training, Mason said.

Schools are using several approaches to clarify expectations of faculty and give them tools to help. About 900 faculty and staff at the University of North Carolina have received training in Mental Health First Aid , which provides basic skills for supporting people with mental health and substance use issues. Other institutions are offering workshops and materials that teach faculty to “recognize, respond, and refer,” including Penn State’s Red Folder campaign .

Faculty are taught that a sudden change in behavior—including a drop in attendance, failure to submit assignments, or a disheveled appearance—may indicate that a student is struggling. Staff across campus, including athletic coaches and academic advisers, can also monitor students for signs of distress. (At Penn State, eating disorder referrals can even come from staff working in food service, said counseling psychologist Natalie Hernandez DePalma, PhD, senior director of the school’s counseling and psychological services.) Responding can be as simple as reaching out and asking if everything is going OK.

Referral options vary but may include directing a student to a wellness seminar or calling the counseling center to make an appointment, which can help students access services that they may be less likely to seek on their own, Hernandez DePalma said. Many schools also offer reporting systems, such as DukeReach at Duke University , that allow anyone on campus to express concern about a student if they are unsure how to respond. Trained care providers can then follow up with a welfare check or offer other forms of support.

“Faculty aren’t expected to be counselors, just to show a sense of care that they notice something might be going on, and to know where to refer students,” Shollenberger said.

At Johns Hopkins, he and his team have also worked with faculty on ways to discuss difficult world events during class after hearing from students that it felt jarring when major incidents such as George Floyd’s murder or the war in Ukraine went unacknowledged during class.

Many schools also support faculty by embedding counselors within academic units, where they are more visible to students and can develop cultural expertise (the needs of students studying engineering may differ somewhat from those in fine arts, for instance).

When it comes to course policy, even small changes can make a big difference for students, said Diana Brecher, PhD, a clinical psychologist and scholar-in-residence for positive psychology at Toronto Metropolitan University (TMU), formerly Ryerson University. For example, instructors might allow students a 7-day window to submit assignments, giving them agency to coordinate with other coursework and obligations. Setting deadlines in the late afternoon or early evening, as opposed to at midnight, can also help promote student wellness.

At Moraine Valley Community College (MVCC) near Chicago, Shelita Shaw, an assistant professor of communications, devised new class policies and assignments when she noticed students struggling with mental health and motivation. Those included mental health days, mindful journaling, and a trip with family and friends to a Chicago landmark, such as Millennium Park or Navy Pier—where many MVCC students had never been.

Faculty in the psychology department may have a unique opportunity to leverage insights from their own discipline to improve student well-being. Hard, who teaches introductory psychology at Duke, weaves in messages about how students can apply research insights on emotion regulation, learning and memory, and a positive “stress mindset” to their lives ( Crum, A. J., et al., Anxiety, Stress, & Coping , Vol. 30, No. 4, 2017 ).

Along with her colleague Deena Kara Shaffer, PhD, Brecher cocreated TMU’s Thriving in Action curriculum, which is delivered through a 10-week in-person workshop series and via a for-credit elective course. The material is also freely available for students to explore online . The for-credit course includes lectures on gratitude, attention, healthy habits, and other topics informed by psychological research that are intended to set students up for success in studying, relationships, and campus life.

“We try to embed a healthy approach to studying in the way we teach the class,” Brecher said. “For example, we shift activities every 20 minutes or so to help students sustain attention and stamina throughout the lesson.”

Creative approaches to support

Given the crucial role of social connection in maintaining and restoring mental health, many schools have invested in group therapy. Groups can help students work through challenges such as social anxiety, eating disorders, sexual assault, racial trauma, grief and loss, chronic illness, and more—with the support of professional counselors and peers. Some cater to specific populations, including those who tend to engage less with traditional counseling services. At Florida Gulf Coast University (FGCU), for example, the “Bold Eagles” support group welcomes men who are exploring their emotions and gender roles.

The widespread popularity of group therapy highlights the decrease in stigma around mental health services on college campuses, said Jon Brunner, PhD, the senior director of counseling and wellness services at FGCU. At smaller schools, creating peer support groups that feel anonymous may be more challenging, but providing clear guidelines about group participation, including confidentiality, can help put students at ease, Brunner said.

Less formal groups, sometimes called “counselor chats,” meet in public spaces around campus and can be especially helpful for reaching underserved groups—such as international students, first-generation college students, and students of color—who may be less likely to seek services at a counseling center. At Johns Hopkins, a thriving international student support group holds weekly meetings in a café next to the library. Counselors typically facilitate such meetings, often through partnerships with campus centers or groups that support specific populations, such as LGBTQ students or student athletes.

“It’s important for students to see counselors out and about, engaging with the campus community,” McCowan said. “Otherwise, you’re only seeing the students who are comfortable coming in the door.”

Peer counseling is another means of leveraging social connectedness to help students stay well. At UVA, Mason and his colleagues found that about 75% of students reached out to a peer first when they were in distress, while only about 11% contacted faculty, staff, or administrators.

“What we started to understand was that in many ways, the people who had the least capacity to provide a professional level of help were the ones most likely to provide it,” he said.

Project Rise , a peer counseling service created by and for Black students at UVA, was one antidote to this. Mason also helped launch a two-part course, “Hoos Helping Hoos,” (a nod to UVA’s unofficial nickname, the Wahoos) to train students across the university on empathy, mentoring, and active listening skills.

At Washington University in St. Louis, Uncle Joe’s Peer Counseling and Resource Center offers confidential one-on-one sessions, in person and over the phone, to help fellow students manage anxiety, depression, academic stress, and other campus-life issues. Their peer counselors each receive more than 100 hours of training, including everything from basic counseling skills to handling suicidality.

Uncle Joe’s codirectors, Colleen Avila and Ruchika Kamojjala, say the service is popular because it’s run by students and doesn’t require a long-term investment the way traditional psychotherapy does.

“We can form a connection, but it doesn’t have to feel like a commitment,” said Avila, a senior studying studio art and philosophy-neuroscience-psychology. “It’s completely anonymous, one time per issue, and it’s there whenever you feel like you need it.”

As part of the shift toward rapid access, many schools also offer “Let’s Talk” programs , which allow students to drop in for an informal one-on-one session with a counselor. Some also contract with telehealth platforms, such as WellTrack and SilverCloud, to ensure that services are available whenever students need them. A range of additional resources—including sleep seminars, stress management workshops, wellness coaching, and free subscriptions to Calm, Headspace, and other apps—are also becoming increasingly available to students.

Those approaches can address many student concerns, but institutions also need to be prepared to aid students during a mental health crisis, and some are rethinking how best to do so. Penn State offers a crisis line, available anytime, staffed with counselors ready to talk or deploy on an active rescue. Johns Hopkins is piloting a behavioral health crisis support program, similar to one used by the New York City Police Department, that dispatches trained crisis clinicians alongside public safety officers to conduct wellness checks.

A culture of wellness

With mental health resources no longer confined to the counseling center, schools need a way to connect students to a range of available services. At OSU, Sharma was part of a group of students, staff, and administrators who visited Apple Park in Cupertino, California, to develop the Ohio State: Wellness App .

Students can use the app to create their own “wellness plan” and access timely content, such as advice for managing stress during final exams. They can also connect with friends to share articles and set goals—for instance, challenging a friend to attend two yoga classes every week for a month. OSU’s apps had more than 240,000 users last year.

At Johns Hopkins, administrators are exploring how to adapt school policies and procedures to better support student wellness, Shollenberger said. For example, they adapted their leave policy—including how refunds, grades, and health insurance are handled—so that students can take time off with fewer barriers. The university also launched an educational campaign this fall to help international students navigate student health insurance plans after noticing below average use by that group.

Students are a key part of the effort to improve mental health care, including at the systemic level. At Morehouse College, Sera serves as the adviser for Chill , a student-led advocacy and allyship organization that includes members from Spelman College and Clark Atlanta University, two other HBCUs in the area. The group, which received training on federal advocacy from APA’s Advocacy Office earlier this year, aims to lobby public officials—including U.S. Senator Raphael Warnock, a Morehouse College alumnus—to increase mental health resources for students of color.

“This work is very aligned with the spirit of HBCUs, which are often the ones raising voices at the national level to advocate for the betterment of Black and Brown communities,” Sera said.

Despite the creative approaches that students, faculty, staff, and administrators are employing, students continue to struggle, and most of those doing this work agree that more support is still urgently needed.

“The work we do is important, but it can also be exhausting,” said Kamojjala, of Uncle Joe’s peer counseling, which operates on a volunteer basis. “Students just need more support, and this work won’t be sustainable in the long run if that doesn’t arrive.”

Further reading

Overwhelmed: The real campus mental-health crisis and new models for well-being The Chronicle of Higher Education, 2022

Mental health in college populations: A multidisciplinary review of what works, evidence gaps, and paths forward Abelson, S., et al., Higher Education: Handbook of Theory and Research, 2022

Student mental health status report: Struggles, stressors, supports Ezarik, M., Inside Higher Ed, 2022

Before heading to college, make a mental health checklist Caron, C., The New York Times, 2022

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Research Topics & Ideas: Mental Health

100+ Mental Health Research Topic Ideas To Fast-Track Your Project

If you’re just starting out exploring mental health topics for your dissertation, thesis or research project, you’ve come to the right place. In this post, we’ll help kickstart your research topic ideation process by providing a hearty list of mental health-related research topics and ideas.

PS – This is just the start…

We know it’s exciting to run through a list of research topics, but please keep in mind that this list is just a starting point . To develop a suitable education-related research topic, you’ll need to identify a clear and convincing research gap , and a viable plan of action to fill that gap.

If this sounds foreign to you, check out our free research topic webinar that explores how to find and refine a high-quality research topic, from scratch. Alternatively, if you’d like hands-on help, consider our 1-on-1 coaching service .

Overview: Mental Health Topic Ideas

• Mood disorders
• Anxiety disorders
• Psychotic disorders
• Personality disorders
• Obsessive-compulsive disorders
• Post-traumatic stress disorder (PTSD)
• Neurodevelopmental disorders
• Eating disorders
• Substance-related disorders

Mood Disorders

Research in mood disorders can help understand their causes and improve treatment methods. Here are a few ideas to get you started.

• The impact of genetics on the susceptibility to depression
• Efficacy of antidepressants vs. cognitive behavioural therapy
• The role of gut microbiota in mood regulation
• Cultural variations in the experience and diagnosis of bipolar disorder
• Seasonal Affective Disorder: Environmental factors and treatment
• The link between depression and chronic illnesses
• Exercise as an adjunct treatment for mood disorders
• Hormonal changes and mood swings in postpartum women
• Stigma around mood disorders in the workplace
• Suicidal tendencies among patients with severe mood disorders

Anxiety Disorders

Research topics in this category can potentially explore the triggers, coping mechanisms, or treatment efficacy for anxiety disorders.

• The relationship between social media and anxiety
• Exposure therapy effectiveness in treating phobias
• Generalised Anxiety Disorder in children: Early signs and interventions
• The role of mindfulness in treating anxiety
• Genetics and heritability of anxiety disorders
• The link between anxiety disorders and heart disease
• Anxiety prevalence in LGBTQ+ communities
• Caffeine consumption and its impact on anxiety levels
• The economic cost of untreated anxiety disorders
• Virtual Reality as a treatment method for anxiety disorders

Psychotic Disorders

Within this space, your research topic could potentially aim to investigate the underlying factors and treatment possibilities for psychotic disorders.

• Early signs and interventions in adolescent psychosis
• Brain imaging techniques for diagnosing psychotic disorders
• The efficacy of antipsychotic medication
• The role of family history in psychotic disorders
• Misdiagnosis and delayed treatment of psychotic disorders
• Co-morbidity of psychotic and mood disorders
• The relationship between substance abuse and psychotic disorders
• Art therapy as a treatment for schizophrenia
• Public perception and stigma around psychotic disorders
• Hospital vs. community-based care for psychotic disorders

Personality Disorders

Research topics within in this area could delve into the identification, management, and social implications of personality disorders.

• Long-term outcomes of borderline personality disorder
• Antisocial personality disorder and criminal behaviour
• The role of early life experiences in developing personality disorders
• Narcissistic personality disorder in corporate leaders
• Gender differences in personality disorders
• Diagnosis challenges for Cluster A personality disorders
• Emotional intelligence and its role in treating personality disorders
• Psychotherapy methods for treating personality disorders
• Personality disorders in the elderly population
• Stigma and misconceptions about personality disorders

Obsessive-Compulsive Disorders

Within this space, research topics could focus on the causes, symptoms, or treatment of disorders like OCD and hoarding.

• OCD and its relationship with anxiety disorders
• Cognitive mechanisms behind hoarding behaviour
• Deep Brain Stimulation as a treatment for severe OCD
• The impact of OCD on academic performance in students
• Role of family and social networks in treating OCD
• Alternative treatments for hoarding disorder
• Childhood onset OCD: Diagnosis and treatment
• OCD and religious obsessions
• The impact of OCD on family dynamics
• Body Dysmorphic Disorder: Causes and treatment

Post-Traumatic Stress Disorder (PTSD)

Research topics in this area could explore the triggers, symptoms, and treatments for PTSD. Here are some thought starters to get you moving.

• PTSD in military veterans: Coping mechanisms and treatment
• Childhood trauma and adult onset PTSD
• Eye Movement Desensitisation and Reprocessing (EMDR) efficacy
• Role of emotional support animals in treating PTSD
• Gender differences in PTSD occurrence and treatment
• Effectiveness of group therapy for PTSD patients
• PTSD and substance abuse: A dual diagnosis
• First responders and rates of PTSD
• Domestic violence as a cause of PTSD
• The neurobiology of PTSD

Neurodevelopmental Disorders

This category of mental health aims to better understand disorders like Autism and ADHD and their impact on day-to-day life.

• Early diagnosis and interventions for Autism Spectrum Disorder
• ADHD medication and its impact on academic performance
• Parental coping strategies for children with neurodevelopmental disorders
• Autism and gender: Diagnosis disparities
• The role of diet in managing ADHD symptoms
• Neurodevelopmental disorders in the criminal justice system
• Genetic factors influencing Autism
• ADHD and its relationship with sleep disorders
• Educational adaptations for children with neurodevelopmental disorders
• Neurodevelopmental disorders and stigma in schools

Eating Disorders

Research topics within this space can explore the psychological, social, and biological aspects of eating disorders.

• The role of social media in promoting eating disorders
• Family dynamics and their impact on anorexia
• Biological basis of binge-eating disorder
• Treatment outcomes for bulimia nervosa
• Eating disorders in athletes
• Media portrayal of body image and its impact
• Eating disorders and gender: Are men underdiagnosed?
• Cultural variations in eating disorders
• The relationship between obesity and eating disorders
• Eating disorders in the LGBTQ+ community

Substance-Related Disorders

Research topics in this category can focus on addiction mechanisms, treatment options, and social implications.

• Efficacy of rehabilitation centres for alcohol addiction
• The role of genetics in substance abuse
• Substance abuse and its impact on family dynamics
• Prescription drug abuse among the elderly
• Legalisation of marijuana and its impact on substance abuse rates
• Alcoholism and its relationship with liver diseases
• Opioid crisis: Causes and solutions
• Substance abuse education in schools: Is it effective?
• Harm reduction strategies for drug abuse
• Co-occurring mental health disorders in substance abusers

Choosing A Research Topic

These research topic ideas we’ve covered here serve as thought starters to help you explore different areas within mental health. They are intentionally very broad and open-ended. By engaging with the currently literature in your field of interest, you’ll be able to narrow down your focus to a specific research gap .

It’s important to consider a variety of factors when choosing a topic for your dissertation or thesis . Think about the relevance of the topic, its feasibility , and the resources available to you, including time, data, and academic guidance. Also, consider your own interest and expertise in the subject, as this will sustain you through the research process.

Always consult with your academic advisor to ensure that your chosen topic aligns with academic requirements and offers a meaningful contribution to the field. If you need help choosing a topic, consider our private coaching service.

Good morning everyone. This are very patent topics for research in neuroscience. Thank you for guidance

What if everything is important, original and intresting? as in Neuroscience. I find myself overwhelmd with tens of relveant areas and within each area many optional topics. I ask myself if importance (for example – able to treat people suffering) is more relevant than what intrest me, and on the other hand if what advance me further in my career should not also be a consideration?

This information is really helpful and have learnt alot

Phd research topics on implementation of mental health policy in Nigeria :the prospects, challenges and way forward.

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At any one time, a diverse set of individual, family, community and structural factors may combine to protect or undermine mental health. Although most people are resilient, people who are exposed to adverse circumstances – including poverty, violence, disability and inequality – are at higher risk of developing a mental health condition.

Mental health conditions include mental disorders and psychosocial disabilities as well as other mental states associated with significant distress, impairment in functioning or risk of self-harm.

In 2019, 970 million people globally were living with a mental disorder, with anxiety and depression the most common.

Mental health conditions can cause difficulties in all aspects of life, including relationships with family, friends and community. They can result from or lead to problems at school and at work.

Globally, mental disorders account for 1 in 6 years lived with disability. People with severe mental health conditions die 10 to 20 years earlier than the general population. And having a mental health condition increases the risk of suicide and experiencing human rights violations.

The economic consequences of mental health conditions are also enormous, with productivity losses significantly outstripping the direct costs of care.

WHO’s World mental health report: transforming mental health for all called on all countries to accelerate progress towards implementing the action plan by deepening the value given to mental health, prioritizing mental health promotion and prevention, and developing networks of community-based services.

In 2019, WHO launched the  WHO Special Initiative for Mental Health (2019–2023): Universal Health Coverage for Mental Health  to ensure access to quality and affordable mental health care for 100 million more people in 12 priority countries. WHO’s Mental Health Gap Action Programme (mhGAP) similarly aims to scale up services for mental, neurological and substance use disorders, especially in low- and middle-income countries.

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Mental Health Treatment Gap-The Implementation Problem as a Research Problem

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• 1 Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
• PMID: 35704300
• DOI: 10.1001/jamapsychiatry.2022.1468

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Global Issues Are Taking a Major Toll on Young People’s Mental Health

Economic, climate and technology woes are weighing on young adults, a report finds. It recommends overhauling how we approach mental health care.

By Christina Caron

Chloé Johnson, 22, has been feeling hopeless lately.

She’s struggling to focus on classes at her local community college in Dallas while also working full-time, making $18 an hour as a receptionist.

Her car broke down, so the $500 that she had managed to save will now go toward a down payment for a used vehicle.

And she was recently passed over for a promotion.

“Right now it just feels, like, very suffocating to be in this position,” said Ms. Johnson, who was diagnosed last year with bipolar II disorder, depression and A.D.H.D. “I’m not getting anywhere or making any progress.”

It’s an endless loop: Ms. Johnson’s mental health has worsened because of her financial difficulties and her financial problems have grown, partly because of the cost of mental health treatment but also because her disorders have made it more difficult to earn a college degree that could lead to a more lucrative job.

“I’ve failed several classes,” she said. “I burn out really easily, so I just give up.”

The mental health of adolescents and young adults has been on the decline and it’s partly because of “harmful megatrends” like financial inequality, according to a new report published on Tuesday in the scientific journal The Lancet Psychiatry. The global trends affecting younger generations also include wage theft , unregulated social media , job insecurity and climate change , all of which are creating “a bleak present and future for young people in many countries,” according to the authors.

Why focus on global trends?

The report was produced over the course of five years by a commission of more than 50 people, including mental health and economic policy experts from several continents and young people who have experienced mental illness.

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The link between substance abuse and mental health

What comes first: substance abuse or the mental health problem, recognizing a dual diagnosis , signs and symptoms of substance abuse, signs and symptoms of common co-occurring disorders, treatment for a dual diagnosis, finding the right treatment program , self-help for a dual diagnosis, group support , helping a loved one with a dual diagnosis, dual diagnosis: substance abuse and mental health.

Dealing with co-occurring disorders? Learn how to tackle addiction when you're also dealing with depression, anxiety, or another mental health problem.

When you have both a substance abuse problem and a mental health issue such as depression, bipolar disorder, or anxiety, it is called a co-occurring disorder or dual diagnosis. Dealing with substance abuse, alcoholism, or drug addiction is never easy, and it’s even more difficult when you’re also struggling with mental health problems.

In co-occurring disorders, both the mental health issue and the drug or alcohol addiction have their own unique symptoms that may get in the way of your ability to function at work or school, maintain a stable home life, handle life’s difficulties, and relate to others. To make the situation more complicated, the co-occurring disorders also affect each other. When a mental health problem goes untreated, the substance abuse problem usually gets worse. And when alcohol or drug abuse increases, mental health problems usually increase too.

Co-occurring substance abuse problems and mental health issues are more common than many people realize. According to reports published in the Journal of the American Medical Association :

• Roughly 50 percent of individuals with severe mental disorders are affected by substance abuse.
• 37 percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness.
• Of all people diagnosed as mentally ill, 29 percent abuse alcohol or drugs.

While substance abuse problems and mental health issues don’t get better when they’re ignored—in fact, they are likely to get much worse—it’s important to know that you don’t have to feel this way. There are things you can do to conquer your demons, repair your relationships, and get on the road to recovery. With the right support, self-help, and treatment, you can overcome a co-occurring disorder, reclaim your sense of self, and get your life back on track.

Speak to a Licensed Therapist

BetterHelp is an online therapy service that matches you to licensed, accredited therapists who can help with depression, anxiety, relationships, and more. Take the assessment and get matched with a therapist in as little as 48 hours.

Substance abuse and mental health disorders such as depression and anxiety are closely linked, although one doesn’t necessarily directly cause the other. Abusing substances such as marijuana or methamphetamine can cause prolonged psychotic reactions, while alcohol can make depression and anxiety symptoms worse. Also:

Alcohol and drugs are often used to self-medicate the symptoms of mental health problems. People often abuse alcohol or drugs to ease the symptoms of an undiagnosed mental disorder, to cope with difficult emotions, or to temporarily change their mood. Unfortunately, self-medicating with drugs or alcohol causes side effects and in the long run often worsens the symptoms they initially helped to relieve.

Alcohol and drug abuse can increase the underlying risk for mental disorders. Since mental health problems are caused by a complex interplay of genetics, the environment, and other factors, it’s difficult to say if abusing substances ever directly causes them. However, if you are at risk for a mental health issue, abusing alcohol or drugs may push you over the edge. For example, there is some evidence that those who abuse opioid painkillers are at greater risk for depression and heavy cannabis use has been linked to an increased risk for schizophrenia.

Alcohol and drug abuse can make symptoms of a mental health problem worse. Substance abuse may sharply increase symptoms of mental illness or even trigger new symptoms. Abuse of alcohol or drugs can also interact with medications such as antidepressants, anxiety medications , and mood stabilizers, making them less effective at managing symptoms and delaying your recovery.

It can be difficult to identify a dual diagnosis. It takes time to tease out what might be a mental health disorder and what might be a drug or alcohol problem. The signs and symptoms also vary depending upon both the mental health problem and the type of substance being abused, whether it’s alcohol, recreational drugs, or prescription medications. For example, the signs of depression and marijuana abuse could look very different from the signs of schizophrenia and alcohol abuse. However, there are some general warning signs that you may have a co-occurring disorder:

• Do you use alcohol or drugs to cope with unpleasant memories or feelings, to control pain or the intensity of your moods, to face situations that frighten you, or to stay focused on tasks?
• Have you noticed a relationship between your substance use and your mental health? For example, do you get depressed when you drink? Or drink when you’re feeling anxious or plagued by unpleasant memories?
• Has someone in your family grappled with either a mental disorder or alcohol or drug abuse?
• Do you feel depressed, anxious, or otherwise out of balance even when you’re sober?
• Have you previously been treated for either your addiction or your mental health problem? Did the substance abuse treatment fail because of complications from your mental health issue or vice versa?

Dual diagnosis and denial

Denial is common in both substance abuse and mental health issues. It’s often hard to admit how dependent you are on alcohol or drugs or how much they affect your life. Similarly, the symptoms of conditions such as depression, anxiety, bipolar disorder, or PTSD can be frightening, so you may try to ignore them and hope they go away. Or you may be ashamed or afraid of being viewed as weak if you admit you have a problem.

But substance abuse and mental health issues can happen to any of us. And admitting you have a problem and seeking help is the first step on the road to recovery.

Abused substances include prescription medications (such as opioid painkillers, ADHD medications, and sedatives), recreational or street drugs (such as marijuana, methamphetamines, and cocaine), and alcohol (beer, wine, and liquor). A substance abuse problem is not defined by what drug you use or the type of alcohol you drink, though. Rather, it comes down to the effects your drug or alcohol use has on your life and relationships. In short, if your drinking or drug use is causing problems in your life, you have a substance abuse problem.

To help you spot the signs of a substance abuse problem, answering the following questions may help. The more “yes” answers you provide, the more likely your drinking or drug use has become a problem.

• Have you ever felt you should cut down on your drinking or drug use?
• Do you need to use more and more drugs or alcohol to attain the same effects on your mood or outlook?
• Have you tried to cut back, but couldn’t?
• Do you lie about how much or how often you drink or use drugs?
• Are you going through prescription medication at a faster-than-expected rate?
• Have your friends or family members expressed concern about your alcohol or drug use?
• Do you ever feel bad, guilty, or ashamed about your drinking or drug use?
• Have you done or said things while drunk or high that you later regretted?
• Has your alcohol or drug use caused problems at work, school, or in your relationships?
• Has your alcohol or drug use gotten you into trouble with the law?

The mental health problems that most commonly co-occur with substance abuse are depression , bipolar disorder , and anxiety disorders .

Common signs and symptoms of depression

• Feelings of helplessness and hopelessness
• Loss of interest in daily activities
• Inability to experience pleasure
• Appetite or weight changes
• Sleep changes
• Loss of energy
• Strong feelings of worthlessness or guilt
• Concentration problems
• Anger, physical pain, and reckless behavior (especially in men)

Common signs and symptoms of anxiety

• Excessive tension and worry
• Feeling restless or jumpy
• Irritability or feeling “on edge”
• Racing heart or shortness of breath
• Nausea, trembling, or dizziness
• Muscle tension, headaches
• Trouble concentrating

Common sign and symptoms of mania in bipolar disorder

• Feelings of euphoria or extreme irritability
• Unrealistic, grandiose beliefs
• Decreased need for sleep
• Increased energy
• Rapid speech and racing thoughts
• Impaired judgment and impulsivity
• Hyperactivity
• Anger or rage

Other mental health problems that commonly co-occur with substance abuse or addiction include Schizophrenia , Borderline Personality Disorder , and PTSD.

The best treatment for co-occurring disorders is an integrated approach, where both the substance abuse problem and the mental disorder are treated simultaneously. Whether your mental health or substance abuse problem came first, long-term recovery depends on getting treatment for both disorders by the same treatment provider or team. Depending on your specific issues:

Treatment for your mental health problem may include medication, individual or group counseling, self-help measures, lifestyle changes, and peer support.

Treatment for your substance abuse may include detoxification, managing of withdrawal symptoms, behavioral therapy, and support groups to help maintain your sobriety.

Keep in mind:

Make sure that the program is appropriately licensed and accredited, the treatment methods are backed by research, and there is an aftercare program to prevent relapse. Additionally, you should make sure that the program has experience with your particular mental health issue. Some programs, for example, may have experience treating depression or anxiety, but not schizophrenia or bipolar disorder.

There are a variety of approaches that treatment programs may take, but there are some basics of effective treatment that you should look for:

• Treatment addresses both the substance abuse problem and your mental health problem.
• You share in the decision-making process and are actively involved in setting goals and developing strategies for change.
• Treatment includes basic education about your disorder and related problems.
• You are taught healthy coping skills and strategies to minimize substance abuse, strengthen your relationships, and cope with life’s stressors, challenges, and upset.

Dual diagnosis programs

Finding the right program can help you to:

• Think about the role that alcohol and/or drugs play in your life. This should be done confidentially, without judgement or any negative consequences. People feel free to discuss these issues when the discussion is confidential and not tied to legal consequences.
• Learn more about alcohol and drugs , such as how they interact with mental illness and medication.
• Become employed and find other services that may help the process of recovery.
• Identify and develop your personal recovery goals . If you decide that your use of alcohol or drugs may be a problem, a counselor trained in dual diagnosis treatment can help you work on your specific recovery goals for both illnesses.
• Experience counseling specifically designed for people with dual diagnosis . This can be done individually, in a group of peers, with your family, or a combination of all these.

Treatment programs for veterans with co-occurring disorders

Veterans deal with additional challenges when it comes to co-occurring disorders. The pressures of deployment or combat can exacerbate underlying mental disorders, and substance abuse is a common way of coping with the unpleasant feelings or memories associated with PTSD in military veterans .

Often, these problems take a while to show up after a vet returns home, and may be initially mistaken for readjustment. Untreated co-occurring disorders can lead to major problems at home and work and in your daily life, so it’s important to seek help.

In addition to getting professional treatment, there are plenty of self-help steps you can take to address your substance abuse and mental health issues. Remember: Getting sober is only the beginning. As well as continuing mental health treatment, your sustained recovery depends on learning healthier coping strategies and making better decisions when dealing with life’s challenges.

Tip 1: Manage stress and emotions

Learn how to manage stress. Drug and alcohol abuse often stems from misguided attempts to manage stress. Stress is an inevitable part of life, so it’s important to have healthy coping skills so you can deal with stress without turning to alcohol or drugs. Stress management skills go a long way towards preventing relapse and keeping your symptoms at bay.

Cope with unpleasant feelings. Many people turn to alcohol or drugs to cover up painful memories and emotions such as loneliness, depression, or anxiety. You may feel like doing drugs is the only way to handle unpleasant feelings, but HelpGuide’s free Emotional Intelligence Toolkit can teach you how to cope with difficult emotions without falling back on your addiction.

Know your triggers and have an action plan. When you’re coping with a mental disorder as well as a substance abuse problem, it’s especially important to know signs that your illness is flaring up. Common causes include stressful events, big life changes, or unhealthy sleeping or eating patterns. At these times, having a plan in place is essential to preventing a drink or drug relapse. Who will you talk to? What do you need to do to avoid slipping?

Tip 2: Connect with others

Make face-to-face connection with friends and family a priority. Positive emotional connection to those around you is the quickest way to calm your nervous system. Try to meet up regularly with people who care about you. If you don’t have anyone you feel close to, it’s never too late to meet new people and develop meaningful friendships .

Follow doctor’s orders. Once you are sober and you feel better, you might think you no longer need medication or treatment. But arbitrarily stopping medication or treatment is a common reason for relapse in people with co-occurring disorders. Always talk with your doctor before making any changes to your medication or treatment routine.

Get therapy or stay involved in a support group. Your chances of staying sober improve if you are participating in a social support group like Alcoholics Anonymous or Narcotics Anonymous or if you are getting therapy.

Tip 3: Make healthy lifestyle changes

Exercise regularly. Exercise is a natural way to bust stress, relieve anxiety, and improve your mood and outlook. To achieve the maximum benefit, aim for at least 30 minutes of aerobic exercise on most days.

Practice relaxation techniques. When practiced regularly, relaxation techniques such as mindfulness meditation, progressive muscle relaxation, and deep breathing can reduce symptoms of stress, anxiety, and depression, and increase feelings of relaxation and emotional well-being.

Adopt healthy eating habits. Start the day right with breakfast, and continue with frequent small meals throughout the day. Going too long without eating leads to low blood sugar, which can make you feel more stressed or anxious. Getting enough healthy fats in your diet can help to boost your mood.

Get enough sleep. A lack of sleep can exacerbate stress, anxiety, and depression, so try to get 7 to 9 hours of quality sleep a night.

Tip 4: Find new meaning in life

To stay alcohol- or drug-free for the long term, you’ll need to build a new, meaningful life where substance abuse no longer has a place.

Develop new activities and interests. Find new hobbies, volunteer activities , or work that gives you a sense of meaning and purpose. When you’re doing things you find fulfilling, you’ll feel better about yourself and substance use will hold less appeal.

Avoid the things that trigger your urge to use. If certain people, places, or activities trigger a craving for drugs or alcohol, try to avoid them. This may mean making major changes to your social life, such as finding new things to do with your old buddies—or even giving up those friends and making new connections.

As with other addictions, groups are very helpful, not only in maintaining sobriety, but also as a safe place to get support and discuss challenges. Sometimes treatment programs for co-occurring disorders provide groups that continue to meet on an aftercare basis. Your doctor or treatment provider may also be able to refer you to a group for people with co-occurring disorders.

While it’s often best to join a group that addresses both substance abuse and your mental health disorder, twelve-step groups for substance abuse can also be helpful—plus they’re more common, so you’re likely to find one in your area. These free programs, facilitated by peers, use group support and a set of guided principles—the twelve steps —to obtain and maintain sobriety.

Just make sure your group is accepting of the idea of co-occurring disorders and psychiatric medication. Some people in these groups, although well meaning, may mistake taking psychiatric medication as another form of addiction. You want a place to feel safe, not pressured.

Helping someone with both a substance abuse and a mental health problem can be a roller coaster. Resistance to treatment is common and the road to recovery can be long.

The best way to help someone is to accept what you can and cannot do. You cannot force someone to remain sober, nor can you make someone take their medication or keep appointments. What you can do is make positive choices for yourself, encourage your loved one to get help, and offer your support while making sure you don’t lose yourself in the process.

[Read: Helping Someone with a Drug Addiction]

Seek support. Dealing with a loved one’s mental illness and substance abuse can be painful and isolating. Make sure you’re getting the emotional support you need to cope. Talk to someone you trust about what you’re going through. It can also help to get your own therapy or join a support group.

Set boundaries. Be realistic about the amount of care you’re able to provide without feeling overwhelmed and resentful. Set limits on disruptive behaviors and stick to them. Letting the co-occurring disorders take over your life isn’t healthy for you or your loved one.

Educate yourself. Learn all you can about your loved one’s mental health problem, as well as substance abuse treatment and recovery . The more you understand what your loved one is going through, the better able you’ll be to support recovery.

Be patient. Recovering from co-occurring disorders doesn’t happen overnight. Recovery is an ongoing process and relapse is common. Ongoing support for both you and your loved one is crucial as you work toward recovery, but you can get through this difficult time together and regain control of your lives.

Helplines and support groups

Call the  NAMI HelpLine  at 1-800-950-6264 or the  SAMHSA helpline  at 1-800-662-4357.

Call the  SANEline  at 07984 967 708.

all the  Sane Helpline  at 1800 187 263.

Visit  Mood Disorders Society of Canada  for links to provincial helplines.

Call the  Vandrevala Foundation Helpline  at 1860 2662 345.

Support groups

SAMHSA Substance Abuse Treatment Facility Locator  provides a searchable database of private and public treatment facilities or you can call the helpline at 1-800-662-4357.

Dual Recovery Anonymous   offers 12-step meetings in various countries for people who are chemically dependent and also affected by a mental health disorder.  Other peer support groups, such as  Alcoholics Anonymous ,  Narcotics Anonymous ,  SMART Recovery , and  Women for Sobriety  can also be a good source of support as you go through recovery and most have worldwide chapters.

More Information

• Co-Occurring: Mental Health and Substance Abuse - Advice and help for individuals with co-occurring disorders and their loved ones. (Mental Health America)
• Comorbidity: Addiction and Other Mental Illnesses - The link between substance abuse and mental health. (National Institute on Drug Abuse)
• Substance Use Disorders - The relationship between anxiety and substance use. (ADAA)
• Mental Health Disorders and Teen Substance Use - Why it’s especially risky for kids with emotional or behavioral challenges to drink or use drugs. (Child Mind Institute)
• One Breath, Twelve Steps - Buddhism-inspired mindful practices for overcoming addiction from a  HelpGuide affiliate . (Sounds True)
• Substance-Related and Addictive Disorders. (2013). In Diagnostic and Statistical Manual of Mental Disorders . American Psychiatric Association. Link
• Anxiety Disorders. (2013). In Diagnostic and Statistical Manual of Mental Disorders . American Psychiatric Association. Link
• Bipolar and Related Disorders. (2013). In Diagnostic and Statistical Manual of Mental Disorders . American Psychiatric Association. Link
• Depressive Disorders. (2013). In Diagnostic and Statistical Manual of Mental Disorders . American Psychiatric Association. Link
• Grant, Bridget F., Frederick S. Stinson, Deborah A. Dawson, S. Patricia Chou, Mary C. Dufour, Wilson Compton, Roger P. Pickering, and Kenneth Kaplan. “Prevalence and Co-Occurrence of Substance Use Disorders and Independent Mood and Anxiety Disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions.” Archives of General Psychiatry 61, no. 8 (August 2004): 807–16. Link
• Drake, Robert E. “Co-Occurring Alcohol Use Disorder and Schizophrenia” 26, no. 2 (2002): 4. Link
• Lipari, Rachel N. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health,” 2018, 82. Link
• Kelly, Thomas M., and Dennis C. Daley. “Integrated Treatment of Substance Use and Psychiatric Disorders.” Social Work in Public Health 28, no. 3–4 (2013): 388–406. Link
• Baigent, Michael. “Managing Patients with Dual Diagnosis in Psychiatric Practice.” Current Opinion in Psychiatry 25, no. 3 (May 2012): 201–5. Link
• Ross, Stephen, and Eric Peselow. “Co-Occurring Psychotic and Addictive Disorders: Neurobiology and Diagnosis.” Clinical Neuropharmacology 35, no. 5 (October 2012): 235–43. Link
• Santucci, Karen. “Psychiatric Disease and Drug Abuse.” Current Opinion in Pediatrics 24, no. 2 (April 2012): 233–37. Link
• NIDA. 2018, August 1. Comorbidity: Substance Use Disorders and Other Mental Illnesses. Retrieved from National Institute on Drug Abuse on July 15, 2021. Link

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State Laws Strongly Affect Mental Health of Trans People, Study Finds

Key takeaways.

There's been a recent wave of state legislation that either supports or denies the rights of transgender people, depending on the state

New research out of Washington state suggests that once trans people understand their rights are protected, anxiety and depression levels drop

The findings are another example of the huge impact state legislation can have on the well-being of trans people

THURSDAY, Aug. 22, 2024 (HeathDay News) -- There's a strong association between a state's policies and laws around the rights of transgender people and the mental health of transgender residents, a new study shows.

"Trans individuals who were worried about having their rights taken away had significantly higher odds of experiencing depression and anxiety symptoms," the study authors reported Aug. 22 in the journal JAMA Network Open.

"Contrarily, those who knew about the state-level protective legislation, specifically protections against hate crimes, had lower odds of depression and anxiety symptoms," said a team led by Arjee Restar , an assistant professor of epidemiology at the University of Washington in Seattle.

As Restar's team noted, there's been a vigorous movement in recent years to either restrict or preserve a trans person's access to health care and other services, depending on the state they live in.

"In the last few years, states within the U.S. have advanced a record number of bills targeting the restriction of lesbian, gay, bisexual, trans and other queer protections and rights; as of June 2024, more than 598 bills across 43 states had been introduced, with 43 passed specific to targeting trans people’s rights," the research team noted.

Not all states have enacted such laws.

In Washington state, for example, "several measures have been taken to protect trans rights," Restar and her team pointed out. Those measures include legislation that bars discrimination against trans people in the workplace, schools and housing, as well as measures barring the denial of health insurance coverage for treatments specific to trans people.

Does knowing about these measures make a difference for the day-to-day mental well-being of transgender people?

To find out, the Seattle team surveyed almost 800 trans adults living in Washington state in March and April of 2023.

Most (about 86%) did say they currently did have some level of depression -- a figure that's much higher than was found in earlier studies.

"This was likely because data from those studies may capture the prevalence of mental health outcomes with a dataset that predates 2021, when anti-trans legislation in the U.S. first started escalating," the researchers said.

Overall, trans people who said that they worried about their rights being taken away were 66% more likely to be battling depression, and almost three times as likely to suffer from anxiety, compared to those who said they weren't worried, the study found.

Whether or not they knew about Washington state's efforts to protect their rights was key, however.

Participants who said they were aware of Washington's efforts to safeguard trans people's rights had a 56% lower odds for current depression and an 89% lower odds for anxiety, compared to those who weren't aware, the researchers found.

"Those who knew about the state-level protective legislation, specifically protections against hate crimes, had lower odds of depression and anxiety symptoms," Restar's group said. "Trans individuals who correctly knew about the protective policy and were not worried about having their rights taken away reported the lowest odds of depression and anxiety."

All of this highlights the "crucial role" legal protection plays in safeguarding the mental well-being of trans people, the authors concluded.

More information

There's more the impact of local legislation on transgender mental health at the American Psychological Association .

SOURCE: JAMA Network Open , Aug. 22, 2024

What This Means For You

Knowing that their state supports or denies transgender rights has a strong association with an individual trans person's mental wellbeing

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Ulan-Ude (Russia): Why Go to the Capital of Buryatia?

• By Anastasiya
• September 1, 2018

How to get to Ulan-Ude? A drill to know if you travel by Russian trains

It may seem that getting to Ulan-Ude is not that difficult: you either fly into it or take one of many trains from Irkutsk . Yet, there is one drill a traveler who is not originally from Russia would not know: the train timetables all over Russia are Moscow time, whether they are in Siberia or Saint-Petersburg. We did not read the tickets attentively and came to the railway station at 8 pm; to be honest, we ran into the station since we were late. However, we could not see our train on the timetable and asked for help; this is how we learned that our train would depart in six hours only. It is written in the tickets with very small letters that the departure time is Moscow time.

Where to stay

In the end, we came to Ulan-Ude at 11 AM and tried to find the guesthouse we booked from Booking. However, it turned out that this was the apartment and we had to wait for the administrator to bring the key. We spent a lot of money calling the administrator and ran out of the Internet; when she finally came, it turned out that the price in booking was per person, although we booked a “double.” Since we did not have any internet left to book anything else, we had to take it. Make sure you read the reviews well: the majority of “guesthouses” in Ulan-Ude are apartments with quite unpredictable policies.

The center of Ulan-Ude

How to get to Ivolginsky Datsan

Ivolginsky Datsan

You only need 5 to 7 hours to see the center of Ulan-Ude and Ivolginsky Datsan, which is why the city is great as a hub and a short stop on the way from Irkutsk to Mongolia. It feels so much like the city in between these two: it is still next to Baikal and in many ways is similar to Olkhon and Arshan , but is much more Buddhist, like Mongolia . From Ulan-Ude, we departed to Kyakhta, the city at Mongolia border and then to Mongolia.

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Atmospheric Air Pollution by Stationary Sources in Ulan-Ude (Buryatia, Russia) and Its Impact on Public Health

Bair o. gomboev.

1 Baikal Institute of Nature Management SB RAS, 670047 Ulan-Ude, Russia

2 Department of Geography and Geoecology Chair, Faculty of Biology, Geography and Land Management, Banzarov Buryat State University, 670000 Ulan-Ude, Russia

Irina K. Dambueva

3 Institute of Biological Problems of the North FEB RAS, 685000 Magadan, Russia

Sergey S. Khankhareev

4 Federal Service for Supervision of Consumer Rights Protection and Human Welfare in Buryatia (Rospotrebnadzor), 670045 Ulan-Ude, Russia

Valentin S. Batomunkuev

Natalya r. zangeeva, vitaly e. tsydypov, bayanzhargal b. sharaldaev, aldar g. badmaev, daba ts.-d. zhamyanov, elena e. bagaeva, ekaterina v. madeeva, marina a. motoshkina, valentina g. ayusheeva, tumun sh. rygzynov, aryuna b. tsybikova, alexander a. ayurzhanaev, bator v. sodnomov, zorikto e. banzaraktcaev, aleksei v. alekseev, aryuna b. lygdenova, beligma s. norboeva, associated data.

Not applicable.

For the first time in the territory of the Russian Far East, a study related to the establishment of correlations between air quality and public health in Ulan-Ude (Buryatia, Russia) was carried out. This study is based on the analysis of official medical statistics on morbidity over several years, the data on the composition and volume of emissions of harmful substances into the air from various stationary sources, and laboratory measurements of air pollutants in different locations in Ulan-Ude. This study confirmed that the morbidity of the population in Ulan-Ude has been increasing every year and it is largely influenced by air pollutants, the main of which are benzo( a )pyrene, suspended solids, PM 2.5 , PM 10 , and nitrogen dioxide. It was found that the greatest contribution to the unfavorable environmental situation is made by three types of stationary sources: large heating networks, autonomous sources (enterprises and small businesses), and individual households. The main air pollutants whose concentrations exceed the limits are benzo( a )pyrene, formaldehyde, suspended particles PM 2.5 , PM 10 , and nitrogen dioxide. A comprehensive assessment of the content of various pollutants in the atmospheric air showed that levels of carcinogenic and non-carcinogenic risks to public health exceeded allowable levels. Priority pollutants in the atmosphere of Ulan-Ude whose concentrations create unacceptable levels of risk to public health are benzo( a )pyrene, suspended solids, nitrogen dioxide, PM 2.5 , PM 10 , formaldehyde, and black carbon. The levels of morbidity in Ulan-Ude were higher than the average for Buryatia by the main disease classes: respiratory organs—by 1.19 times, endocrine system—by 1.25 times, circulatory system—by 1.11 times, eye diseases—by 1.06 times, neoplasms—by 1.47 times, congenital anomalies, and deformations and chromosomal aberrations—by 1.63 times. There is an increase in the incidence of risk-related diseases of respiratory organs and the circulatory system. A strong correlation was found between this growth of morbidity and atmospheric air pollution in Ulan-Ude.

1. Introduction

Modern urbanization in the cities of Siberia and the Far East leads to increased emissions of pollutants into the air [ 1 , 2 , 3 , 4 ]. The expansion of local pollution hotspots is becoming a regional problem and the number of pollutants continues to increase. According to international standards, the main pollutants are: fine suspended particles PM 2.5 and PM 10 , sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), carbon oxide (CO), and ozone (O 3 ) [ 5 , 6 , 7 ]. These air pollutants affect not only the air quality but also public health. PM 10 and PM 2.5 contain inhalable particles that are so small that they can penetrate the thoracic region of the respiratory system and thereby cause respiratory and cardiovascular morbidity, increasing the risk of cardiopulmonary mortality [ 8 ]. When SO 2 , NO 2 , and O 3 pollutants penetrate the respiratory system, they cause chronic bronchitis, asthma, heart ischemia, and lung cancer [ 9 , 10 , 11 , 12 , 13 ]. Urban air pollution has attracted a great deal of attention from both public groups and governments at all levels [ 14 ]. Solving this problem has become an important research task. Many studies deal with pollutant concentrations, temporal and seasonal distribution, the influence of transport, and the correlation between atmospheric and meteorological factors [ 15 , 16 ]. The relationship between the level of mortality in Russian regions from different causes and the level of atmospheric pollution has also been analyzed [ 17 ].

In 2021, the number of additional deaths from all causes related to atmospheric air pollution in residential areas was probabilistically amounted to 4.6 cases per 100 thousand people on average in Russia (or 0.31% of the actual mortality rate of the population of Russia). In the territory of 15 Russian regions in 2021, population mortality from malignant neoplasms was probabilistically associated with atmospheric air pollution, the number of additional cases was in the range from 0.1 to 63.7 cases per 100 thousand population. Average Russian levels were exceeded in the territories of nine regions in the range from 2.5 to 32.7 times. The highest levels were recorded in Zabaikalsky Krai, Kemerovo Oblast, Krasnoyarsk Krai, Buryatia, and Chelyabinsk Oblast (8.5–63.7 cases per 100 thousand population) [ 4 , 18 ].

In the settlements of Eastern Siberia, even in the absence of large industries with emission sources, the state of atmospheric air is unsatisfactory during the long heating period.

Ulan-Ude is the administrative center of the Republic of Buryatia; the city’s population is 436,400 people. Ulan-Ude is annually included in the Priority List of Russian cities with the highest level of air pollution according to the Federal Service for Hydrometeorology and Environmental Monitoring (Rosgidromet). The average annual concentrations of benzo( a )pyrene, suspended substances, PM 2.5 , PM 10 , and formaldehyde annually exceed the maximum allowable concentrations [ 17 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ].

The greatest contribution to air pollution in Ulan-Ude is made by enterprises of the fuel and energy complex (two central heating and power plants in Ulan-Ude—CHPP-1 and CHPP-2, large centralized boilers of the Ulan-Ude energy complex, which are part of PAO “Territorial Generating Company No 14” and numerous small boilers), individual households, and motor transport [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ].

Moreover, the climatic and topographic conditions (mountain and basin topography), which are very unfavorable for the dispersion of impurities, contribute to the accumulation of harmful substances in the surface layer of the atmosphere [ 24 , 35 ]. The territory of Ulan-Ude refers to a zone of high air pollution potential (hereinafter—APP) where meteorological conditions of pollutant dispersion in the atmosphere contribute to the transfer of harmful substances over considerable distances [ 36 ]. Atmospheric air pollution in Ulan-Ude has been worsening due to the expansion of household development in the suburban areas of Tarbagataisky, Ivolginsky, and Zaigraevsky districts. Over the past decade, the number of individual households with autonomous heating boilers and stoves has increased from 20,000 to 77,000, according to preliminary estimates. The Government of Buryatia, executive authorities, and municipalities receive complaints from residents about air pollution during the heating period.

The condition of atmospheric air is one of the priority environmental factors affecting public health. High levels of atmospheric air pollution can cause diseases of the respiratory organs, cardiovascular system, central nervous system, vision, blood, oncopathology, as well as developmental and immune system disorders [ 37 ].

In this paper we attempt to establish a correlation between the morbidity of the population of Ulan-Ude and atmospheric air pollution. This study aimed to establish the impact of atmospheric air pollution from stationary sources on the health of the population of Ulan-Ude.

The research objectives are as follows: (1) to analyze the data on the state of atmospheric air pollution in Ulan-Ude; (2) to analyze the main sources of atmospheric air pollution in Ulan-Ude as well as the additional research data on the use of fuel at autonomous heating sources, i.e., individual households and small boilers of enterprises; (3) to determine the levels of health risks for the population of Ulan-Ude when exposed to polluted atmospheric air; (4) to analyze the morbidity indicators of the population of Ulan-Ude and correlating them with the level of atmospheric air pollution.

2. Materials and Methods

In this study, we analyzed the composition and volume of emissions of pollutants into the atmospheric air by economic entities according to the methodology approved by Rosstat Order No. 661 dated 8 November 2018 “On Approval of the Methodology for Statistical Observation of Atmospheric air Protection” (form No. 2-TP “Information on atmospheric air protection”). We used data on the average annual concentrations of pollutants in the atmospheric air of Ulan-Ude that were obtained from meteorological stations that are operated by the Buryat Center for Hydrometeorology and Environmental Monitoring (hereinafter—the Buryat CHEM) for 2011–2020. We also analyzed data on atmospheric air pollution at monitoring sites in Ulan-Ude, measured by the experts of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in Buryatia (Rospotrebnadzor).

As part of this study, the concentrations of pollutants in air emissions from households were measured. The findings of this study are based not on calculation methods, but on actual data that were obtained for the first time for Ulan-Ude. These data largely clarify the composition and mass of pollutants that are emitted into the atmospheric air. Pollutant emissions from conventional fuel combustion were measured for 6 days. Measurements were taken during combustion and smoldering of fuel 3 times a day.

The tests of atmospheric air in different periods of the year were carried out in an accredited laboratory of OOO “Occupational Safety and Health Certification Center” (Accreditation certificate RA.RU.21AI87, issued on 5 July 2016). A total of 324 air samples were taken during 54 surveys to measure the concentrations of pollutants.

All the measurements were made using methods that comply with Article 5 of the Federal Law No. 102 FZ “On Ensuring the Uniformity of Measurements”, using the following state standards GOST 17.2.4.07–90 [ 38 ], GOST 17.2.4.06–90 [ 39 ]; and official measurement methods: DKIN.413411.002 RE [ 40 ], GOST 33007–2014 [ 41 ], FR.1.31.2015.20718 (PNDF 13.1.76–15) [ 42 , 43 ]. Calibrated instruments included in the State Register of Measuring Instruments were used [ 44 ].

The gross pollutant emission for each type of heat source and fuel type was calculated using the following formula:

where М х is the pollutant emission rate (g/s), t is the total usage time of heat sources (h), P is the share of a particular type of heat source, N is the number of households, and k is the unit conversion factor (hours into seconds).

The measured concentrations of pollutants were compared with the maximum allowable concentrations (MAC) approved by Decree of Chief State Sanitary Doctor of Russia No. 165 dated 22 December 2017 “On Approval of Hygienic Standards GN 2.1.6.3492–17 «Maximum allowable concentrations of pollutants in the air of urban and rural settlements»”.

We also geographically mapped the quantitative and qualitative composition of pollutant emissions and the concentration fields (pollution maps) provided by the municipal administration of Ulan-Ude. Analytical information from Rospotrebnadzor in Buryatia on the morbidity rate in Ulan-Ude in 2011–2020 was used. The source data on population morbidity were the statistical reporting forms No. 12 “Morbidity of patients residing in the service area of a medical organization”. Correlation analysis of population morbidity and atmospheric air pollution was performed in MS Excel.

In this study, we analyzed data on atmospheric air pollution in Ulan–Ude for the ten–year period (2011–2020). The monitoring of atmospheric air in Ulan-Ude was carried out at three monitoring stations, operated by the Buryat CHEM, and seven monitoring sites, surveyed by the experts of Rospotrebnadzor ( Table 1 ).

Locations of the air monitoring stations/sites in Ulan-Ude.

In 2020 (according to the Buryat CHEM data), the average annual concentrations in Ulan-Ude exceeded MACs for benzo( a )pyrene by 10.3 times, for suspended solids by 1.3 times, for nitrogen dioxide by 1.08 times, and for fine particulate matter PM 2.5 and PM 10 by 1.76 and 1.5 times, respectively. In 2020 relative to 2011, there was a 3.68-fold increase in the average annual concentrations of benzo( a )pyrene, 2.0-fold increase in sulfur dioxide, 1.25-fold increase in phenol (25.0%), 1.92-fold increase in nitrogen dioxide (91.67%), and a 1.08-fold increase in nitrogen oxide (7.5%). Also, in 2020 relative to 2017, there was a 1.31-fold (31.34%) increase in PM 2.5 concentrations and a 1.25-fold (25.0%) increase in PM 10 . Over the entire study period (2011–2020), the average daily concentrations exceeded MACs for benzo( a )pyrene by 2.8–11.95 times, suspended solids by 1.3–1.88 times, formaldehyde by 1.1–2.3 times, nitrogen dioxide by 1.1–1.13 times, ozone by 1.07–1.53 times, PM 2.5 by 1.34–1.76 times, and PM 10 by 1.07–1.5 times.

The Air Pollution Index (API) is an integral indicator calculated on the basis of the average annual concentrations of pollutants, their MAC values, and the degree of their danger. To compare the pollution levels in various localities and years, the API 5 index was calculated for the average annual concentrations of the five most important air pollutants (in accordance with the official regulatory document RD 52.04.667–2005, issued by Rosgidromet). An API in the range of 5–6 is regarded as elevated, 7–13—high, and ≥14—very high. In Ulan-Ude for the period 2011–2020, there was an increase in API values from 10.0 to 37.1 ( Table 2 ). In 2011–2012, the degree of air pollution was rated as “high”, and from 2013 to 2020 it was “very high”.

Dynamics of the average annual concentrations of pollutants, API, and degree of air pollution in Ulan-Ude in 2011–2020 (according to the Buryat CHEM), in shares of MAC.

‘−’—data not available.

The monitoring data since 2015 indicate that the most intense air pollution in Ulan-Ude is observed during the heating season, especially under adverse meteorological conditions (hereinafter referred to as AWC). According to the Buryat CHEM data, in January 2020, during the AWC period, benzo( a )pyrene concentrations exceeded the average daily MAC by 57.2 times (at the monitoring station on ulitsa Babushkina). In January 2020, the average daily concentrations of benzo( a )pyrene in Ulan-Ude exceeded MAC by 30.0 times, and in March—by 7.5 times ( Figure 1 ).

Annual dynamics of benzo( a )pyrene concentrations in the air of Ulan-Ude in 2016–2020, measured at the air monitoring stations (operated by the Buryat CHEM), shares of MAC.

According to the Directorate of Rospotrebnadzor in Buryatia, during the study period, the average daily concentrations of benzo( a )pyrene exceeded MAC in the 20th city blocks by 29.5 times, on ulitsa Tereshkovoi by 1.3 times, in Istok by 4.8 times, in Energetik by 8.5 times, in Gorky by 17.2 times, and on ulitsa Kluchevskaya by 33.6 times. According to long-term data, the highest level of air pollution in Ulan-Ude is registered annually in the cold period of the year due to increased emissions of pollutants from small boiler facilities and autonomous heating sources, including individual households, located around the city and in its central part. The ranking of monitoring sites in Ulan-Ude by the coefficient of total air pollution (K sum ) for 2011–2021 showed that in the cold period of the year, pollution is rated as “very high” in Zarechny, Kirzavod, ulitsa Revolutsii 1905, and ulitsa Klyuchevskaya. During the warm period of the year, air pollution at all monitoring sites is rated as “moderate”.

The territory of Ulan-Ude refers to a zone of high air pollution potential where meteorological conditions of pollutant dispersion in the atmosphere contribute to the transfer of harmful substances over considerable distances. According to the data of the Institute of Physical Materials Science SB RAS, the probability of temperature inversions in the lower 100-m layer of the atmosphere is 77%. Under such conditions, emissions from industrial facilities and autonomous heat sources are poorly dispersed, creating high concentrations of harmful substances in the surface layer of the atmosphere in the city limits.

Analysis of climatic data for Ulan-Ude, provided by the Buryat CHEM, and quantitative assessment of various factors indicate the predominance of processes that hinder atmospheric purification. In general, the meteorological potential of self-purification of the atmosphere in Ulan-Ude is low. It requires effective measures to limit emissions of pollutants into the atmosphere.

This study examined three groups of stationary sources of emissions of harmful substances into the air of Ulan-Ude during the heating season of 2020/2021: (1) large heating networks (CHPP-1, CHPP-2; large, centralized boilers of the Ulan-Ude energy complex, which are part of PAO “Territorial Generating Company No 14”); (2) autonomous sources (enterprises and small businesses); and (3) individual households. The total emissions from these sources during the period amounted to 83.8 thousand tons of pollutants ( Table 3 ).

Air emissions of pollutants from stationary sources in Ulan-Ude during the heating season of 2020/2021 (thousand tons).

As can be seen from Table 3 , individual households make the greatest contribution to the overall air pollution. In Ulan-Ude and its suburbs, there are 207 settlements and neighborhoods with 77,607 households, 77.7% of which use wood-burning stoves, and 22.3% use boilers. The total pollutant emissions from households in Ulan-Ude and its suburbs (by administrative boundaries) during the heating season 2020/2021 are shown in Table 4 .

Total pollutant emissions from households in Ulan-Ude and its suburbs per year (during the heating season 2020/2021.

The experts of Rospotrebnadzor in Buryatia assessed the risk to public health on the basis of data on the average annual concentrations of air pollutants measured at monitoring stations. In 2020, chronic inhalation exposure to pollutants could cause disease in the population of Ulan-Ude: respiratory system (hazard index HI = 10.8, with the permissible value of 1), blood diseases (HI = 1.7), vision diseases (HI = 1.67), fetal growth disorders (HI = 12.0), immune system (HI = 11.9), increased mortality (HI = 5.5), and tumors (HI = 10.3) ( Figure 2 ).

Hazard indices (HI) of non-carcinogenic risk to public health in Ulan-Ude with unidirectional effects of atmospheric air pollutants on human organs and systems in 2011–2020.

The hazard indices of non-carcinogenic risks to the health of the population of Ulan-Ude exceeded the permissible levels due to the content of pollutants in the air such as benzo( a )pyrene (HQ = 10.3), formaldehyde (HQ = 1.7), suspended solids (HQ = 1.7), PM 10 (HQ = 1.5), PM 2.5 (HQ = 1.8), and nitrogen dioxide (HQ = 1.1).

The level of individual carcinogenic risk for the population of Ulan-Ude was 1.62 × 10 −4 , which is considered “acceptable for professional groups and unacceptable for the population”. Priority pollutants in the atmospheric air that formed the carcinogenic risk were black carbon (52.1%, CR = 0.84 × 10 −4 ) and formaldehyde (40.7%, CR = 0.66 × 10 −4 ) ( Figure 3 ).

The level of individual carcinogenic risk to public health from exposure to pollutants in the atmospheric air of Ulan-Ude, 2011–2020 (CR × 10 −4 ). Permissible level CR = 1 × 10 −4 .

Statistics for the period 2011–2020 show that for some risk-related diseases, the morbidity of the population in Ulan-Ude exceeds the average figures for the Republic of Buryatia. The total morbidity rate in Ulan-Ude was 1.2 times higher than the average in Buryatia and amounted to 77,077.63 cases per 100 thousand people (63,985.43 cases per 100 thousand people in Buryatia). Respiratory system morbidity in Ulan-Ude was 34,154.29 cases per 100 thousand people, which is 1.19 times higher than the average for Buryatia (28,648.46 per 100 thousand people). Corresponding exceedances were registered for the diseases of endocrine system by 1.25 times, circulatory system by 1.11 times, eye diseases by 1.06 times, neoplasms by 1.47 times, and congenital anomalies, deformities, and chromosomal abnormalities by 1.63 times ( Table 5 ).

Comparative characteristics of morbidity in Ulan-Ude and Buryatia for 2011–2020.

According to Rospotrebnadzor in Buryatia, in 2020 the morbidity structure was as follows: respiratory diseases—46.9%; injuries, poisonings, and accidents—11.6%; digestive diseases—4.3%; skin diseases—3.6%; and diseases of the urogenital system and circulatory system—3.5% each ( Figure 4 ) [ 45 ].

Structure of morbidity in Ulan-Ude in 2020, %.

Respiratory diseases account for the largest share of the total morbidity rate in Ulan-Ude and Buryatia, both for 2020 and over a multi-year period. The morbidity of the population of Ulan-Ude during the period from 2011 to 2020 has increased for respiratory diseases by 11.5%, and by 8.35% for diseases of the circulatory system ( Table 6 ).

Dynamics of population morbidity in Ulan-Ude for 2011–2020 (cases per 100,000 population).

To establish the correlation between air pollution and the growth of morbidity in Ulan-Ude, a correlation analysis was carried out with a small number of observations (n=10 years). To assess the strength of the correlation, we used the generally accepted criteria: correlation coefficient r xy < 0.3 indicates a weak correlation, 0.3 ≤ r xy < 0.7—average correlation, and 0.7 ≤ r xy —very high correlation. The correlation reliability criterion was calculated as follows: t r = r xy /m r , where m r is the mean error. A correlation is considered reliable if t r ≥ 3.

The correlation coefficient between the atmospheric air pollution index (API 5 ) and the incidence of respiratory diseases in Ulan-Ude is r xy = 0.7784 (m r = 0.2219, t r = 3.5068, n = 10), indicating that the two data sets are strongly correlated. The correlation coefficient between API 5 and the incidence of circulatory system diseases is r xy = 0.7437 (m r = 0.2363, t r = 3.1471, n = 10), which also indicates a strong correlation between the two data series.

4. Discussion

It has been established that the degree of atmospheric air pollution in Ulan-Ude is estimated as very high. Over the past decade, the atmospheric pollution index has increased by 3.71 times due to high concentrations of benzo( a )pyrene, PM 2.5 , PM 10 , and nitrogen dioxide [ 45 , 46 , 47 ].

The high level of atmospheric pollution is caused by emissions from CHPPs that operate year-round, as well as emissions from autonomous heat sources of individual households during the heating period. The growing number of households with autonomous heating, the increasing amount of coal burned, and the lack of opportunities to use alternative sources of thermal energy, combined with the low potential for dispersion of harmful impurities in the atmosphere leads to increased air pollution in Ulan-Ude, both in its central part and in the suburbs.

The assessment showed that atmospheric air pollution in Ulan-Ude poses an increased risk to public health. Concentrations of pollutants in the atmospheric air have been found to present elevated levels of non-carcinogenic risk to public health, exceeding permissible values from 1.1 to 12 times. Chronic inhalation exposure to pollutants may cause health disorders of the population of Ulan-Ude from the respiratory organs, immune system, disorders of fetal development, neoplasms, diseases of the vision, blood diseases, and increased mortality. The level of individual carcinogenic risk exceeds the permissible level for the population of Ulan-Ude by 1.62 times and is estimated as “acceptable for professional groups and unacceptable for the population as a whole”.

Analysis of the morbidity in the Ulan-Ude population revealed an increase in the incidence of risk-related diseases such as the respiratory organs and circulatory system. Their strong correlation with atmospheric air pollution in Ulan-Ude was established.

Thus, this study analyzed the data on emissions of pollutants into the atmospheric air from stationary sources, statistics on the morbidity of the population over the past decade, and the results of measurements of air quality (both at the monitoring stations and monitoring sites in micro-districts of Ulan-Ude). The results of the study confirmed that the morbidity of the population in Ulan-Ude has been increasing, and this is largely due to very high pollution of the atmospheric air.

In order to reduce carcinogenic and non-carcinogenic risks to public health in Ulan-Ude, the Directorate of Rospotrebnadzor in Buryatia has established cooperation with executive bodies and local authorities. In 2020, amendments were made to the regulatory and legal acts of the Republic of Buryatia to prohibit the use of autonomous sources of pollutant emissions into the atmosphere when there is a technical possibility of connecting to centralized heating networks. As a result of significant efforts made by the executive and legislative branches of the Republic of Buryatia, the city of Ulan-Ude has been included in the list of settlements in which the experimental quoting of pollutant emissions to the atmospheric air is carried out based on the integrated calculations of atmospheric air pollution (according to the Russian Federation Government Decree of 7 July 2022 No. 1852-r). The Directorate of Rospotrebnadzor in Buryatia initiated the updating of the summary calculations of atmospheric air pollution in Ulan-Ude, on the basis of which management decisions will be made in the framework of the federal project “Clean Air”.

5. Conclusions

• In Ulan-Ude, there has been a 3.71-fold increase in air pollution over the period of 2011–2020. In 2011–2012, the degree of air pollution was assessed as “High”, and from 2013 to 2020—as “Very High”. Priority pollutants whose concentrations exceed MAC are benzo(a)pyrene, PM 2.5 , PM 10 , suspended solids, and nitrogen dioxide.
• The main stationary sources of atmospheric air pollution are large enterprises of the fuel and energy complex, autonomous heat supply sources of small enterprises, and individual households (which make the greatest contribution to the air pollution). There has been an increase in the number of households with autonomous sources of heating.
• Chronic inhalation exposure to pollutants may cause health disorders of the population of Ulan-Ude from the respiratory organs, immune system, disorders of fetal development, neoplasms, diseases of the vision, blood diseases, and increased mortality. The concentrations of pollutants in the atmospheric air have been found to present elevated levels of non-carcinogenic risk to public health, exceeding permissible values from 1.1 to 12 times. The level of individual carcinogenic risk exceeds the permissible level for the population of Ulan-Ude by 1.62 times. Priority pollutants in the atmosphere of Ulan-Ude whose concentrations create unacceptable levels of risk to public health are benzo(a)pyrene, suspended solids, nitrogen dioxide, PM 2.5 , PM 10 , formaldehyde, and black carbon.
• The levels of morbidity in Ulan-Ude were higher than the average for Buryatia by the main disease classes: respiratory organs by 1.19 times, endocrine system by 1.25 times, circulatory system by 1.11 times, eye diseases by 1.06 times, neoplasms by 1.47 times, congenital anomalies, and deformations and chromosomal aberrations by 1.63 times. There is an increase in the incidence of risk-related diseases of the respiratory organs and circulatory system. A strong correlation was found between this growth of morbidity and atmospheric air pollution in Ulan-Ude.

Funding Statement

This research was carried out within the framework of the budget projects of Baikal Institute of Nature Management, Siberian Branch of the Russian Academy of Sciences.

Author Contributions

Conceptualization, B.O.G. and I.K.D.; methodology, I.K.D., S.S.K., E.E.B. and E.V.M.; software, B.B.S., A.G.B., D.T.-D.Z., M.A.M., T.S.R., A.B.T., Z.E.B. and A.V.A.; validation, B.O.G., I.K.D., N.R.Z., V.E.T., A.A.A. and B.V.S.; formal analysis, S.S.K., V.S.B., N.R.Z., V.E.T., B.B.S., A.G.B., D.T.-D.Z., M.A.M., V.G.A., T.S.R., A.B.T., A.A.A., B.V.S., Z.E.B., A.V.A., E.E.B., E.V.M., A.B.L. and B.S.N.; investigation, B.O.G., S.S.K., V.S.B., E.E.B. and E.V.M.; resources, B.O.G. and V.S.B.; data curation, B.O.G., V.S.B., D.T.-D.Z. and V.G.A.; writing—original draft preparation, I.K.D. and V.S.B.; writing—review and editing, B.O.G.; visualization, V.S.B., N.R.Z., A.G.B., D.T.-D.Z., A.A.A. and B.V.S.; supervision, B.O.G.; project administration, B.O.G.; funding acquisition, B.O.G. All authors have read and agreed to the published version of the manuscript.

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