Number of Californians with mental health distress sharply increased from 2014 to 2018

UCLA study finds the trend was especially pronounced among 18- to 24-year-olds
Woman in distress
According to projections based on the California Health Interview Survey, about 3.2 million Californians experienced serious psychological distress in 2018.

From 2014 to 2018, the number of California adults who reported that they had experienced serious psychological distress in any given year increased by 42%, according to a UCLA Center for Health Policy Research policy brief published today.

The finding is based on research in the California Health Interview Survey, which each year gathers data from more than 20,000 respondents. Based on the surveys, UCLA researchers project that nearly 2.2 million Californians experienced serious psychological distress in 2014, and that the figure steadily increased through 2018, when, according to their projections, 3.2 million experienced such issues.

The report defined serious psychological distress as symptoms that interfere with social, educational and occupational functioning and that require mental health treatment.

The number of young adults (ages 18 to 24) reporting serious distress increased 103.5% from 2014 to 2018, the largest increase among any age group in the study. The report also reveals that:

  • The number of men reporting serious distress (68.4% increase from 2014 to 2018) increased more than the number of women.
  • People who held part-time jobs (103.3% increase) had a greater increase than people with other employment status.
  • Asians and Asian Americans (170.6% increase) had a greater increase than any other racial/ethnic group.
  • People who identify as lesbian, gay or bisexual (44.2% increase) had a greater increase than those who identified as heterosexual.
  • People who have at least a college degree (64.7%) had a greater increase than those with lower levels of education.

"It is critical to look at structural and social factors such as education, income, employment and discrimination that may be related to mental health inequities," said D. Imelda Padilla-Frausto, lead author of the study and a research scientist at the center. "This can help explain why a high percentage of adults who identify as lesbian, gay or bisexual have experienced serious distress and why the number of people in that group reporting serious distress has continued to increase.

"Because our society does not completely embrace people who identify as lesbian, gay or bisexual, they face discrimination, violence and stigma, which can lead to inequities in educational attainment, employment discrimination and financial insecurity. And that lack of acceptance and equal opportunity can lead to mental health inequities."

The authors provide seven sets of recommendations to address the trend, focusing on structural factors that may be contributing to people's increasing levels of distress, and in particular the lack of access to mental health services for people in underserved communities.

"Reducing psychological distress will require reducing inequities in educational attainment, employment and financial security, access to affordable and quality care, as well as among at-risk groups across age, gender, sexual orientation, and race and ethnicity," Padilla-Frausto said.

Even before the COVID-19 pandemic began, more than 3 million California households were unable to meet basic living costs. Padilla-Frausto and her co-authors write that the issues the report raises are particularly important considering the psychological and economic effects of the pandemic, which are likely to exacerbate the structural factors that tend to bring on psychological distress.

They urge policymakers to prioritize equity-based economic recovery policies that consider the disadvantages that at-risk groups were already facing, including lack of access to basic needs and services.

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