LOS ANGELES — As the pandemic drags on, its effects are continuing to have an outsize effect on Californians’ mental health. More state residents are reporting the need to seek professional help for mental health or use of alcohol and citing emotional impairment for basic life activities such as working or socializing with friends and family.
That’s the upshot of the 2021 California Health Interview Survey released Wednesday.
Conducted by the UCLA Center for Health Policy Research, CHIS is an annual survey of Californians throughout the state that looks at hundreds of variables affecting their health. The 2021 survey interviewed about 30,000 state residents of various backgrounds between March 18 and Nov. 30 “which covered a full second year of the impacts from the COVID-19 pandemic that allowed us to measure the pandemic’s cumulative impact,” said CHIS Director Todd Hughes.
The CHIS has long asked about specific health behaviors, such as what a person eats, drinks and smokes, but 2021’s survey included new questions about childhood trauma; climate change; the presence and storage of firearms in the home; concerns about firearm victimization; encounters with the police or court system; and housing security.
One in four California adults in the 2021 survey said there was a time in the past 12 months when they needed to see a professional because of problems with their mental health, emotions or use of alcohol or drugs, Hughes said. That marked a three-point increase compared with 2019. To cope, more Californians in 2021 took prescription medications, such as antidepressants or sedatives, compared with two years earlier.
The survey noted a similar increase, from 20% in 2019 to 26% in 2021, of California adults reporting impairment because of their emotions, whether that manifested in their work performance, social life or relationships with friends and family.
“The impact of the pandemic has been especially pronounced for young adults,” Hughes said. The survey found that 18- to 24-year-olds reporting serious suicidal ideation increased from 23.7% in 2019 to 30.5% last year.
Adverse childhood experiences
For the first time in 2021, the survey began collecting information on Adverse Childhood Experiences, or ACEs, such as violence or sexual abuse in the home where a person grew up.
“A set of potentially traumatic experiences that occur when we are young may be the root cause of some of the most common, serious and costly health and social challenges facing our state,” Hughes said.
Individuals who reported having had four or more ACEs reported experiencing serious psychological distress at four times the rate of those who had experienced no ACEs. African American, American Indian and Alaska native adults had the highest rates of ACEs in the 2021 survey.
The 2021 survey found that African American adults were stopped more often by police in the past three years than other groups. One in three African American adults had been stopped at least one time, compared with one in five for all California adults.
Such encounters led to increased reports of serious psychological distress. While 17% of California adults experienced serious psychological distress in the last year, that number increased to 25.5% for adults who had been stopped by the police and 24.9% for adults who lived with someone who was arrested.
The survey found that 44.8% of California adults had experienced extreme-weather-related events last year, such as extreme heat waves, flooding, wildfires, smoke from a wildfire or public safety power shutoffs of electricity to prevent a wildfire. About 9.8% of California adults overall reported mental health impacts from extreme weather, but the percentages varied by region.
In the Northern Sierra region, where the Dixie and Caldor Fires contributed to one of the worst wildfire seasons in state history, 23.9% of adults reported mental health impacts from extreme weather. Adults living in the Greater Bay Area and Sacramento Area also reported higher rates of mental health impacts from climate change compared with Southern California.
The survey found that 4.7% of California adults felt fairly or very unstable about their current housing situation. Young adults age 18 to 24 reported feeling the most housing insecure, with 6.2% feeling fairly or very unstable. Older adults age 65 to 79 and 80 years old or older had the lowest rates of feeling fairly or very unstable at 3.3% and 2.6%, respectively.
Correlating feelings of housing insecurity with the pandemic, the survey found that people who had lost their job because of COVID reported feeling fairly or very unstable in their current housing three times more often than those who had not lost a job.
People who reported their overall health as poor were also five times more likely than those who rated their overall health as excellent to report feeling fairly or very unstable in their current housing situation. The survey found that people reporting poor overall health were three times more likely than those with excellent health to report they worry very often about struggling with their mortgage or rent payments.
Gun safety and fears of gun violence
Over one in six, or 17.6% of California adults, reported in the 2021 survey that they live with a gun at home. The survey found that U.S.-born adults had three times the proportion of having a firearm at home compared with immigrants: 22.5% of U.S.-born adults had guns compared with 7.7% of immigrants.
The survey found that 13.8% of lesbian, gay or bisexual adults reported having a firearm at home compared to 18.1% of non-LGB adults. Veterans and individuals living in rural areas reported the highest rates of having a firearm at home: 38.1% and 31.9%, respectively. Rural adults had almost twice the proportion of having a firearm at home compared to individuals living in urban areas.
While 72.5% of California gun owners use a cable lock or lock container to store their guns, 19.6% use a trigger lock and 7.9% use a combination of a trigger lock and cable lock/lock container.
One in thirteen gun owners (7.7%) keep their firearm at home loaded and unlocked. Veterans and gun owners in rural areas had the highest rates of keeping a firearm at home loaded and unlocked — 13.9% and 9.7%, respectively. Immigrants had the lowest rate of keeping a firearm loaded and unlocked (5.5%).
One in eight California adults, or 12.9%, reported that they were very worried about being a victim of gun violence. Immigrants were the most worried, at 24% — three times more than U.S.-born adults. While 7.7% of U.S.-born adults reported being very worried, rates were higher for young adults (14.3%), as well as lesbians, gays and bisexuals (13.7%).
Adults living in rural areas and veterans were the least worried in the survey; 6.5% of adults in rural areas and 4.4% of veterans said they were very worried about being a victim of gun violence.