Mental Health and Wellbeing of LGBTQ+ Individuals during the COVID-19 Pandemic

Background

During the COVID-19 pandemic, many people experienced isolation, loneliness, job and income loss, food insecurity, increased substance use, anxiety, and depression. Lesbian, gay, bisexual, transgender, queer, and other (LGBTQ+) individuals were disproportionately impacted by the pandemic. They experienced increased substance use, health disparities, job loss, sleep problems, risk for COVID-19, and fear of COVID-19; and had less access to quality and appropriate health care when compared to non-LGBTQ+ individuals. Further, LGBTQ+ populations face potential isolation, lack of support from family members, less contact with supportive and affirming groups, and disruption in mental health services. Most research with LGBTQ+ individuals during the pandemic focused on specific populations, such as college students or people living in metropolitan areas. This study was one of the first large-scale surveys exploring the health and wellness of diverse LGBTQ+ adults across the United States during the COVID-19 pandemic.

Methods

Surveys were distributed using the Qualtrics Panel, and over 700 individuals from diverse ages, racial/ethnic backgrounds, genders, sexualities, locations (urban and rural), education levels, and income levels responded. Survey items focused on individual demographics, mental health and treatment, social support (Berkman-Syme Social Network Index) and loneliness (UCLA 3-item Scale). We analyzed levels of and changes in both mental health and loneliness using linear regression models that adjust for demographics, employment and income changes, overall health, substance use disorder, and COVID-19 infection.

Results

Nearly 400 of the respondents had current mental health concerns, with almost 60% receiving treatment. Most respondents reported that their mental health worsened during the pandemic. Individuals who had mental health concerns but were not receiving treatment reported the greatest decline in mental health during the pandemic. Those who were less likely to have worsened mental health included those aged 25 and older, those in urban areas, religious or spiritual individuals, those in good overall health, and people who did not have current or previous mental health concerns.

LGBTQ+ individuals were more likely to report experiences of loneliness if they were out to fewer individuals in their lives, lived in rural communities, had poor health, and had current mental health concerns. Interestingly, those who were hospitalized during the pandemic were less likely to report loneliness, and individuals who had strong social networks were more likely to report loneliness.

Conclusions and Implications

Mental health and wellbeing outcomes were worse for LGBTQ+ individuals during the COVID-19 pandemic if they lived in rural areas, had poor overall health, and had prior mental health concerns. This study has implications for social work practice and for future research. Social work practitioners should be aware of the unique experiences of LGBTQ+ populations, including the context of health and mental health disparities. This study also highlights the need for robust services and outreach for individuals who may experience isolation and loneliness. Future research could review the longer-term impacts of the pandemic on LGBTQ+ individuals and examine the unique experiences of loneliness reported by those who are hospitalized and those who have robust social networks that are suddenly cut off.