The COVID-19 outbreak has led to a fourfold increase in the number of people accessing Mental Health America (MHA) services for help with depression, anxiety, and other mental health problems, according to the MHA (http://www.mhanational.org), one of the nation's oldest mental health assistance providers. Since 2014, the MHA has maintained a publicly accessible online service with useful information about common mental health issues.

"We continue to see staggering numbers that indicate increased rates of depression and anxiety because of COVID-19," said Paul Gionfriddo, MHA president and chief executive officer, in a press release.

Using requests made in January for MHA's online mental health screening services as a baseline, the organization found that requests increased slightly from January through April, and then jumped sharply during May and June. For example, anxiety screenings in June were 406% greater than in January, while screenings for depression were 457% greater. The percentage of people diagnosed as "at risk" for psychosis spiked in May, when lockdown and self-isolation began, and then continued to rise in June to more than four times the number in January. A sixfold increase was noted for those considering suicide or "self-harm."

A key finding of the MHA report is that social consequences of the pandemic, rather than the threats of sickness or death, are chiefly responsible for stress in people using the screening tools. Loneliness and isolation were identified as the main causes of depression and anxiety (73%), followed by past trauma (46%) or relationship problems (44%). As nearly half of those seeking help self-identified as girls/women between 11 to 25 years of age, the study's finding are especially useful in raising awareness of the harmful effects of the COVID-19 pandemic on this population.-Frank Brodhead