Analyzing over 10 million web search queries in March 2020, researchers found that the stay-at-home orders are associated with a significant decrease in searches for suicidal ideation, anxiety, negative thoughts, and sleep disturbances, with the most prominent decrease in suicidal ideation and anxiety searches.
The Research Background
By March 23, 2020, 11 states in U.S. had issued stay-at-home orders to help mitigate the spread of coronavirus. A group of researchers wanted to evaluate the impact of stay-at-home orders on mental health search queries between March 16-23.
Researchers examined the changes in mental health search queries on Google. Specifically, they looked at changes in patterns of search activity following issuance of stay-at-home orders in these states compared to all other states.
Outcomes included search terms measuring anxiety, depression, obsessive-compulsive, negative thoughts, irritability, fatigue, anhedonia, concentration, insomnia, and suicidal ideation.
The Research Findings
The results indicated that topics related to anxiety, negative thoughts about oneself and the future, sleep disturbances, and suicidal ideation were each associated with dramatic increases prior to stay-at-home orders being announced with subsequent and considerable leveling off during these periods, approximately the same time as the stay-at-home orders were announced and enacted.
As seen in the plot below, “afraid,” “anxiety,” “apathy,” “avoiding,” “hopeless,” “insomnia,” “irritable,” “procrastinate,” “restless,” “suicide,” “suicidality,” and “worthless” each showed rapid increases in search queries several days prior to the official enactment of the stay-at-home policies.
Moreover, each of these terms was associated with a leveling-off effect approximately 2 days prior to the implementation of the stay-at-home policy (ie, approximately the same time as the stay-at-home policy was announced). For all but 1 of these 12 symptoms (ie, “avoiding”), the leveling off remained consistent through the last day of data collection. Note that the terms associated with the strongest changes in these trends were “afraid,” “suicide,” “anxiety,” and “suicidal.”
This plot depicts the changes in search patterns relative to the orders going into effect. Negative time of stay-at-home values reflects the time before the stay-at-home orders go into effect, and positive values reflect the time following the order going into effect. The escalation phase designates approximately 4 days prior to the stay-at-home orders going into effect. The interruption phase spans between approximately 4 days and 0 days before the orders go into effect, and the new normal phase represents the times the 5 days after orders go into effect.
The Research Takeaways
Some prior researches have found an association between internet search behavior and real-world mental health data. Specifically, studies have found robust associations between suicide search queries and completed suicide rates. Many of these studies have also found links between mental health search data and observed rates of life stressors, such as divorce and unemployment.
Moreover, the early observed increase in “suicide” searches corroborates media reports that suicide calls have been increasing during the COVID-19 outbreak in the United States.
Thus, the research findings may point toward emerging evidence that stay-at-home orders may have immediately, at least temporarily, mitigated suicide risk. Also, the flattening of anxiety symptom searches suggest that stay-at-home orders may have had an immediate effect on altering this rising trajectory, preventing further fears and unrest given known governmental action.
Nicholas C Jacobson; Damien Lekkas; George Price; Michael V Heinz; Minkeun Song; A James O’Malley; Paul J Barr. 2020. “Flattening the Mental Health Curve: COVID-19 Stay-at-Home Orders Are Associated With Alterations in Mental Health Search Behavior in the United States.” In JMIR Mental Health, vol. 7, issue 6.