Rates of mental illness were already high in the U.S., but the pandemic intensified everything: Illness, loneliness, job loss, grief, and other stressors related to COVID induced a nationwide rise in anxiety and depression. As difficult as the pandemic has been, however, it hit some groups far harder than others. It exacerbated social and economic inequities already known to drive and sustain poor mental health among marginalized communities. Those in rural America, already less likely to receive mental health care than those in urban areas, were particularly hard hit. So were people of color, who are more likely to be hospitalized and die from COVID and are less likely to receive mental health care compared with white people. And for those who were unhoused or formerly incarcerated, the consequences have been profound.

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