Science Communication & Media
Depression is purple, but unmet need for treatment is red Catherine Ettman* Catherine Ettman Ross Hatton Brian Castrucci Sandro Galea
As depression becomes more visible in the public conversation, it has also become bound in national divides, with suggestions that depression is more likely among persons who affiliate with one political party. We sought to assess 1) whether depression is associated with political party affiliation and 2) the use of mental health care by political affiliation. Using a nationally representative sample of U.S. adults (N=2,325) surveyed in March-April 2023, we assessed the relation between political party and 1) positive screen for depression (PHQ-9>9) or anxiety (GAD-7>9), and 2) self-reported use of a mental health care provider in the past 12 months. We used logistic regression models and adjusted for social and economic characteristics to test for differences by political party in the predicted probability of a positive PHQ or GAD screen and reporting not having seen a mental health provider in the past 12 months. Adjusted models controlled for: sex, race and ethnicity, age, education, household income, home ownership, parent status, marital status, and metropolitan status). The weighted prevalence of depression was 19.2% among Republicans and 24.2% among Democrats, but these differences were not statistically significant (p=0.07). In adjusted models controlling for sociodemographic factors, the adjusted prevalence of depression was 21.2% among Republicans and 25.3% among Democrats (p=0.152). However, in both unadjusted and adjusted models, Republicans were significantly more likely (88.3% in unadjusted and 86.8% in adjusted) to report not having seen a mental health provider in the past 12 months relative to Democrats (76.2% in unadjusted models <0.01 and 76.6% in adjusted models, p <.01). Results were consistent for symptoms of anxiety. Poor mental health is common across Democrats and Republicans; however, use of mental health care is lower among Republicans than Democrats. Lower use of mental health care may be due to stigma (demand) or lack of access to health care (supply). Mental health and access to mental health care may be bipartisan public health topics to pursue during the 2024 election and in coming years. Mental health could be a national priority that unites the U.S. population in increasingly divided times.
