Since the start of the COVID-19 pandemic, there has been empirical and anecdotal reports of declines in both emergency and ambulatory medical visits. However, little research has been conducted to identify why these declines have occurred. New research now shows a strong association between mental health symptoms and medical care avoidance.

Among a sample of over 73,000 U.S. adults from the Household Pulse Survey, a weekly survey conducted by the U.S. Census Bureau that aims to collect data on the social and economic impacts of COVID-19, researchers found that adults who experienced four common symptoms of anxiety and depression have upwards of two times greater risk of delaying medical care or not receiving needed non-coronavirus medical care amidst the pandemic.

“The results from our study are alarming given that delaying medical care can have significant adverse short- and long-term health outcomes, depending on the condition,” said Kyle T. Ganson, PhD, MSW, assistant professor at the University of Toronto’s Factor-Inwentash Faculty of Social Work and lead author on the study. “We need to increase access to telehealth, and in the U.S., health insurance policies must be expanded to cover telehealth services that address non-emergency medical concerns.”

The study, published online in the Journal of General Internal Medicine,, found that in the four weeks prior to participating in the survey in June, 41% of the sample delayed medical care. In addition, nearly one third of the Americans surveyed did not receive necessary non-coronavirus medical care.

“Patients with chronic medical conditions or new symptoms that they are concerned about need to continue to seek medical advice,” says senior author Jason M. Nagata, MD, MSc, assistant professor at the University of California, San Francisco’s Department of Pediatrics. “As the pandemic continues, it remains vitally important that the public have accurate and updated information on the risks and benefits of seeking medical care.”

The study also found that symptoms of anxiety and depression were overwhelmingly common among the sample. In the seven days prior to the survey, 65% reported being nervous, anxious or on edge, 56% reported not being able to stop or control worrying, 53% reported having little interest or pleasure in doing things, and 52% reported feeling down, depressed, or hopeless.

“More people are experiencing symptoms of anxiety and depression during the pandemic, which can often be addressed through telepsychiatry and telemental health services. As a clinical social worker, I have seen how effective and accessible teletherapy can be in addressing these symptoms,” says Dr. Ganson.

The study’s authors say that their findings also have important implications for clinical practice. “Medical professionals, social workers, and clinicians need to proactively take steps to help clients work through symptoms of anxiety and depression,” Dr. Ganson says. “This will help to improve the likelihood that they will seek the medical care they need.”