The Effects of COVID-19 on the Mental Health of Intergenerational Families

Abstract

Due to the unexpected deadly virus that has inhabited our daily lives, the rise in worry, stress, and anxiety has taken control over many people’s lives. Our interest in this topic led to our exploration on the impacts of stress and mental health, along with the access to mental health resources, financial changes, and the overall methods of coping with self-isolation throughout the pandemic. Our study is to examine how COVID-19 has affected the mental health and stress of those around us. One of our defining factors of stress in family households is unemployment. This is due to people losing their jobs and having increased levels of depression, anxiety, distress, and low self-esteem. As our research was conducted, multiple resources for those experiencing issues with their mental health or financial issues were discovered. Not surprisingly, COVID-19 had an impact on the average person affecting their stress and mental health stability levels, even if they never had the virus themselves.

Introduction

The year 2020 provided some of the most unexpected turns of events. A rise in cases from a new deadly virus, formally named COVID-19, took over every news channel, both across the nation and globally. Businesses were forced to shut down and people were instructed to stay in their homes as they worried for the safety of their loved ones. As society has come to terms with a new sense of normalcy, the effects of COVID-19 still show a great impact on mental illness and high-stress level cases today.

The Centers for Disease Control and Prevention (CDC) website states that:
“The COVID-19 pandemic has had a major effect on our lives. Many of us are facing challenges that can be stressful, overwhelming, and cause strong emotions in adults and children. Public health actions, such as social distancing, are necessary to reduce the spread of COVID-19, but they can make us feel isolated and lonely and can increase stress and anxiety. Learning to cope with stress in a healthy way will make you, the people you care about, and those around you become more resilient” (“Coping with Stress” 2021) CDC.

The objective of this paper is to gain information on COVID-19 and the interlinked effects of mental health on intergenerational families. Intergenerational families were chosen due to a wider variety of ages and different risk factors. In this study, we examined the question: How have the effects of the COVID-19 pandemic influenced the mental health of intergenerational families in Northern California? While numerous studies have been conducted on the COVID-19 virus and the different risk factors for multigenerational families, the link between COVID-19 and mental illnesses for those same families has not yet been conducted to its full extent. For this reason, our research paper is an intent to help widen the knowledge given about the increase in mental health issues following the current global pandemic.

Literature review

Our topic investigates the effects of COVID-19 on the mental health of intergenerational families. We examined multiple articles that helped us understand what is happening in our community. Throughout the literature review we explore the impacts of stress and mental health, access to mental health resources, financial changes, and how people cope with the effects of isolation during the COVID-19 pandemic.

An article written by the CDC called Coping with Stress highlights important facts that we should know. The article states, “Many of us are facing challenges that can be stressful, overwhelming, and cause strong emotions in adults and children. Public health actions, such as social distancing, are necessary to reduce the spread of COVID-19, but they can make us feel isolated and lonely and can increase stress and anxiety.” (CDC 2021) The article gives a clear understanding of what many are experiencing within Sonoma County.

It has been reported that many families throughout Sonoma County are having a difficult time finding access to mental health resources. During the initial stages of the pandemic, society was in what is known as “survival mode”, causing a lot of adrenaline to run through our bodies. (Dorsey 2021) With the pandemic now becoming manageable, processing the effects of the pandemic mentally has taken its toll on some. Evidence found in an article called Bay Area sees therapist shortage as California reopens following COVID-19 pandemic by Dustin Dorsey explains that the reason it is difficult to receive mental health services is due to a lack of behavioral health professionals in the Bay Area. (Dorsey 2021) It reports that because of the high cost of living, it is pushing out psychiatrists, drug and alcohol counselors, and behavioral health counselors.

Many are experiencing the effects of COVID-19 with cases of mental illness, stress, and anxiety. Our study is to examine how COVID-19 has affected the mental health and stress of those around us. The CDC has stated that there are high rates of people struggling with their mental health. Those most affected are essential workers, minority groups, children, and unpaid caregivers. This can lead to more cases of substance use and people falling victim to suicidal thoughts. In June of last year, 40% of adults faced mental health and stress symptoms due to COVID-19 (Czeisler et al. 2020) CDC. There were many who lost their jobs due to the pandemic, which in return put more stress in families due to new financial issues. During the pandemic in Sonoma County, we saw a rise in the cost of living. Families struggling with financial issues have led to strains in their mental health and high levels of stress. During the pandemic, 56% of 18–24-year-olds reported having anxiety or depressive disorder. There was also an increase of substance use among young adults, the percentage rose from 13 to now 25%. Suicidal rates also took a rise amongst younger adults increasing to 26% compared to the previous 11% (Panchal et al. 2021) KFF.

One defining factor of stress in family households is unemployment. People who have lost their jobs have increased levels of depression, anxiety, distress, and low self-esteem. Lives were changed drastically due to limited incomes which caused high levels of stress. The rates for mental health changes and stress levels increased from 32% to 53% (Panchal et al. 2021) KFF.

As we continued our research, we came upon multiple resources for those experiencing mental health or financial issues. The Sonoma County website offers many helpful sources for those in need of assistance (“Coronavirus Response” 2020) Sonoma County Resources . Funds for mental health resources were cut in Sonoma County and became restored after the approval of Measure O, a quarter-cent sales tax for 10 years, which will help with the funds for mental health and resources for people that need them. An article in the Press Democrat called “Rise in mental health crises among Sonoma County youth a growing concern,” states that 7 out of 10 high school students are feeling more anxious about their future. This fear comes from fearing the unknown and possible vaccination requirements (Baig 2020) The Press Democrat.

Methods

We collaborated as a group and created our main question, “How has COVID-19 affected the mental health of intergenerational families?” Once we created the question, we each began to research Mental Health and COVID-19 articles in various publications. We created a document to place any article links we found. Once we each found 5-10 articles each, we read them and collectively worked to delete duplicates and weed out articles that were not pertinent to our main question. We created a 218-page reader consisting of data regarding COVID-19 to support our topic.

Next, we needed a way to collect data, so we decided that we would devise a list of questions. We wrote an introduction to our research questions to show the importance of the work we were doing. We felt it was important for the interviewees to know that our paper would be a published work upon completion, and that their responses would be entirely confidential.

We agreed that each member would bring 2-3 questions they felt would be pertinent to our topic of research. We worked together to word the questions in a way that would make those interviewed feel comfortable with sharing their stories about if/how COVID-19 has affected their and their family’s mental health. Moreover, we were able to create a list of twenty questions. Once the questions were complete, we placed them in an order that created an interview that flowed nicely from one question to the next. Each member of our group would use those questions to interview 2-3 people from Northern California that lived in a home with 2-3 generations in the same household. We focused on the Northern California region to be more specific in our research and to also provide helpful information that could help our local government to see what programs or services may be necessary for people in our communities who may need to access mental health services. Race was not a factor in determining who to interview, as we focused our research on anyone that we knew that had 2-3 generations living in the same home. Some of the two generation households also interacted daily with a third generation, usually a parent or grandparent, which lived in a separate home.

Once our list of interview questions and introduction were complete, we paired up into teams so that one member would interview, and the other would take copious notes. One of our groups had three people in it, so they rotated. This way the interviewer would have their full attention on their task of interviewing and not trying to keep up with notetaking. Once a plan was set, we began interviewing our subjects. Interviewing people online or over the phone due to COVID-19 restrictions was more difficult than interviewing in person. Some interviewers found it easier to use a transcription service to help us keep up with the notetaking. This, along with the second member taking notes, helped ensure that important data would not be overlooked. Overall, we found that people were comfortable with being interviewed, and the sessions went well.

After we finished our interviews, we compiled our data onto a document that we could each access. We divided the work by breaking up the data by sections. One person was responsible for compiling the data for questions 1-4, another for questions 5-8, and so on. Once our data compilation was complete, we reviewed the data to see if there were any commonalities to the questions posed to those we interviewed. Those common aspects were what we used to create the body of our work.

We examined whether or not race factored into our data analysis. There was not an even distribution of races interviewed, to conclude one way or another, that race could be a factor. The majority of our respondents were of Hispanic or Latino descent, due to that being the demographic of our research group. We concluded that regardless of race or ethnicity, families were all affected in some manner by stresses or anxieties, and that Covid-19 did not affect one race more than another, in terms of mental health and stress. Financially, most all were affected in one way or another, whether it was job loss or spending more on food due to the family being home more, so again race was not a factor. Our data also showed that race was not a factor in whether or not a person sought professional help for their mental health and stress, as those that sought help were all from different races.

Data Analysis

After a review of all interviews conducted, it was discovered that the average number of people living in a household was five, with more than half of the participants living with other family members or their children. 75% of those interviewed stated they or a family member have had COVID-19 during the pandemic. Sadly, some of our respondents had children who tested positive for COVID-19. Another common aspect amongst interviewees was the elevated anxiety and stress levels that were experienced when self-diagnosing symptoms similar to those of COVID-19.

When interviewees were asked if they felt the pandemic has heightened their family's anxiety levels when self-diagnosing mild symptoms, one response stood out. “Yes, very much. Every little cough and sneeze. The word ‘COVID’ just gets thrown around so often. Hand sanitizer is everywhere, Lysol wipes, everything. We are just a lot cleaner and trying to look out for each other and find a way to not spread germs.” This response explains how worried and paranoid people are about contracting COVID-19. A sneeze or cough a met with stares and looks of concern from bystanders as they assume you might be sick and or have the virus.

Not surprisingly, COVID-19 had an impact on the average person affecting their stress and mental health stability levels, even if they never had the virus themselves. Here is a statement by one of our interviewees when asked about their stress levels, “I have been in a state of high anxiety ever since it began,” they answered, “Some days, I would get so nervous I would feel like I would be sick because of worry that my family would become ill. My mother is in her seventies and lives down in SoCal and I worried about her as well, she has had cancer and has asthma, high blood pressure, and diabetes. My mother-in-law has had portions of her lung removed and has a bleeding disorder, so we worry about her a lot as well, we care for her daily.”

We then inquired if our subject’s family’s mental health, anxiety and stress levels had been affected by the pandemic. Again, the common response was yes, especially before the vaccine came out. Those who did not contract the COVID-19virus, experienced heightened stress and anxiety levels, especially those who worked in healthcare or other essential services.

Not only were people mental and emotionally disrupted, but they were also financially effected. Five of the respondents lost their jobs; businesses went out of service and people even lost their homes. Others had the luxury of remaining employed by working from home throughout the pandemic and are continuing to do so today. Those who were financially impacted were grateful for the government assistance they received. “Yes, my kids have had times where they needed assistance and when my spouse was off, we struggled a bit here and there,” said an interviewee, “The government checks were a huge help for us all.” The checks helped many get by when they needed financial assistance due to being laid off or having hours cut short at their jobs.

This pandemic has left everyone feeling affected one way or another. When interviewees were asked if COVID-19 impacted or affected their family members in terms of their mental health, one answered, “We were not sure how to take this situation, but we got through it.” The majority reported feeling distant and lonely, even while being with someone for large periods of time. Not being able to visit, interact or hang out with friends and family took a toll on many of those interviewed.

COVID-19 has affected many people in many different ways: mentally, emotionally, and physically. Families have been torn apart and it has served as a wakeup call for some people to reconnect with their loved ones, even if only at a distance. When asked, “Have you or your family utilized mental health professionals during the COVID-19 pandemic?”, over 50% of those interviewed answered no, they either do not have enough time or they're pushing through it like they used to. When we asked, “In what ways do you feel like COVID-19 has impacted or affected family members in terms of their mental health?” anxiety and stress surrounding becoming infected or infecting others were the most common answers. One response that stood out was, “my daughter has become a germaphobe. She doesn't want to touch any doorknobs and, you know, she's really good about washing her hands now. Same with my son, but my daughter particularly, she's really sensitive to it, and she already had anxiety to begin with. Now she doesn't want to leave the house without a mask, even if we're outdoors, and although we're not mandated to wear a mask outdoors, she still wants to wear a mask.” COVID-19 has had an impact on the mental health of all respondents' children, especially in terms of stress and anxiety surrounding distance learning.

We then asked if COVID-19 has affected social interactions with other family members. Most respondents stated that COVID-19 has affected social interactions with family members, due to stay-at-home orders. Many said that they felt distanced from the family members that they would normally gather with at social family functions, or those that they felt were at risk, although most said that they felt that they had forged a stronger bond with their immediate family members that were a part of their “bubble” of people they interacted with. A few respondents said that their families found ways, such as regular phone or video calls to stay connected, even if they could not be together physically. There were also some respondents that stated that they no longer interacted or spoke with certain family members. due to differing views on masking, vaccines, or perceived risk taking in terms of social interactions and possible exposure to COVID-19. One person stated, “We stick to our bubble that includes a couple of really good friends and my neighbor. There are friends and family that we choose not to associate with due to our differing opinions on the virus and vaccines. I have only spoken to my father once since Covid. He is a Trump supporter and refuses to respectfully discuss things like masking and vaccination. Thankfully they have not contracted the virus, as they do not mask. I have an aunt and a couple cousins that we do not speak with due to the same thing. Hopefully this divide will not remain a long-term issue, as I love my family and don’t like the disconnect.”

Fear of an elderly family member becoming ill was a common response when those interviewed were asked, “What do you feel that has been the most stressful for you during the Covid-19 pandemic overall?” Those who had school-aged children noted that online/distance learning was the most stressful part of the pandemic for them. It was difficult to help their children and there were random technical issues with computer connectivity. Some children really struggled with not being at school. Another source of stress came from not being able to be with their family.

When asked how they responded to stresses relating to Covid-19, half of the interviewees answered that they took walks or worked out in some way. They also mentioned spending time doing things outdoors and a lot of time with immediate family over the phone. There were some who maintained a generally positive attitude and are taking it day by day. One interviewee talked about facing difficulties because her spouse was out of work, and she was working from home. The new amount of time they were spending together caused more arguments than usual which prompted them to seek couples counseling, which has helped them tremendously.

The most common response to the question “What coping mechanism have you used?”, was being outdoors and going for walks. Many said they spent more time talking to family about what was going on, especially those with children. A couple of the families got new pets. Some said that they avoided the news and social media to keep their stress levels down, as the constant bombardment really affected them. When asked, “Has COVID-19 affected the way you spend your free time?”, all but one interviewee responded with yes. Most said that they were no longer going out socially, and instead staying at home to be with their immediate family. A few found that they had more free time than they were used to but were not happy about it due to not having anything to do. Those who did not feel they had a lot of free time due to work and other responsibilities said they were more careful with how they now used their free time compared to the past.

The pandemic brought mental health to the forefront as many feared contracting the virus, being laid off from their jobs, or fearing getting the virus while working as an essential employee. The interviewees were then asked if they took any time off from their work or family interaction to relieve the stress or mental health effects brought on by the pandemic. 47% answered yes, 42% answered they did not take time from work or family interactions while 11% said they were planning to. All interviewees responded that they have spent more time at home since the pandemic with a few including that they were more conscious with the decision at the beginning of the pandemic.

Social isolation and distancing were a concept that was very new to the world, and it caused mental health effects including depression and loneliness. One interviewee, who called themselves a very social person, answered that social isolation caused them to lose touch with people and affected new friendships because they were not able to maintain them. Loneliness, depression, and paranoia became a common theme among the interviewees when posed with the question, “How has social isolation affected you during the COVID-19 pandemic?” Though social isolation and distancing brought many negative mental health effects, the interviewees shared that their families and friends have helped them cope with those side effects. One stated “My family is indispensable. I would have been lost without them. Just having someone to share my worries with and to feel like I am helping them to cope has been good for me too.”

Conclusion

In conclusion, the public is informed daily about the physical effects of COVID-19 by news outlets and the CDC. They are provided with ways to prevent exposure which includes different ways to manage the symptoms if you have been exposed. However, the effects of this pandemic on someone’s mental health are still not fully known, as we are still in its midst. Our project was to study the question, “How have the effects of the COVID-19 pandemic influenced the mental health of inter-generational families in Northern California?”, with the main focus on intergenerational families. There is a wider variety of factors such as age, race, and language that could also be incorporated into accomplishing the research.

As we have shown, by interviewing families and examining different articles, we were able to explore the effects and/or impacts of mental health during the pandemic on our respondents. It is important to mention that the majority or those interviewed were Hispanic or Latino families, but there was not a significant difference with the impacts of COVID-19 on them, or those from other races or ethnicities. Many of the participants were facing challenges such as losing loved ones or not being able to socialize with other family members or close friends outside of their homes. Our participants also experienced a long set of emotions, including stress and anxiety, which affected them directly or indirectly. We also concluded that unemployment was a contributing factor to stress in families.

Moreover, it was interesting to learn that some participants were not dramatically affected and only suffered minor challenges, such as having to spend more time with family due to stay-at-home policies. Finally, collecting data for this project became difficult at times due to some of the interviews being conducted via zoom. Despite that difficulty, we were able to obtain enough information to conclude that individuals and families have struggled in terms of their mental health and stress during the COVID-19 pandemic.




Appendix
Good morning/afternoon/evening ______________.
My name is ______________ and this is my classmate(?) ______________. We are Sociology students working under the guidance of Dr. Peter Phillips, at Sonoma State University. We are part of a research group that is studying the effects COVID-19 has had on the mental health of intergenerational families. We are interested in households that have two or more generations that live and interact with one another daily. You and your immediate family have been chosen to be interviewed for our study. Your participation will help give important information regarding the effects of Covid-19 and mental health. During our interview, we will be speaking with you individually and will ask you questions about how your stress and mental health has been affected by COVID-19. Your responses to our questions will be kept completely confidential in our research paper. Upon completion of this research project, it will become a published work. Do you agree to take part in our study of the effects COVID-19 has had on the mental health of intergenerational families?
Thank you, your participation is appreciated.
How many members are in your household?
What are your relationships with one another?
Have you or another immediate family member contracted the Covid-19 virus?
If you have had the COVID-19 virus, what are some general effects experienced after recovery?

Do you feel the pandemic has heightened your families’ anxiety level when self-diagnosing mild symptoms?

Do you feel that Covid-19 has impacted your stress and mental health?

Has Covid-19 impacted the stress and mental health of your family members?

Has your family been affected by financial stress during the Covid-19 pandemic?

In what ways do you feel like Covid-19 has impacted or affected family members in terms of their mental health?

Have you or your family utilized mental health professionals during the Covid-19 pandemic?

How has Covid-19 affected relationships in your family?

Has Covid-19 affected your social interactions with other members of your family?

What has been most stressful for you during the Covid-19 pandemic overall?

How have you responded to the stresses relating from Covid-19?

What mechanisms have you used to help overcome these stresses?

Has the Covid-19 pandemic affected the way you spend your free time?

During this time, have you taken any time off from work or regular family interactions for your own stress and mental health?

Have you spent more time at home during the Covid-19 pandemic?
How has social isolation affected you during Covid-19 pandemic?
Have your friends and family members helped you cope with the effects of isolation during the Covid-19 pandemic?

Is there anything else you would like to tell us?
Thank You!



References
Anon. 2021. “Coronavirus Response.” Sonoma County Emergency and Preparedness Information. Retrieved November 23, 2021 (https://socoemergency.org/emergency/novel-coronavirus/).
Anon. 2020. “Mental Health, Substance Use, and Suicidal Ideation during the COVID-19 Pandemic - United States, June 24–30, 2020.” Centers for Disease Control and Prevention. Retrieved November 23, 2021 (https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm).
Baig, Yousef. 2020. “Sonoma County Teens Stressed and It's Affecting Academic Performance.” Santa Rosa Press Democrat. Retrieved November 23, 2021 (https://www.pressdemocrat.com/article/news/rise-in-mental-health-crises-among-sonoma-county-youth-a-growing-concern/).
Nirmita Panchal, Rabah Kamal and Feb 2021. 2021. “The Implications of COVID-19 for Mental Health and Substance Use.” KFF. Retrieved November 23, 2021 (https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/).
Dorsey, D. (2021, July 3). Bay Area sees therapist shortage as California reopens following COVID-19 pandemic. ABC7 San Francisco. Retrieved November 23, 2021, from https://abc7news.com/mental-health-coronavirus-pandemic-covid-19/10850759/.
National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health (Ed.). (2021, July 22). Coping with stress. Centers for Disease Control and Prevention. Retrieved November 23, 2021, from https://www.cdc.gov/mentalhealth/stress-coping/cope-with-stress/index.html#healthy-ways.