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Note: This brief was updated on March 20, 2023 to incorporate the latest available data.

Concerns about mental health and substance use remain elevated three years after the onset of the COVID-19 pandemic, with 90% of U.S. adults believing that the country is facing a mental health crisis, according to a recent KFF/CNN survey. The pandemic has affected the public's mental health and well-being in a variety of ways, including through isolation and loneliness, job loss and financial instability, and illness and grief.

Over the course of the pandemic, many adults reported symptoms consistent with anxiety and depression, with approximately four in ten adults reporting these symptoms by early 2021, before declining to approximately three in ten adults as the pandemic continued (Figure 1). Additionally, drug overdose deaths have sharply increased - largely due to fentanyl - and after a brief period of decline, suicide deaths are once again on the rise. These negative mental health and substance use outcomes have disproportionately affected some populations, particularly communities of color and youth. As the end of the declaration of the public health emergency nears - on May 11, 2023 - many people continue to grapple with worsened mental health and well-being and face barriers to care.

This brief explores mental health and substance use during, and prior to, the COVID-19 pandemic. We highlight populations that were more likely to experience worse mental health and substance use outcomes during the pandemic and discuss some innovations in the delivery of services. We analyze and present findings using the most recent data available at the time of this publication - including the Household Pulse Survey and the CDC WONDER database. Key takeaways include:

Symptoms of anxiety and depression increased during the pandemic and are more pronounced among individuals experiencing household job loss, young adults, and women. Adolescent females have also experienced increased feelings of hopelessness and sadness compared to their male peers.

Deaths due to drug overdose increased sharply across the total population coinciding with the pandemic - and more than doubled among adolescents. Drug overdose death rates are highest among American Indian and Alaska Native people and Black people.

Alcohol-induced death rates increased substantially during the pandemic, with rates increasing the fastest among people of color and people living in rural areas.

After briefly decreasing, suicide deaths are on the rise again as of 2021. From 2019 to 2021, many communities of color experienced a larger growth in suicide death rates compared to their White counterparts. Additionally, self-harm and suicidal ideation has increased faster among adolescent females compared to their male peers.

Several changes have been implemented in the delivery of mental health and substance use services since the onset of the pandemic, including the utilization of telehealth, steps to improve access to treatment for opioid use disorders, expansion of school-based mental health care, and the rollout of the 988 crisis line. As the public health emergency declaration comes to an end, it is possible that some of these changes will be interrupted.

Prevalence of Mental Illness and Substance Use During the Pandemic

Anxiety and depression

The pandemic was associated with a high prevalence of anxiety and depression symptoms in adults. Research suggests that these symptoms increased during the pandemic, but the extent of this increase is unclear. Throughout the pandemic, symptoms of anxiety and depression have been more pronounced among several populations.

For example, individuals experiencing household job loss were more likely than their counterparts to report symptoms of anxiety and/or depression (53% vs. 30%) in February 2023 (Figure 2). Job loss and unemployment - which have long been associated with adverse mental health outcomes - increased substantially early on in the pandemic.

Fifty percent of young adults (ages 18-24) reported anxiety and depression symptoms in 2023, making them more likely than older adults to experience mental health symptoms (Figure 2). Young adults have experienced a number of pandemic-related consequences - such as closures of universities, transitioning to remote work, and loss of income or employment - that may contribute to poor mental health. Additionally, young adults in college settings may encounter increased difficulty accessing treatment.

Symptoms of anxiety and/or depression were also elevated among women (36%) compared to men (28%) in February 2023 (Figure 2). Even before the pandemic, women were more likely than men to report mental health disorders, including serious mental illness.

Concerns about youth mental health further increased with the onset of the pandemic and the recent uptick in gun violence. In a recent KFF/CNN survey, roughly half of parents (47%) said the pandemic had a negative impact on their child's mental health, including 17% who said it had a "major negative impact". Poor mental health has been more pronounced among adolescent females in particular. As shown in Figure 3, the gap in the share of adolescent females and males reporting feelings of hopelessness and sadness - symptoms indicative of depressive disorder - widened from 2019 (47% vs. 27%, respectively) to 2021 (57% vs. 29%, respectively). Many female adolescents also reported adverse experiences in 2021, which can negatively impact mental health.

Substance use and deaths

The pandemic has coincided with an increase in substance use and increased death rates due to substances. In 2021, there were over 106,600 deaths due to drug overdose in the U.S. - the highest on record. This spike in deaths has primarily been driven by substances laced with synthetic opioids, including illicitly manufactured fentanyl.

Further, the overall drug overdose death rate rose by 50% during the pandemic (Figure 4), but varied across states. While drug overdose death rates increased across all racial and ethnic groups, the increases were larger for people of color compared to White people. White people continue to account for the largest share of deaths due to drug overdose per year, but people of color are accounting for a growing share of these deaths over time. In 2021, the highest drug overdose death rates were among American Indian Alaska Native (AIAN) people (56.6 per 100,000), Black people (44.2 per 100,000), and White people (36.8 per 100,000) (Figure 4). Differences in drug overdose deaths by sex were also exacerbated during the pandemic. As shown in Figure 4, the gap in the drug overdose death rates between males and females increased from 2019 (29.6 vs. 13.7 per 100,000, respectively) to 2021 (45.1 vs. 19.6 per 100,000, respectively).

Research suggests that substance use among adolescents has declined, yet drug overdose deaths have sharply increased among this population, primarily due to fentanyl-laced substances. Among adolescents, drug overdose deaths have more than doubled from 2019 (282 deaths) to 2021 (637 deaths) following a period of relative stability. Male, Black, and Hispanic youth have experienced the highest increases in deaths due to drug overdose.

During the pandemic, excessive drinking increased along with alcohol-induced deaths. Alcohol-induced death rates increased by 38% during the pandemic, with rates the highest and increasing the fastest among AIAN people. AIAN people died of alcohol-induced causes at a rate of 91.7 per 100,000 in 2021, six times more than the next highest group - Hispanic people at a rate of 13.6. Black people also experienced significant increases in alcohol-induced deaths during COVID, with rates increasing more than 45% (Figure 5). Both rural and metropolitan areas experienced an increase in alcohol-induced deaths during the pandemic, but rural areas saw the largest increase (46% increase compared to 36%).

Suicidal ideation and deaths

Concerns about suicidal ideation and suicide deaths have also grown during the pandemic. Notably, self-harm and suicidal ideation has increased among adolescent females. Thirty percent of adolescent females seriously considered attempting suicide in 2021 compared to 14% of their male peers (Figure 6). Other analyses found that as the pandemic progressed, emergency department visits for suicide attempts increased among adolescents, primarily driven by females.

Suicide deaths in the U.S. began to increase in 2021 after briefly slowing in 2019 and 2020, although some research suggests that some suicides may be misclassified as drug overdose deaths since it can be difficult to determine whether drug overdoses are intentional. From 2019 to 2021, many communities of color experienced a larger growth in suicide death rates compared to their White counterparts. In 2021, suicide deaths by firearm accounted for more than half ( 55%) of all suicides in the U.S., but varied greatly across states.

The pandemic has also raised concerns about mental illness, suicide, and substance use among other populations. Essential workers and people with chronic health conditions may have experienced worsened mental health due to increased risk of contracting or becoming severely ill from COVID-19. Many of these individuals, particularly those with chronic conditions, were already at-risk of experiencing poor mental health outcomes prior to the pandemic. LBGT+ people have historically faced mental health problems at higher rates than their non-LGBT+ peers. The pandemic has continued to negatively impact LBGT+ people's mental health in disproportionate ways. In addition, people experiencing prolonged COVID-19 symptoms, or long COVID, may be more likely to develop new mental health conditions or to experience worsening of existing ones.

Changes in the Delivery of Mental Health and Substance Use Disorder Services

Leading up to the pandemic, many people faced barriers accessing mental health and substance use disorder services for reasons including costs, not knowing where to obtain care, limited provider options, and low rates of insurance acceptance. Young adults, Black adults, men, and uninsured people were less likely to receive services compared to their peers.

In recent years, access to care barriers may have worsened due to pandemic disruptions and closures, workforce shortages, and increased demand for services. In response to growing need, some policies and strategies were implemented to address access challenges, such as growth of telehealth, improved access to opioid use disorder treatment, the expansion of school-based mental health services, and the rollout of 988; however, challenges remain.

The delivery of mental health and substance use disorder services via telehealth grew sharply during the pandemic. By 2021, nearly 40% of all mental health and substance use disorder outpatient visits were delivered through telehealth. These behavioral health services via telehealth have also been more utilized in rural areas than urban areas during the pandemic. This underscores the role telehealth can play in improving access to behavioral health services in rural areas, which often face additional provider and resource shortages. Further, community health centers - which serve low-income and medically underserved communities, including communities of color and those in rural areas - experienced a large increase in behavioral health visits in 2021, largely driven by telehealth. During the pandemic, many state Medicaid programs expanded coverage of behavioral health telehealth services. This includes broadening the range of behavioral health services offered virtually and allowing for more provider types to be reimbursed for telehealth services. Many state Medicaid programs reported that telehealth has helped maintain and expand access to behavioral services during the pandemic. Some private payers have also improved coverage for mental health and substance use services by removing pre-pandemic telehealth coverage restrictions. Although telehealth can broaden access to care, in-person care may be necessary or preferred for some or for those experiencing challenges with technology and digital literacy.

As opioid-related overdose deaths have sharply increased, measures to improve access to treatment have been implemented. Following the onset of the pandemic, the federal government allowed for new flexibilities in opioid use disorder (OUD) treatment to ease access barriers, for example allowing for take-home methadone doses and covering telehealth treatment, and the Biden administration has proposed making these flexibilities permanent. Further, the 2023 Consolidated Appropriations Act eliminated the X-waiver requirement for prescribing buprenorphine, which substantially increases the number of providers who are authorized to prescribe buprenorphine to treat OUD. Voluntary guidelines for providers have also been issued to help reduce opioid overprescribing and misuse. At the same time, the Drug Enforcement Agency recently proposed returning to previous rules that required in-person visits before prescribing controlled substances to patients via telehealth, though there are some exceptions.

In response to growing mental health concerns among youth, integration of mental health services in school-based settings became a priority. Recent legislation aims to expand mental health care in schools - a setting that is easily accessible by children and adolescents. Specifically, legislation provides funding to expand and train mental health providers in schools; implement suicide, drug, and violence prevention programs; and provide trauma support services, among others. Further, recognizing Medicaid's importance in covering and financing behavioral health care for children, CMS is now required to provide updated guidance on how to support and expand school-based behavioral health services. The recently passed Consolidated Appropriations Act (CAA) continues to build on prior pandemic-era legislation that promotes access to behavioral health care for children. For example, to ensure more stable coverage for low-income children the CAA requires states to provide 12 months of continuous eligibility for children in Medicaid and CHIP.

An easy-to-remember number for the suicide and behavioral health crisis hotline, 988, was launched in 2022. On July 16, 2022, the federally mandated crisis number, 988, became available to all landline and cell phone users, providing a single three-digit number to access a network of over 200 local and state funded crisis centers where those in need may receive crisis counseling, resources and referrals. After 988 implementation, national answer rates increased alongside increases in call volume. Long-term sustainable funding of local 988 crisis call centers remains uncertain in many states. In addition to 988, some states are developing behavioral health crisis response systems, such as mobile crisis or crisis stabilization units, which will enable a specialized behavioral health response for behavioral health crises that require intervention. The CAA included provisions aimed at strengthening and evaluating 988 and the developing behavioral health crisis continuum.

Despite steps taken to improve the delivery of mental health and substance use services, challenges remain. Provider workforce challenges are widespread, with nearly half of the U.S. population ( 47%) living in a mental health workforce shortage area. Shortages may contribute to access challenges and contribute to increases in psychiatric boarding in emergency rooms. Additionally, provider network directories are often outdated, further contributing to access challenges. While recent legislation has taken steps in response - including funding for at least 100 new psychiatry residency positions, grants for mental health peer support providers, and improvements to provider directories through the CAA - these are relatively small measures in the face of big access challenges. The lack of a diverse mental health care workforce may contribute to limited mental health treatment among people of color. Separately, even with insurance coverage, individuals with mental health needs face challenges accessing care. While Medicaid enrollees have limited out-of-pocket costs there is variation in who is eligible and the range of services covered across states. Additionally, the end of Medicaid's continuous enrollment provision - on March 31, 2023 - could result in millions of disenrollments over the next year which could disrupt access to behavioral health services. Among private insurance enrollees, enrollees, with mental illness face high out-of-pocket costs; and these costs vary substantially across states. While most adults with mental illness have private insurance, rates of mental illness and substance use disorders are most prevalent among nonelderly adults with Medicaid.

Looking Ahead

Although steps have been taken to address negative mental health impacts stemming from the pandemic, mental health and substance use concerns remain elevated. Heightened racism and increasing gun violence may also contribute to poor mental health outcomes. Further, negative mental health impacts have been more pronounced among several populations, including communities of color, young adults and children - populations which have historically experienced increased barriers to care. Additionally, despite renewed discussions and new federal grants for state parity enforcement under the CAA, challenges with mental health parity persist - including lack of clarity on specific protections, low compliance rates, and slow federal enforcement. Finally, the COVID-19 public health emergency will end in May 2023, which may at least partially unravel steps taken toward delivering mental health services via telehealth and improving access to substance use disorder services.

History has shown that the mental health impact of disasters outlasts the physical impact, suggesting today's elevated mental health needs will continue well beyond the coronavirus outbreak itself. As we emerge from the COVID-19 pandemic and the federal public health emergency draws to an end, it will be important to consider how the increased need for mental health and substance use services may persist long term, even as new cases and deaths due to COVID-19 hopefully subside.

This work was supported in part by Well Being Trust. KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities.

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The Implications of COVID-19 for Mental Health and Substance Use | KFF

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This brief explores mental health and substance use during, and prior to, the COVID-19 pandemic. We highlight populations that were more likely to experience worse mental health and substance use outcomes during the pandemic and discuss some innovations in the delivery of services.

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This article was explaining how COVID-19 pandemic is creating/adding more problems with mental health proving their statements with statistics from previous years and now, it showed in the KFF poll that 45% of adults in the U.S. have been impacted with stress with the virus and many other percentages.

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Jennifer Casarella, MD on April 21, 2021

There are many different conditions that are recognized as mental illnesses. The more common types include:

Anxiety disorders: People with anxiety disorders respond to certain objects or situations with fear and dread, as well as with physical signs of anxiety or panic, such as a rapid heartbeat and sweating. An anxiety disorder is diagnosed if the person's response is not appropriate for the situation, if the person cannot control the response, or if the anxiety interferes with normal functioning. Anxiety disorders include generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobias.

Mood disorders: These disorders, also called affective disorders, involve persistent feelings of sadness or periods of feeling overly happy, or fluctuations from extreme happiness to extreme sadness. The most common mood disorders are depression, bipolar disorder, and cyclothymic disorder.

Psychotic disorders: Psychotic disorders involve distorted awareness and thinking. Two of the most common symptoms of psychotic disorders are hallucinations -- the experience of images or sounds that are not real, such as hearing voices -- and delusions, which are false fixed beliefs that the ill person accepts as true, despite evidence to the contrary. Schizophrenia is an example of a psychotic disorder.

Eating disorders: Eating disorders involve extreme emotions, attitudes, and behaviors involving weight and food. Anorexia nervosa, bulimia nervosa, and binge eating disorder are the most common eating disorders.

Impulse control and addiction disorders: People with impulse control disorders are unable to resist urges, or impulses, to perform acts that could be harmful to themselves or others. Pyromania (starting fires), kleptomania (stealing), and compulsive gambling are examples of impulse control disorders. Alcohol and drugs are common objects of addictions. Often, people with these disorders become so involved with the objects of their addiction that they begin to ignore responsibilities and relationships.

Personality disorders: People with personality disorders have extreme and inflexible personality traits that are distressing to the person and/or cause problems in work, school, or social relationships. In addition, the person's patterns of thinking and behavior significantly differ from the expectations of society and are so rigid that they interfere with the person's normal functioning. Examples include antisocial personality disorder, obsessive-compulsive personality disorder, histrionic personality disorder, schizoid personality disorder,and paranoid personality disorder.

Obsessive-compulsive disorder (OCD): People with OCD are plagued by constant thoughts or fears that cause them to perform certain rituals or routines. The disturbing thoughts are called obsessions, and the rituals are called compulsions. An example is a person with an unreasonable fear of germs who constantly washes their hands.

Post-traumatic stress disorder (PTSD): PTSD is a condition that can develop following a traumatic and/or terrifying event, such as a sexual or physical assault, the unexpected death of a loved one, or a natural disaster. People with PTSD often have lasting and frightening thoughts and memories of the event, and tend to be emotionally numb.

Other, less common types of mental illnesses include:

Stress response syndromes (formerly called adjustment disorders): Stress response syndromes occur when a person develops emotional or behavioral symptoms in response to a stressful event or situation. The stressors may include natural disasters, such as an earthquake or tornado; events or crises, such as a car accident or the diagnosis of a major illness; or interpersonal problems, such as a divorce, death of a loved one, loss of a job, or a problem with substance abuse. Stress response syndromes usually begin within three months of the event or situation and ends within six months after the stressor stops or is eliminated.

Dissociative disorders: People with these disorders suffer severe disturbances or changes in memory, consciousness, identity, and general awareness of themselves and their surroundings. These disorders usually are associated with overwhelming stress, which may be the result of traumatic events, accidents, or disasters that may be experienced or witnessed by the individual. Dissociative identity disorder, formerly called multiple personality disorder, or "split personality," and depersonalization disorder are examples of dissociative disorders.

Factitious disorders: Factitious disorders are conditions in which a person knowingly and intentionally creates or complains of physical and/or emotional symptoms in order to place the individual in the role of a patient or a person in need of help.

Sexual and gender disorders: These include disorders that affect sexual desire, performance, and behavior. Sexual dysfunction, gender identity disorder, and the paraphilias are examples of sexual and gender disorders.

Somatic symptom disorders: A person with a somatic symptom disorder, formerly known as a psychosomatic disorder or somatoform disorder, experiences physical symptoms of an illness or of pain with an excessive and disproportionate level of distress, regardless of whether or not a doctor can find a medical cause for the symptoms.

Tic disorders: People with tic disorders make sounds or display nonpurposeful body movements that are repeated, quick, sudden, and/or uncontrollable. (Sounds that are made involuntarily are called vocal tics.) Tourette's syndrome is an example of a tic disorder.

Other diseases or conditions, including various sleep-related problems and many forms of dementia, including Alzheimer's disease, are sometimes classified as mental illnesses, because they involve the brain.

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Jennifer Casarella, MD on April 21, 2021 There are many different conditions that are recognized as mental illnesses. The more common types include: Anxiety disorders: People with anxiety disorders respond to certain objects or situations with fear and dread, as well as with physical signs of anxiety or panic, such as a rapid heartbeat and sweating.

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Most people know the basics of mental health like anxiety and stress but this website shows a list of the multiple types of mental health disorders that give you a better understanding  by providing description on how they affect another.

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This article is showing the symptoms of stress/depression and goes into more detail on how its severe to older people. This site also gives ways to cope with stress explaining numerous ways. There is also something called  secondary traumatic stress where you can get stress again after being relieved but they give ways to cope as well.

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Since the COVID-19 pandemic began, Americans have been watching the numbers of those infected rise daily. Fear of COVID-19 causing physical harm or even death has become a real, daily concern. COVID-19 has disrupted our normal routines, impaired access to community services, forced social distancing, and limited recreational options, as well as increased our concerns about employment, financial circumstances, and medical well-being. All of these stressors can impact a person's mental health, both by stretching the capacity to tolerate life stressors and by exacerbating pre-existing psychiatric conditions. While most of us are feeling stressed and anxious, COVID-19 is plaguing people with mental health issues in particular ways:

- The Centers for Disease Control (CDC) recommends that patients receiving mental health treatment continue seeking and receiving care while keeping an eye out for new or worsening symptoms-but access to care using systems that have been in place for decades has been uprooted by the COVID-19 pandemic. Mental health providers are adapting to this challenge by offering telemedicine services, but adoption has been inconsistent, and technological limitations can degrade the quality of this technique. Patients who are accustomed to face-to-face visits are now being asked to adjust to these changes at the same time their stressors may be increasing in severity and quantity. At Greenbrook TMS, we're meeting this challenge by increasing access to telehealth. We now offer our consultations and other select appointments to take place via teleconference or phone call.

-Involuntary social isolation resulting from social distancing and shelter-in-place policies can remove the positive buffering effect that comes with visiting friends and family. In-home isolation can cause boredom and can increase maladaptive habits such as excessive alcohol use and illicit drug use. This can exacerbate underlying diseases including mental health concerns.

-Shelter-in-place and social distancing policies may alter relationship patterns with other members of the household due to constant immersion. Disruptions to daily routines and higher frequency of interpersonal interactions with members of the household can stress frustration tolerance and conflict resolution skillsets. Keeping perspective during conflict can be more difficult without the benefit of a complete exposure to the world that existed before COVID-19.

-For patients who have trouble determining what is real and what is not, contending with an unprecedented, invisible threat can cause delusional beliefs to flare. Inconsistent reactions from policymakers, health providers, and other institutions can create further confusion. Anxiety associated with excessive preoccupation with perceived threats now must negotiate risks from a virus that cannot be seen and whose presence cannot be detected in real time. Efforts to mitigate that risk through diligent hygiene and social distancing can be unsatisfying without immediate feedback to confirm a threat has been successfully avoided. Even mild symptoms previously dismissed as allergies or the common cold can raise the specter of a non-severe COVID-19 infection, triggering additional worry about infection to other household occupants. All of these concerns can lead to frustrating somatic ruminations and fears that can be difficult to abate, particularly for individuals struggling with obsessive compulsive disorder who already harbor thoughts or compulsions around germs, contamination, and cleanliness. Additionally, the supply shortages of goods and certain foods and heightened political tensions associated with emergency policy development and deployment can add to the sense of catastrophe we are facing.

I recommend we all acknowledge the epic challenges that are being placed before us with COVID-19. Greater patience and understanding can go a long way to traversing this pandemic. But even with the best decisions and behaviors, people may find they develop new mental health symptoms or previous symptoms can become exacerbated. Remain engaged in mental health care if you have existing providers. If you have new symptoms and no previous relationship with a mental health provider then your primary care physician can be an excellent resource for institution of initial treatment and referral recommendations if appropriate.

If you are struggling with depressive or obsessive compulsive symptoms that have not improved despite medication or psychotherapy treatment, or if your symptoms were previously well controlled but are flaring due to recent events, you may have treatment-resistant depression, and we can help. Transcranial magnetic stimulation, or TMS therapy, is a safe, FDA cleared, non-drug, non-invasive treatment for depression. TMS therapy is offered in an outpatient environment, away from hospitals and emergency rooms that are on the front lines of caring for patients with COVID-19. We accept most insurance plans, including Medicare and, in many states, Medicaid.

All Greenbrook TMS NeuroHealth centers remain 100 percent operational during the COVID-19 pandemic. We have implemented aggressive hygiene procedures and telemedicine capabilities to be able to provide service to our patients in as safe a manner as possible. Call us today for a free consultation to see if TMS can help you.
This article was written by: Dr. Geoffrey Grammer, Chief Medical Officer, Greenbrook TMS NeuroHealth Centers

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Why COVID-19 is also a mental health pandemic | WTOP

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Since the COVID-19 pandemic began, Americans have been watching the numbers of those infected rise daily. Fear of COVID-19 causing physical harm or even death has become a real, daily concern. COVID-19 has disrupted our normal routines, impaired access to community services, forced social distancing, and limited recreational options, as well as increased our concerns about employment, financial circumstances, and medical well-being.

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This site provides how our restrictions with COVID-19 can harm our mental health. Mental health providers are providing telemedicine services which basically are call services but there are many challenges since its not face to face. It also explains how its effect in shelter patients as well. There are trying to show its going take a long time till we go back to normal so they provide a profit TMS therapy on the site.

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1.   Physical activity like walking around your neighborhood when doing so this release a chemical in your brain to cause you to feel better.

2.  Doing something your good at this will bring your focus on building strength up in confidence and try to put that in your everyday routines.

3.  Getting sleep around 7 therefore your body better developed and can pay more attention

4.  Talking to someone that can be trusted with telling your problems and this can lead for them to help you manage your stress.

5. Take a time out this can be doing yoga or mediating which helps clear your head.

6.  Just interact with  others so you don’t feel like your alone

7.  Your diet try not to skip meals and limit drinking  alcohol because those leads to anxiety panic attacks and et.c

8.  Focusing on one thing can help if not bringing more stress

9.  Tell yourself something positive this can help make you feel better as a person

10.  Laughing helps reduce anxiety so watch something funny or hang with that one bud that makes you laugh

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https://www.mhanational.org/31-tips-boost-your-mental-health
https://www.mentalhealth.org.uk/publications/how-to-mental-health
https://www.psychologytoday.com/us/blog/women-s-mental-health-matters/201510/9-ways-you-can-improve-your-mental-health-today