INSTITUTE FOR POLICY RESEARCH

The Political Consequences of Poor Mental Health

Research suggests that ignoring the decline in Americans’ mental health could eventually put U.S. democracy at risk

  

Since the start of the COVID-19 pandemic, the nation’s mental health has been in decline. Years of uncertainty, lockdowns, grief, and economic precarity led to at least four out of 10 American adults experiencing high levels of psychological distress at some point during the pandemic.

At the same time, polarization and division among Americans is on the rise, causing concern about the state of American democracy. Recent polls show majorities of Americans lack trust in the government, are not satisfied with the way democracy is working, and believe that democracy is in danger of collapse.

A growing number of studies by IPR political scientist James Druckman and his colleagues suggest a possible relationship between Americans’ mental health problems and the nation’s political health. While they are still early in their investigation of this connection, the researchers believe if the nation’s mental health isn’t taken seriously it could have consequences for democratic stability.

Depressive Symptoms and Concerning Political Behaviors

Americans' mental health has been a central focus of the COVID States Project, a national survey assessing Americans’ attitudes and behaviors, since April 2020. Druckman worked with scholars like Roy Perlis, a professor of psychiatry at Harvard Medical School, to conduct the surveys. This interdisciplinary collaboration between experts in political science and public health led them to ask questions about how Americans’ declining mental health could impact society and politics.

In peer-reviewed studies analyzing the surveys, they find a relationship between having moderate to severe depressive symptoms and a belief in conspiracy theories, especially among White males earning more than $150,000 annually. The researchers also discovered that adults experiencing moderate or greater depression were more likely to believe COVID-19 vaccine misinformation. 

“The theory behind that is when you're experiencing depressive symptoms, you often feel a loss of control,” Druckman explained. “And that loss of control can lead to certain types of beliefs or behaviors that might not be the most helpful because you're trying to just regain some of that control.”

In other words, conspiracy beliefs may help people cope with stress or uncertainty by providing narratives to threatening events. The researchers also believe that depression could make people more susceptible to misinformation.

Another study shows that among those who believe in conspiracy theories and who have regularly or recently participated in politics, depression is linked to their support for the storming of the U.S. Capitol on January 6, 2021, and election violence. And in a working paper, the researchers find that severe depression can also intensify the relationship between COVID-19 conspiracy beliefs and endorsing a 2020 election fraud claim, as well as voting in 2022 for candidates for governor who cast doubt on the 2020 election results.

These studies suggest the combination of depression and conspiracy beliefs may be a gateway to troubling behaviors for democracy—the normalization of political violence and the endorsement of 2020 election fraud claims. 

Additionally, they discover that among a group of roughly 25,000 American adults, nearly one-third of people who reported major symptoms of depression currently own a gun or planned to buy one. Individuals with depression who had purchased a firearm for the first time were less likely to have done so for protection against crime. In fact, they were more likely to say that they had purchased a firearm because of concern about COVID-19 or for protection against someone they knew.

Beyond being a public health crisis, Druckman says this is consistent with the relationship he and his colleagues find between depressive symptoms and an inclination for violence.

“I think those are all reasons for worrying—when you start to see such a massive increase in the number of people experiencing depressive symptoms,” he said, pointing to the findings of the five different studies.

A Complex Research Agenda

While a rising number of the U.S. population is exhibiting signs of depression—nearly three times as many since 2019—there has been little to no investigation into the relationship between mental health and political outcomes, or democracy more broadly. This is in part because it’s a fraught topic and complicated to study.

One issue is that depression can be caused by a number of complex factors—an important caveat when thinking about the relationship between mental health and social or political outcomes. Druckman believes that we should be cautious about attributing responsibility for certain behaviors to mental health issues to avoid stigmatizing people experiencing depression.

Another obstacle is that mental health and political behavior are challenging to study.

“It is difficult to tease apart the causal connections, in part, because it's very difficult to think about causal studies of depression,” Druckman explained. For instance, does depression make people more likely to believe conspiracy theories, or does a belief in conspiracy theories lead to depression?

But documenting causation, not simply correlation, in the relationship between depression and misinformation or conspiracy theories would involve using randomized control trials, which could be difficult to design with participants who are already experiencing depression. Another limitation is the inability to study experimentally how depression may contribute to an uptick in support for violence, voting for election deniers, and buying a gun, so the researchers do not have empirical evidence to make a strong causal connection.

Creating policy solutions given the current political landscape could be even more complex, says Druckman, when you link mental health to certain behaviors. In the case of mass shootings, he argues, blaming mental health issues as the problem ignores policy solutions like restricting gun purchases that some evidence suggests are more effective at preventing these events.

Instead, he suggests policy solutions start with preventive care to reduce the risk for depression, along with providing more adequate care for those who are already suffering from it.

“One of the issues when people are having mental health challenges, it becomes much harder for them to navigate a healthcare system,” he said, suggesting more resources could help people take advantage of mental health programs already available.

Do We Put Democracy at Risk if We Ignore Our Mental Health?

While few researchers have asked whether the rise in Americans struggling with mental health problems could lead to democratic erosion, Druckman and his colleagues believe this question is crucial to investigate further, saying mass depression represents a crisis point for democracy. 

“First and foremost, you want to think about the public health and the toxic consequences for the people that are suffering from depression,” he said. “I do think that there are clear political ramifications in terms of the quality of democracy.”

He says that democracies have a responsibility to care about the public health of their citizens.

“I think when you see an uptick in depression, to the extent that we've seen, that is a sign that democracy is not operating at the quality that one would want from a normative perspective,” Druckman explained. 

While they are still studying this topic, he says that based on their evidence so far, depression has been linked to concerning behaviors even in terms of overall democratic stability, which should be taken seriously. With funding from the National Institutes of Health, the scholars intend to conduct more research on the connection between undemocratic behaviors and mental health over the next two years. They will look at other potential consequences and how other emotional pathways, such as anxiety and loneliness, might play into this interaction.

“There is a lot of concern about political extremism at present and when a population is suffering from poor mental health, no one should be surprised that people make extremist choices that they otherwise may not make,” Druckman said.

James Druckman is the Payson S. Wild Professor of Political Science and IPR associate director and fellow. 

Photo credit: iStock

Published: October 23, 2023.