JMIR Publications

ABSTRACT

Background:

The impacts of the coronavirus (COVID-19) pandemic on mental health across the world and in the United States have been well documented. However, there is limited research examining the long-term effects of the pandemic on mental health, particularly in relation to pervasive policies such as statewide mask mandates as well as political party affiliation.

Objective:

The goal of the present study was to examine whether statewide mask mandates and political party affiliations yielded differential changes in mental health symptoms across the United States through leveraging state-specific internet search query data.

Methods:

This paper leverages Google search queries from March 24, 2020 through March 29, 2021 in each of the 50 states in the United States. Among these states, 39 implemented statewide mask mandates—with 16 of these states being Republican—to combat the spread of COVID-19. This paper investigates whether mask mandates impact mental health differentially in states with and without mandates by exploring variations in mental health search queries across the United States. Along with this, political party affiliation was examined as a potential covariate to determine whether mask mandates had differential effects in Republican and Democratic states. Generalized additive mixed models (GAMMs) were implemented to model associations between mask mandates, political party, and mental health search volume.

Results:

The results of GAMMs revealed that search volume for “restless” significantly increased following a mask mandate across all states, whereas the search volume for “irritable” and “anxiety” increased and decreased, respectively, following a mandate for Republican states in comparison with Democratic states.

Conclusions:

The present findings suggest that mask mandates were associated nonlinearly with significant changes in anxiety-related search behavior. Policy makers should take into consideration the mental impact of public health-related mandates.