The mental health of US veterans before and after the COVID-19 pandemic: examining the demographic and environmental correlates of courses of distress in the LIGHT cohort.

PURPOSE: We examined courses of distress in US veterans before, during, and after the COVID-19 pandemic and the impact of demographic and environmental characteristics on patterns of distress.

METHODS

We used survey data (n = 1064; Mage = 38.85, 49.1% female) from the Longitudinal Investigation of Gender, Health, and Trauma (LIGHT) study. Using data from three time points (pre-pandemic, peri-pandemic, and post-pandemic), participants were classified into one of five groups based on whether they met clinical cut-offs for depression, generalized anxiety, and/or PTSD at a given time point. We then examined demographic and environmental correlates of group membership and used relative importance analyses to identify the strongest correlates of group membership.

RESULTS

For female and younger veterans, distress increased from pre-pandemic to peri-pandemic, decreased from peri-pandemic to post-pandemic, and then returned to pre-pandemic levels two years later. For male and older veterans, there was no change in distress from pre-pandemic to peri-pandemic, an increase in distress from peri-pandemic to post-pandemic, then a return to pre-pandemic distress levels. Most participants were classified as Resistant (60.1%), followed by Persistent (20.5%), Remitted (7.6%), Exacerbated (6.4%), and Resilient (5.5%). Income, community danger, neighborhood cohesion, and post-pandemic related distress were the strongest correlates of persistent distress, the most vulnerable group.

CONCLUSION

Overall, veterans were resilient in response to the pandemic. However, findings suggest that female and younger veterans were disproportionately impacted. The relationships we identified between environmental factors and persistent distress underscore the need for interventions that address both individual and structural factors that impact distress.