Mental health symptoms, well-being and experiences of the COVID-19 pandemic: A mixed-methods practice-based study

The COVID-19 pandemic necessitated abrupt and substantial changes in daily life, and public health strategies intended to protect physical health can negatively affect mental health and well-being, especially for individuals with pre-existing mental health challenges. For this study, we surveyed a sample of clients (N = 94) in the summer of 2020 from a community mental health clinic in the northeast United States. A mixed-methods, concurrent triangulation design was used to (a) identify client subgroups on indicators of mental health (i.e. anxious and depressive symptoms) and emotional, psychological, and social well-being using latent profile analysis (LPA), and (b) within these subgroups, examine qualitative, thematic patterns in self-described challenges, benefits and learning related to the pandemic. The LPA revealed five distinct subgroups with various levels of symptoms and well-being, including Stagnant (moderate symptoms/moderate well-being), Languishing (high symptoms/low well-being), Flourishing (low symptoms, high well-being), Fortitudinous (high symptoms, moderate well-being) and Mobilized (moderate symptoms, high well-being). These divergent subgroups support the need to conceptualise mental health symptoms apart from well-being and assess for heterogeneous constellations of such constructs among psychotherapy clients. Thematic analysis offered additional insight into pandemic experiences within each subgroup, including attention to psychological, emotional, behavioural/lifestyle, relational, physical and ecological/contextual dimensions of self-experience, as well as the ways clients had adjusted to the pandemic's circumstances. Findings support nuanced conceptualisations of positive mental health and offer insight into coping and adaptation during this public health crisis.