More than a mask: Possible relationships between lifting of COVID-19 mask requirements and depression symptoms experienced by US adults with disabilities.

BACKGROUND: Lifting of masking restrictions at key periods during the COVID-19 pandemic may have disproportionately negatively impacted the mental health of individuals with disabilities. OBJECTIVE: This study examines the prevalence of depression-related symptoms in individuals with and without disabilities preceding and following the US rollback of COVID-19 masking mandates. METHODS: Pandemic-era data on reported symptoms of depression from the federal Household Pulse Survey from dates surrounding two major announcements on masking relaxations were analyzed. Possible interactions between disability status and type, age grouping, educational attainment, race/Hispanic ethnicity, and sex variables were considered. RESULTS: Following relaxation of major masking restrictions, people with disabilities experienced elevation in depression symptom presence while people without disabilities experienced lessening in these symptoms. Differences between people with and without disabilities were significant. CONCLUSIONS: Direct causation between masking mandate relaxations and changes in symptoms of depression cannot be drawn from the available data. However, when considered with greater vulnerabilities to COVID-19 experienced by many individuals with disabilities and dismissive rhetoric surrounding masking decisions, negative feelings arising from mandate changes may have led to elevations in symptoms of depression in people with disabilities in sharp contrast to people without disabilities who may have felt relief. Findings indicate future public health decision making, even in times of crisis, should be undertaken with as much caution as possible regarding and in partnership with populations already at risk.