Abstract:Estimating community-specific mental health effects of local events is vital for public health policy. While forecasting mental health scores alone offers limited insights into the impact of events on community well-being, quasi-experimental designs like the Longitudinal Regression Discontinuity Design (LRDD) from econometrics help researchers derive more effects that are more likely to be causal from observational data. LRDDs aim to extrapolate the size of changes in an outcome (e.g. a discontinuity in running scores for anxiety) due to a time-specific event. Here, we propose adapting LRDDs beyond traditional forecasting into a statistical learning framework whereby future discontinuities (i.e. time-specific shifts) and changes in slope (i.e. linear trajectories) are estimated given a location's history of the score, dynamic covariates (other running assessments), and exogenous variables (static representations). Applying our framework to predict discontinuities in the anxiety of US counties from COVID-19 events, we found the task was difficult but more achievable as the sophistication of models was increased, with the best results coming from integrating exogenous and dynamic covariates. Our approach shows strong improvement ($r=+.46$ for discontinuity and $r = +.65$ for slope) over traditional static community representations. Discontinuity forecasting raises new possibilities for estimating the idiosyncratic effects of potential future or hypothetical events on specific communities.
Abstract:Compared to physical health, population mental health measurement in the U.S. is very coarse-grained. Currently, in the largest population surveys, such as those carried out by the Centers for Disease Control or Gallup, mental health is only broadly captured through "mentally unhealthy days" or "sadness", and limited to relatively infrequent state or metropolitan estimates. Through the large scale analysis of social media data, robust estimation of population mental health is feasible at much higher resolutions, up to weekly estimates for counties. In the present work, we validate a pipeline that uses a sample of 1.2 billion Tweets from 2 million geo-located users to estimate mental health changes for the two leading mental health conditions, depression and anxiety. We find moderate to large associations between the language-based mental health assessments and survey scores from Gallup for multiple levels of granularity, down to the county-week (fixed effects $\beta = .25$ to $1.58$; $p<.001$). Language-based assessment allows for the cost-effective and scalable monitoring of population mental health at weekly time scales. Such spatially fine-grained time series are well suited to monitor effects of societal events and policies as well as enable quasi-experimental study designs in population health and other disciplines. Beyond mental health in the U.S., this method generalizes to a broad set of psychological outcomes and allows for community measurement in under-resourced settings where no traditional survey measures - but social media data - are available.