“Is there anything else you would like to tell us?”: An analysis of language features in text responses to a study on mental health during the COVID-19 pandemic

The COVID-19 pandemic and associated restrictions have been a major stressor and exacerbated mental health worldwide. Qualitative data play a unique role in documenting mental state, via both language features and content. Within a longitudinal study on mental health during the COVID-19 pandemic, we analyzed free responses to the question: “Is there anything else you would like to tell us that might be important that we did not ask about?” We applied text analysis methods to ask whether individuals who responded to the item differed from non- responders, whether there were associations between language use and psychological status, and to characterize the content of responses and how responses changed over time. 3,655 individuals provided biweekly measures of mental health and responses to the COVID-19 pandemic for 6 months. Of these, 2,497 participants provided at least one free response (9,741 total responses). Response likelihood was influenced by demographic factors and health status: Participants who were male, Asian, Black, or Hispanic were less likely to respond, and odds of responding increased with age and education as well as with a history of physical health conditions. Although mental illness history did not influence an individual’s overall likelihood of responding, it was associated with more negative sentiment, negative word use, and higher usage of first-person singular pronouns. Responses were dynamically influenced by psychological status, such that distress and loneliness were positively associated with an individuals’ likelihood to respond at a given timepoint, and predicted more negativity. Finally, responses were negative in valence overall, exhibited fluctuations linked with external events, and covered a variety of topics, with the most common being mental health and emotion. Our results identify trends in language use during the first year of the pandemic, and suggest that the both the content of responses and overall sentiment are linked to mental health.