Mental health is an important component of public health, especially in times of crisis. However, monitoring public mental health is difficult because data are often patchy and low-frequency^1,2,3. Here we complement established approaches by using data from helplines, which offer a real-time measure of ‘revealed’ distress and mental health concerns across a range of topics^4,5,6,7,8,9. We collected data on 8 million calls from 19 countries, focusing on the COVID-19 crisis. Call volumes peaked six weeks after the initial outbreak, at 35% above pre-pandemic levels. The increase was driven mainly by fear (including fear of infection), loneliness and, later in the pandemic, concerns about physical health. Relationship issues, economic problems, violence and suicidal ideation, however, were less prevalent than before the pandemic. This pattern was apparent both during the first wave and during subsequent COVID-19 waves. Issues linked directly to the pandemic therefore seem to have replaced rather than exacerbated underlying anxieties. Conditional on infection rates, suicide-related calls increased when containment policies became more stringent and decreased when income support was extended. This implies that financial relief can allay the distress triggered by lockdown measures and illustrates the insights that can be gleaned from the statistical analysis of helpline data.

心理健康是公共卫生的重要组成部分，尤其是在危机时期。然而，监测公众心理健康很困难，因为数据通常是零散的和低频率的^1,2,3。^{在这里，我们通过使用来自求助热线的数据来补充既定方法，这些数据提供了对一系列主题4、5、6、7、8、9}中“显露的”痛苦和心理健康问题的实时测量. 我们收集了来自 19 个国家的 800 万个电话的数据，重点关注 COVID-19 危机。通话量在最初爆发后六周达到顶峰，比大流行前水平高出 35%。增加的主要原因是恐惧（包括对感染的恐惧）、孤独以及在大流行后期对身体健康的担忧。然而，人际关系问题、经济问题、暴力和自杀念头并不像大流行之前那么普遍。这种模式在第一波和随后的 COVID-19 波期间都很明显。因此，与大流行直接相关的问题似乎已经取代而不是加剧了潜在的焦虑。以感染率为条件，当遏制政策变得更加严格时，与自杀相关的电话会增加，而当收入支持扩大时，与自杀相关的电话会减少。