Key Takeaways

  • One in five older adults in the U.S. experienced depression, anxiety, insomnia, substance abuse, or another mental health issue due to COVID-19.

  • Caregivers, too, suffered the negative mental health effects of social isolation, including increased rates of stress, exhaustion, and burnout.

  • The good news? More than 71% of older adults now report being willing to seek mental health care. And this is where online therapy can truly shine.

During the first year of the pandemic alone, the global prevalence of anxiety and depression rose by a staggering 25%, according to the World Health Organization (WHO).1 Three years in, as many as 30% of American adults still report worse mental health and well-being than they had prior to the pandemic.2

“Despite the fact that daily life has largely returned to normal for many, the stress and fear associated with COVID-19 has burrowed deep into our collective psyche,” said Kathleen Cameron, senior director of NCOA’s Center for Healthy Aging. “While this is true for nearly every age group and demographic, older adults remain at particular risk for poorer outcomes if they don’t have adequate support and access to mental health care.”

In fact, in a poll conducted by the University of Michigan’s Institute for Healthcare Policy and Innovation, researchers found that an estimated one in five U.S. adults age 50–80 experienced depression, anxiety, insomnia, or substance abuse since the pandemic began.3 And older adults who reported poorer physical health were more likely to report worse mental health, too—partially because chronic illness and social isolation often go hand-in-hand. Pandemic-related shutdowns further compounded that isolation.

But there’s good news: more older adults are willing to seek mental health care than before—71%, according to the poll.

How has COVID-19 affected older adults’ mental health?

“Due to COVID, I am always stuck at home,” reported Krista G., 62, in early 2021. “I’m scared and depressed, there’s too much going on.”

NCOA first heard about Krista from a Benefits Enrollment Center partner in Florida. And her words reflect an experience common to so many older adults during the pandemic. Concern about catching the virus—or fear that a loved one would—exacerbated feelings of confinement, loneliness, uncertainty, and anxiety. Further, as the American Society on Aging reports, loneliness can heighten negative reactions to life stressors which, in turn, can lead to insomnia, depression, cognitive decline, and other mental health issues.4

“We know that caregivers to older adults suffered, too, no matter their age,” Cameron said. “The quarantine robbed spouses, children, and other unpaid helpers of needed external support, which caused them to feel burned out, exhausted, and stressed.”

Perhaps as a result, perceptions about mental health have changed for the better. Of older adults polled in the University of Michigan study, 13% reported discussing a new mental health concern with their primary care provider—the first important step to getting the help they need.

What strategies can improve older adults’ mental health?

There are many steps older adults can take to manage stress and protect their mental well-being throughout the COVID-19 emergency and beyond. These include:

  • Establishing a routine
    Consistency can be a comforting anchor when things feel chaotic.
    ✅ Eat regular meals
    ✅ Do the morning crossword
    ✅ Schedule a daily call with a friend or family member
    ✅ Go to bed and wake up at the same time
  • Exercising
    Regular physical activity can combat chronic illness and improve mood.
    ✅ Go for a walk
    ✅ Do yoga
    ✅ Try tai chi
    ✅ Play pickleball
  • Maintaining good sleep hygiene
    Good physical and mental health depends on getting restorative sleep.
    ✅ Turn off the television
    ✅ Reduce artificial light
    ✅ Avoid late-night meals
    ✅ Limit alcohol
  • Setting goals
    Trying new things and completing tasks boosts positive feelings of accomplishment.
    ✅ Try a new hobby
    ✅ Take an art class
    ✅ Clean out the junk drawer
    ✅ Learn how to garden

And, of course, mental health counseling can provide much-needed support. With lots of new choices in online therapy, finding help is easier now than ever before.

How can online therapy improve older adults’ mental health?

Also known as “telehealth therapy,” this form of mental health counseling emerged widely during the pandemic shutdown, when the need was acute but access limited. Virtual counseling allows clients to interact with their therapist over a secure connection using a computer, tablet, smartphone, or other internet-enabled device.

Due to its popularity in the time since, telehealth therapy seems destined to stay—which is great news for older adults, Cameron explained.

“The ability to speak to a licensed therapist from the privacy of home can truly reduce barriers to treatment, especially for those who may otherwise be limited by distance, lack of transportation, mobility issues, provider shortages, and other obstacles.”

Plus, online therapy is safe when providers use HIPAA-compliant platforms that protect patient data and confidentiality. And it’s effective for treating anxiety, depression, substance use disorders, and other mental health issues, according to the American Psychological Association.5

How much does online therapy cost?

On average, most online counseling appointments cost between $30 and $90. Some providers are pay-as-you-go, while others follow a subscription-based model. NCOA Adviser’s Reviews Team compared the costs of some common online therapy sites.

Are there ways to make online therapy more affordable?

Right out of the gate, some providers are more affordable than others, Cameron said. That’s why she advises investigating all charges and fees in advance. Additionally, certain telehealth therapy platforms offer financial aid or will charge on a sliding scale, based on a client’s ability to pay.

It’s also worth asking about insurance coverage. Does the online counseling platform accept Medicare or Medicaid? Will the provider bill directly for it, or are clients required to pay up front with a credit card and submit for reimbursement later?

Where can I find online therapy for older adults?

NCOA Adviser’s Reviews Team regularly ranks the best virtual counseling sites for older adults based on over 1,000 hours of in-depth research on mental health, substance use disorders, and online therapy. Among the 8 best online therapy services chosen, our Reviews Team found that the top three choices among adults age 54+ are, in order:

  1. Talkspace (16.7%)
  2. BetterHelp’s Faithful Counseling (11.54%)
  3. (6.41%)

Bottom line

One in five older adults in the U.S. reports lingering psychological effects due to COVID-19—including depression, anxiety, insomnia, and substance abuse. Online counseling services can help improve older adults’ mental health by reducing common barriers to care, which is good news for the growing number of seniors who are willing to seek therapy. When choosing which online therapy platform to use, consider its costs (including insurance coverage), payment method(s), financial assistance opportunities, and third-party reviews.


1. World Health Organization. COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. March 2, 2022. Found on the internet at

2. Nirmita Panchal, et al. The implications of COVID-19 for mental health and substance abuse.”Kaiser Family Foundation. March 2023. Found on the internet at

3. Preeti Malani, MD, et al. National Poll on Healthy Aging: Mental Health Among Older Adults Before and During the COVID-19 Pandemic. May 4, 2021. Found on the internet at

4. Katherine Ramos. Mental health impacts of the COVID-19 pandemic. April 24, 2022. ASA Generations. Found on the internet at

5. American Psychological Association. How well is telepsychology working? July 1, 2020. Found on the internet at