- As the COVID-19 pandemic rages on, the adverse mental health effects of isolation, fear, economic insecurity, substance abuse, deaths of despair, and long-term disruption to cultural norms continue to worsen.
- With so many people struggling to cope, there is a need for increased mental health awareness and care.
- President Biden said he would work to eliminate the stigma surrounding mental health.
As the COVID-19 pandemic rages on, the adverse mental health effects of isolation, fear, economic insecurity, substance abuse, deaths of despair, and long-term disruption to cultural norms continue to worsen. They will linger long after the pandemic itself is finally under control.
There has always been a stigma surrounding mental health. Though mental health awareness has increased due to our communal suffering during the pandemic, mental health issues have steadily risen over the last decade. Historically speaking, it is taboo, especially in the workplace.
If there is a silver lining to the pandemic, it is the stigma’s breakdown. Mental health awareness is on the rise, and the unease surrounding the topic is slowly disintegrating. Through all we have collectively suffered the last 10-12 months, a light has been shone in the darkest corners of our inner selves bringing mental health awareness to the forefront, and we cannot allow that light to dim.
That said, we have a long way to go, and we need our new administration to lead the way toward healing and treating the long term emotional and mental effects the pandemic continues to have on most Americans.
Mental Health and Illness Defined and How the Pandemic Has Impacted Us
Why is mental health awareness critical? According to the American Psychiatric Association, “mental health involves effective functioning in daily activities resulting in productive activities (work, school, caregiving), healthy relationships, and the ability to adapt to change and cope with adversity.” It is critical to overall health and wellbeing.
Conversely, the APA defines mental illnesses as “Health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses are associated with distress or problems functioning in social, work or family activities.”
It is no wonder then, given the social distancing and isolation protocols adopted nearly a year ago to help contain the virus, that our mental health has taken a massive hit, leading to increased mental illnesses like anxiety and depression, and substance abuse disorders.
I don’t know about you, but no one ever taught me how to “…adapt to change and cope with adversity” in a healthy way. Most of us learn these skills by accident as we move through life, often developing destructive coping mechanisms like self-medicating with alcohol and other substances, patterns of emotional avoidance, or some form of self-harm or abusive relationship, all of which can result in or compound mental illnesses.
According to JAMA (The Journal of the American Medical Association), a June 2020 survey from the Centers for Disease Control and Prevention found that 40.9% of respondents reported “at least one adverse mental or behavioral health condition,” including depression, anxiety, post-traumatic stress, and substance abuse, with rates that were 3 to 4 times the rates one year earlier. Remarkably, 10.7% of respondents reported seriously considering suicide in the last 30 days.
JAMA goes on to say, “Of central concern is the transformation of normal grief and distress into prolonged grief and major depressive disorder and symptoms of post-traumatic stress disorder. Prolonged grief disorder is characterized by at least six months of intense longing, preoccupation, or both with the deceased, emotional pain, loneliness, difficulty re-engaging in life, avoidance, feeling energy is meaningless, and increased suicide risk.
Once established, these conditions can become chronic with additional comorbidities such as substance use disorders. Prolonged grief affects approximately 10% of bereaved individuals, but this is likely underestimated distress related to deaths from COVID-19. Further, each COVID-19 death leaves an estimated nine family members bereft, which projects to an estimated 2 million bereaved individuals in the U.S. Thus, the effect of COVID-19 deaths on mental health will be profound. Moreover, the stress and social disruption caused by the pandemic has heightened depression and anxiety globally, and is adversely affecting many individuals with preexisting psychiatric disorders and substance use disorders.”
With so many people struggling to cope, there is a need for increased mental health awareness and care. Yet, many Americans and others suffering worldwide are unable to receive the treatment they need.
An October 2020 news release by the World Health Organization reports that the pandemic has “…disrupted or halted critical mental health services in 93% of countries worldwide while the demand for mental health is increasing.” The survey was conducted from June to August 2020 and evaluates how the provision of mental, neurological, and substance use services has changed due to COVID-19, the types of services that have been disrupted, and how countries are adapting to overcome these challenges.
Countries reported widespread disruption of many kinds of critical mental health services:
- Over 60% reported disruptions to mental health services for vulnerable people, including children and adolescents (72%), older adults (70%), and women requiring antenatal or postnatal services (61%).
- 67% saw disruptions to counseling and psychotherapy; 65% to critical harm reduction services; and 45% to opioid agonist maintenance treatment for opioid dependence.
- More than a third (35%) reported disruptions to emergency interventions, including those for people experiencing prolonged seizures, severe substance use, withdrawal syndromes, and delirium, often a sign of a painful underlying medical condition.
- 30% reported disruptions to medications for mental, neurological, and substance use disorders.
- Around three-quarters reported at least partial disruptions to school and workplace mental health services (78% and 75% respectively).”
Essentially, due to prolonged grief, fear, economic insecurity, and isolation, Americans are experiencing mental illness at unprecedented rates with little recourse, the effects of which range from increases in substance abuse and relapse, domestic violence, and self-harm, to deaths of despair like suicide and overdoses.
All of this is exacerbated by a halt to critical mental health care, especially in rural areas affecting 20% of the American population, where hospital closures have forced residents to drive farther away for care; young people in critical points of development reporting higher occurrence of suicidal and self-harm thoughts, and among select U.S. demographic groups like communities of color and those with household incomes less than $35,000.
How Will the Biden Administration Address the Mental Health Crisis and Deaths of Despair?
In a pre-election interview with Mental Health for the U.S., President Biden said he would work to eliminate the stigma surrounding mental health, redouble efforts made by Obamacare to enforce mental health parity laws, and expand Medicaid and funding for mental health services like telehealth in rural communities. He also says he will double the number of health professionals in schools and publish a “…comprehensive public health and cross-sector approach to addressing suicide in veterans.”
Yet one of our new POTUS’s first actions was to issue an order to block the Keystone XL Pipeline (a complex issue on both sides, to be sure), resulting in massive job loss and unemployment, a leading cause of mental illness.
Of the $900 billion COVID-19 relief package passed ahead of the new year, $4.25 billion was allocated for mental health and substance use disorders. It’s a good start, but in April of 2020, the National Alliance on Mental Health called for $38.5 billion for emergency funding. Hence, the new allocation is still a far cry from what is needed to stabilize an overburdened mental health care system still struggling to recover from budget cuts sustained after the 2008 recession.
Behavioral Health Business provides a look at how the $4.25 billion in funding could be split among various Substance Abuse and Mental Health Services Administration (SAMHSA) programs:
- $1.65 billion for the Substance Abuse and Prevention Treatment Block Grant program;
- $1.65 billion for the Community Mental Health Services Block Grant program;
- $600 million for Certified Community Behavioral Health Clinics (CCBHCs);
- $50 million for various suicide prevention programs;
- $50 million for Project AWARE;
- and $240 million in emergency grants to states.
Fountain House has assembled a 100 Days Mental Health Agenda for the Biden administration, suggesting a list of policy recommendations to “…support our collective mental health that is politically feasible, strategically sound, and morally imperative.”
Americans are anxious for action by the president to address the rising overdose and addiction crisis, made undeniably worse by the pandemic’s mental health stressors. A health alert released by the CDC reported an acceleration of drug overdose deaths from June 2019 to May 2020, with the largest increase from March to May at the onset of the pandemic resulting in 81,230 lives lost, the highest number of drug overdoses over 12 months ever recorded.
On tackling the opioid crisis, a significant contributor to deaths of despair, President Biden says his plan will:
- Hold accountable big pharmaceutical companies, executives, and others responsible for their role in triggering the opioid crisis.
- Make effective prevention, treatment, and recovery services available to all.
- Stop overprescribing while improving access to practical and needed pain management.
- Reform the criminal justice system so that no one is incarcerated for drug use alone.
- Stem the flow of illicit drugs, like fentanyl and heroin, into the United States—mostly from China and Mexico.
Despite these campaign promises, Biden has so far failed to appoint leaders of crucial federal agencies tasked with tackling the drug crisis and delayed a Trump policy that was touted by many as a step toward saving lives.
Passed during his final days in office, the Trump administration’s plan allowed more physicians to prescribe an opioid-treatment drug called buprenorphine and loosened requirements that many said slowed down their ability to treat patients in need. Expressly, DEA-registered physicians could now prescribe the medication without an X-waiver, a federal license obtained through an 8-hour training course required before Trump’s plan.
This would allow for expanded access to medication-assisted treatment (MAT) for opioid use disorder (OUD). According to the U.S. Department of Health and Human Services (HHS), without MAT, the chances of relapse for a person who suffers from OUD are significant. Some legal experts warned that the HHS did not have the authority to remove a Congress regulation, which may have influenced Biden’s decision to halt the plan.
In an interview with NPR, Keith Humphreys, who studies addiction treatment at Stanford University, says the Biden team needs to move fast to make buprenorphine more widely available, as doctors tell him regularly they need this drug to help patients survive.
How Can I Improve My Mental Health and Where Can I Get Help?
Take a mental health screening to determine if you have a mental illness. According to Mental Health America, by August 2020, over a quarter-million people screened positive for some form of mental illness, reporting loneliness, isolation, current events, and financial problems as a source of negative feelings.
Some disorders thrive in isolation, so be aware of warning signs and give yourself and others grace. You may even be able to improve your mental health by improving your gut health and using psychological first aid, a simple set of techniques you can learn for free, to help yourself and others restore a sense of safety.
The National Alliance on Mental Illness (NAMI) provides mental health awareness and treatment options to fit any need, so if you need help, please ask for it.
You are not alone. I promise.
Why This Matters
Americans and people throughout the world are hurting and need help. There is no vaccine for mental illness. The pandemic’s long-term adverse mental health effects like isolation, fear, economic uncertainty, and lack of societal norms like gathering to grieve or celebrate together will reverberate for many years to come.
Deaths of despair and substance abuse issues have been on the rise in this country for the last 20 years and have worsened in the previous 6 to 7 due to the opioid crisis. For the first time in over 100 years, the U.S. has experienced a decline in life expectancy each year since 2014 and is markedly lower than other rich countries, despite spending more on healthcare. This is mainly due to the number of opioid deaths that have risen dramatically since 1990 and outpaced any other nation by over 10%.
Yes, the pandemic has increased mental health awareness and started to destigmatize mental illness.
Still, it is a long-term problem that needs better solutions from our government leaders and healthcare programs, better education, and early intervention for young people, including recognizing symptoms and coping mechanisms. These more holistic approaches consider the gut-brain-axis as a part of treatment and provide care to underserved communities and demographics.
Before the pandemic, WHO says most countries were spending less than 2% of their national health budgets on mental health, and it’s estimated that “…nearly $1 trillion in economic productivity is lost annually from depression and anxiety alone. However, studies show that every $1 spent on evidence-based care for depression and anxiety returns $5.” As a nation, we must invest in mental health awareness, research, treatment, and education to improve Americans’ lives everywhere.
Samantha DeTurk is a health and science writer for ThinkCivics. Sam graduated cum laude from BSU with a major in Theatre and a minor in Telecommunications and spent her first 5 years post-grad working in the radio industry before joining corporate America as a business consultant for a Fortune 300 HCM leader. When she’s not writing or cooking delicious WFPB cuisine, Sam loves singing, acting, spending time at the lake with her husband and ornery kitty Jasper, and (badly) learning to play her ukulele, The UkuBaby.