The epidemic of mental illness during a global pandemic

This article was originally published by USA Today on 8 April 2020 by Benjamin F. Miller, a clinical psychologist, and chief strategy officer of Well Being Trust.

We were already in crisis before the coronavirus hit. 

People were dying from alcohol, drugs, and suicide, were lonely and isolated, and this was before we asked them to isolate even more. Most people recover from the coronavirus in weeks; our health care and social service systems were failing these people before it ever became overwhelmed by a virus. 

Social isolation and loneliness are linked to a variety of mental and physical health problems. From depression to heart disease, these health conditions often get worse when we are alone. Some have even claimed the impact of loneliness on our health is the same as smoking or obesity — and in some cases worse when we consider all the social and economic factors. 

Life expectancy in the United States had already been on the decline, in part driven by unaddressed issues that were some part some social, some part economic, and many parts mental health. Deaths to drug, alcohol, and suicide continue to skyrocket reaching levels that we have never seen. And these issues impact all generations and all ethnic and minority groups though at differing degrees of severity. In the best of times, our country still had not resolved itself that mental health and addiction were big enough a priority; now, in the face of a global crisis, we are at a critical pivot point for mental health in our country, and policymakers must rise to the challenge.

And if the first round of stimulus legislation holds any clues, mental health is still not being taken as seriously as it should despite the fact that impact of coronavirus is very real for many Americans. 

COVID-19 and mental health 

In a recent survey by Benenson Strategy Group, a split sample of 775 adults over 18 were asked questions specific to the coronavirus and mental health. From these data several trends emerge that provide more support for the need to prioritize mental health — and that every lawmaker at every level should understand that by not prioritizing mental health, we may yet again be adding a problem on top of a problem. 

In a matter of weeks, an alarming 55% of adults interviewed said that the coronavirus has affected their mental health. It’s hard to imagine a scenario dealing with something as unknown as coronavirus and not be a bit stressed; however, at this moment the multitude of stressors may be like pouring gasoline on top of an existing wildfire.   

And while the national conversation has rightly focused on the importance of physical distancing to stop the spread of coronavirus, 71% of those surveyed are worried this isolation will have a negative impact on American’s mental health. And data support their worry. Another recently released survey showed that it’s not just our anxiety about ourselves getting sick with coronavirus but also our loved ones.

Call for action

In this coronavirus world, we have already seen some shift from Washington in how mental health needs could be delivered e.g. telepsych services, but the question remains is it enough to start to address the deaths of despair in this country. There is much more that we must do, and now is the time for us to take major action on mental health.  

Invest real dollars in a different type of solution: While our current mental health system needs dollars to support it during this crisis, simply putting more money into something that was already broken does not fix it alone. While the CARES Act provides $425 million to Substance Abuse and Mental Health Services Administration, one has to ask why in a two trillion-dollar bill something so important as mental health didn’t have a few more zeros behind it. It seems as if this is the time to get things right with Congress by putting billions into mental health, not the budget dust offered up through CARES. 

Reconsider our current policies and structures in light of a post coronavirus world: Congress should reassess certain longstanding policies and administrative structures that often impede our ability to achieve meaningful mental health reform. From only allowing certain mental health clinicians to bill Medicare, to how we pay our mental health clinicians, the pre- coronavirus world wasn’t working to support team-based and integrated approaches to mental health so let’s reconsider all these policies now. For a full list of policies that Congress could consider see here.

Adopt a national framework for excellence in mental health: Mental health should be everywhere people show up with needs, and we should not have to wait until we are in crisis or have a diagnosis to get this help. Let’s stop telling people where they have to go for mental health care, and equip our schools, our prisons, our libraries, our technologies — everywhere with the ability to address mental health and addiction. Without a clear vision of what excellence looks like for mental health, we are left with the system we have with no clear north star to follow. Congress could rectify this by adopting a clear integrated framework taking it to scale through funding and implementation. 

Post coronavirus, our country is going to have a major problem to contend with that was already there before and is likely being felt by millions during. Let’s collectively find our voice to demand that this Congress do something more for our mental health.