In addition to the widespread socio-economic distress, civil unrest, and political destabilization, yet another wave of COVID-19 is weighing down the already overwhelming burden of the ongoing pandemic on public health. The viral outbreak has taken a tremendous toll on the global healthcare system and physical wellbeing of millions across the globe. Yet further still, it has contributed to the festering of a mental health epidemic that will long outlast the pandemic environment. ”
An array of additional risk factors is compounding the mental health challenges facing the global population, ranging from unemployment and underemployment to increasing healthcare costs, childcare concerns, and mounting racial inequities. On top of this, mental healthcare services have become inaccessible to many individuals in the United States as COVID-19 restrictions shuttered facilities, suspended support groups, and moved many services to online platforms. The immense psychological burden has acute effects on public health, leading experts to forecast an impending “mental health tsunami” – one of the biggest post-pandemic issues facing the population in 2021 and the years to come.
Alarming State of Mental Health
According to a recent Gallop survey, national mental health is at the lowest point it has been at any time in the previous 20 years. Data gathered by the United States Centers for Disease Control and Prevention reveals a stunning 35% increase in annual suicide rates from those between 1999 to 2018. Furthermore, the number of individuals who have seriously considered suicide has increased significantly since 2019. At the same time, rates of drug overdoses have surged as the prevalence of substance abuse is on the rise with increasing numbers of people struggling to cope with the repercussions of the global health emergency. These numbers are only the tip of the iceberg; research published by the Journal of the American Medical Association estimates that pandemic-related psychological harm will account for $1.58 trillion of financial aftermath.
Rising Mental Health Stressors and Statistics
Mounting social isolation, loneliness, and sleep disturbances are among the many stressors adding to the communal psychological burden. Although high levels of reported loneliness were prevalent before the pandemic, the associated social distancing and quarantine measures have greatly exacerbated its effects. Per data from a 2018 Cigna study, most Americans report being lonely, and loneliness has increased with each subsequent generation. Between March and June of 2019, 41% of adults aged between 50 and 80 reported a lack of companionship, 45% reported feeling socially isolated, and 46% had infrequent social contact – a significant increase in these measures over the prior year.
In 2018, suicide was the 10th leading cause of death overall in the United States as well as the second leading cause of death among 10-34-year-olds and fourth among 35-54-year-olds. Statistics reveal that 12 million adults seriously considered suicide in 2019; 3.5 million had made plans to commit suicide while 1.4 million attempted suicide that year. These alarming figures uncover the mental health crisis prevalent in the U.S. population prior to the implementation of severe pandemic mitigation restrictions which have further plunged individuals into social isolation.
Without support, many individuals may face difficulties in recovery from mental health disorders that thrive in isolation, such as eating disorders and substance use disorders. Rising levels of anxiety, depression, and other mental health risk factors are commonly associated with eating disorders alongside the lack of structure, increased time spent in triggering environments, and mounting difficulties in finding privacy for telehealth and virtual support services. These additional challenges result in increases in disordered behaviors and subsequent relapses.
Implications of Persisting Inequities
The COVID-19 pandemic – and the differential health outcomes and treatment opportunities associated with it – continues to highlight prevailing racial, ethnic, and social inequities affecting millions of Americans. Communities of color have been particularly affected, although a lack of reporting of statistics obscures our understanding of the true impact of the virus on marginalized demographics. Furthermore, barriers to access of support services and adequate healthcare are especially prevalent in disadvantaged neighborhoods, primarily affecting marginalized groups.
For instance, the Native American people’s access to mental health services on reservations has declined even further with no improvements expected by the end of 2021.
In an interview with CNN, Jacque Gray, associate director of Center for Rural Health at University of North Dakota, shared: “I know of one tribe where they have had multiple suicides between the ages of 20-40, leaving children to be raised by grandparents with no support for counseling for the kids or help for the grandparents.”
Research also reports large increases in depression particularly among Asian groups, which are reporting negative mental health symptoms due to pandemic-related racism. At the same time, some members of the LGBTQ+ community have been forced to shelter in place with people who may not be accepting of their gender or sexual orientation. Rates of suicidal ideation have surged among youth in 2020 although these numbers are especially high among young LGBTQ+ people.
“The simple fact is inequity kills,” Lisa Carlson, past president of the American Public Health Association told CNN. “We see those unequal things impacting health directly in the pandemic and really shining a light on problems that we knew were there but are much harder to ignore now.”
Preparing for the Mental Health Epidemic
In addition to concerns about missed diagnoses and delayed medical treatments, the strained healthcare system and its professionals must prepare for the challenges to come. No singular entity can solve the forthcoming mental health crisis; instead, all components of the healthcare system and governmental agencies will need to work in tandem to optimize national psychological care. Experts at Wellbeing Trust published a roadmap for transforming the current mental healthcare system to better prepare it for the current and future mental health crisis. An essential action item is the engagement of the new federal administration and elected officials to find efficient methods for minimizing healthcare costs while enhancing both the quality of care and patient outcomes. Furthermore, experts call for large-scale applications of emerging and existing technologies to help optimize accessibility and effectiveness of the system.
As further psychological stressors continue to compound, the impending mental health crisis may necessitate a widespread intervention. In the interim, clinicians and other medical professionals are encouraged to pay particular attention to the psychological symptoms of their patients as well as their own.