NPHW Guest Post : Mental Health "COVID-19 and Mental Health"

COVID-19 and Mental Health

Ron Melka

Ron Melka is President of the Association of Community Mental Health Authorities of Illinois, and Executive Director of the Lyons Township Mental Health Commission. He is also an Adjunct Professor in the Graduate program for public Administration at the Illinois Institute of Technology (IIT). He holds a Master’s Degree  in Public Administration with honors from IIT, and a Bachelors in Psychology and Sociology for SIU. Among many other roles, he is the former President of the United Way of Illinois

 

This is National Public Health Week, and as President of the Association of Community Mental Health Authorities of Illinois, I wanted to draw your attention to the incredible challenges we all are now facing. It is important to be aware of, and prepared for, the wave of Mental Health issues people is experiencing because of the Covid-19 Pandemic and the resulting shutdowns, isolation and loses that have occurred. There has been so much loss it is hard to fathom, much less the impact on our mental health. Many people have experience the loss of a relative, loved one, friend, co-worker, neighbor, or role model, and are experience grief because of this. Each of the more than half a million deaths have impacted all those around them.

Even more have lost their jobs, livelihoods, businesses, or have someone they know that has. It has impacted many families, and communities. Almost every student in the United States has been affected. Most have been isolated in their homes, Those that have been able to go to classes have had to wear masks, keep distant form each other, and all have had extracurricular activities such as sports, music, theater, dances, and clubs cancelled. People have not been able to visit one another. Many grandparents, grandchildren, siblings, cousins, friends, and acquaintances have not seen each other face-to-face or hugged one another in a year. We are rightly afraid to shake hands with each other, or get too close.

Over 30 million cases of Covid are currently reported by the CDC. Testing positive, even without symptoms, has impacted those and their families, friends, and coworkers. The overall restrictions on us all regarding masks, social distancing, avoiding crowds, and sanitizing have added a level of vigilance we are not accustomed too. The closing of churches, schools, businesses, theaters, beaches, etc. have alter our lives drastically. The loss of income by our businesses, institutions and governments has hurt us all. The list of what each has lost goes on and on.

All of this has resulted in a dramatic increase in mental health problems. There have been dramatic increases in anxiety, depression, suicide, alcohol, and substance abuse. “Bereavement, isolation, loss of income and fear are triggering mental health conditions or exacerbating existing ones. Many people may be facing increased levels of alcohol and drug use, insomnia, and anxiety. Meanwhile, COVID-19 itself can lead to neurological and mental complications, such as delirium, agitation, and stroke. People with pre-existing mental, neurological or substance use disorders are also more vulnerable to SARS-CoV-2 infection ΜΆ they may stand a higher risk of severe outcomes and even death.” (Mental Health News, Google).

“More than 42% of people surveyed by the US Census Bureau in December reported symptoms of anxiety or depression in December, an increase from 11% the previous year. Data from other surveys suggest that the picture is similar worldwide (see ‘COVID’s mental stress’). “I don’t think this is going to go back to baseline anytime soon,” says clinical psychologist Luana Marques, at Harvard Medical School in Boston, Massachusetts, who is monitoring the mental-health impacts of the crisis in US populations and elsewhere.” (Nature, Feb 3, 2021)

A new analysis from FAIR Health found that teenagers' demand for care for mental health skyrocketed last year amid the pandemic, even as their need for medical care in general declined. The percentage of all medical claim lines that were for intentional self-harm nearly doubled in March and April, compared to the same months in 2019. Claim lines for overdoses increased by 94.91% in March and 119.31% in April.

It has been especially hard on those with developmental disabilities. Many need specialized services that cannot be delivered via video conferencing. Physical therapy, occupational therapy, one on one advocacy, and support staff are not available. When the school’s shutdown, so did the Individual Education Plans (IEP) of those in special education, as well as early childhood screenings that determine needed services for toddlers, preschoolers, and other students. The success of many of these services depend on early intervention and any delay can reduce the overall development of a disabled person for the rest of their lives.

There has been a dramatic increase in substance abuse. According to Marissa D. King, Professor of Organizational Behavior at Yale, “the pandemic has catalyzed a set of secondary social crises, including an exacerbation of the opioid epidemic. During COVID, more people have died from opioid overdoses than ever before. Overdose deaths from opioids increased by almost 20% during the early months of the pandemic, a trend that has likely continued”… “The pandemic has been a nightmare scenario for people struggling with or at risk for substance abuse disorders. Social isolation, stress, and unemployment—all known risk factors for use and relapse—have been rampant.”

College students are under increased mental health strains. An article in the March 30th Washington Posts states that “Across the country, some school leaders and experts say the pandemic has brought new urgency to a mental health crisis that had been unraveling on college campuses for years. From social isolation to heightened feelings of inadequacy, students say it has made it harder to concentrate on school and put a strain on families and friendships.”

All ages are affected. Boston University School of Medicine found that persistent loneliness in Midlife can increase the risk of dementia, and Alzheimer’s.

Our systems to address this are already underfunded and overburdened. Doctors, nurses, and medical staff have been under incredible strain for the past year, on top of the already common burnout and stress they commonly experience in their profession. Social workers, psychiatrists, and counselors were already in short supply before the pandemic, and are in even greater demand now.

This needs to be everyone’s priority. We need to shift our focus to providing for this wave of mental health problems that is upon us. Fortunately, there are already increases in federal and state funding for mental health services. We need to determine what are the needs in our local communities and where funds and services need to be targeted. Measuring the current mental health status should be a part of all health departments, doctors, nurse practioners, schools, businesses, and even families; and then having a way to successfully have services provided to address those needs. Insurance companies need to really treat mental health issues in parity with other physical health issues, as the laws already call for. We all need to address this crisis. I wish there were easy answers; however, as you know, one size does not fit all.

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