Mental Health Crisis Looms, Could Affect Millions
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Mental Health Crisis Looms, Could Affect Millions

Coronavirus Fallout: We May Soon Be Experiencing a National Post-Traumatic Stress Disorder

 

Bandy X. Lee

As more than 100,000 people die of Covid-19 in the United States and 40 million jobs disappear, another crisis may eclipse these catastrophes: national mental health trauma.

Social distancing came about largely because of the failure to test, trace and isolate contacts properly in the early stages.

The ensuing runaway pandemic is not just causing an economic recession, but a social recession.

We hear of domestic violence and problems of depression and anxiety every day. Meanwhile isolation and sheltering in place become risk factors for substance abuse, suicide and even homicide.

More than half of Americans report the coronavirus crisis is harming their mental health.

Among frontline healthcare workers and their families, 64% reported worsened mental health, as did 65% of those who lost income. A federal emergency hotline for people in emotional distress registered an increase of more than 1,000% compared with last year.

Another recent report by the Well Being Trust said the pandemic could lead to 75,000 additional “deaths of despair” from drug and alcohol misuse and suicide due to unemployment, social isolation and fear of the virus.

The pandemic could lead to 75,000 additional “deaths of despair” from drug and alcohol misuse and suicide due to unemployment, social isolation and fear of the virus.

Still, there are concerns about the mental health system’s ability to absorb or to reach most people in need.

While the initial outbreak of the novel coronavirus caught hospitals unprepared, the U.S. mental health system—vastly underfunded, undervalued and difficult to access before the pandemic—is even less prepared.

There are no White House briefings about it, and no word of a plan. Congress’ trillions of dollars in emergency coronavirus funding allocated only a tiny portion for mental health, which may not even make up for the recent healthcare cuts and insurance blockage by the Trump administration.

Suicides and Overdoses

We know suicides, overdose deaths and other forms of suffering often surge after natural or man made disasters. An existential crisis occurs with a changed sense of safety and security, an altered view of the world. When the disaster is human-caused or human-exacerbated, a serious loss of faith in humanity occurs. Collective helplessness about the situation is seen. Then politicization of a disaster divides instead of bringing  solidarity and intensifies trauma and grief.

We rapidly are heading toward a form of national post-traumatic stress disorder which may last many years.

The good news is we can do something about it. Amid tragedy, there is an opportunity to recognize and to correct our course. Using our experience of suffering to bring about change is precisely how PTSD is healed.

We can prevent, share and repair.

Self Care Integral

A great deal of prevention is done through education. In 15 years of teaching at Yale Law School, I trained students to consider self care as an integral part of professional responsibility.

It is not selfish or weak but an important aspect of building and protecting one’s overall health. I have recommended:

  • Put aside time for self-care, just like exercise. (An hour a day, an afternoon week, etc.)
  • Devote time to pure enjoyment. During quarantine that may include virtual communication to stay in touch with friends and family. For those in close quarters, it can mean asking for personal time and space.
  • Do not be afraid to consult when necessary.

Awareness of one’s own needs and the importance of mental hygiene itself serves as a huge step in prevention.

A great deal is mitigated through sharing.

A National Academies of Sciences report on the health consequences of social isolation and loneliness in older adults showed that social isolation is associated with significantly increased premature mortality not just from mental but from physical causes.

It found an increase of risk by:

  • 59 percent for functional decline
  • 50 percent for dementia
  • 32 percent for stroke
  • 29 percent for incident coronary heart disease
  • 25 percent for cancer mortality

Older adults may be the most vulnerable, but we are all affected. Breaking through the social isolation and stigma to find ways of sharing is critical. As many as one in five American adults suffer from mental illness, and speaking openly offers significant relief.

Fewer Than Half Treated

Even though so many adults have a diagnosable mental illness, less than half receive treatment, according to federal statistics.

The United States trails behind the rest of the world in mental health awareness and prevention. This is seen in how suicide rates have fallen around the world, while rates in the United States have climbed every year since 1999, increasing 33 percent in the past two decades.

Large, systemic changes are necessary to meet this scale. Parity and access problems need to addressed immediately.

Mental health should no longer be marginalized but treated the same as physical health, as all scientific evidence and the seriousness of the issue require.

Finally, we can no longer ignore the elephant in the nation’s room.

We receive a recurring question from the public: “I am in a state of constant anxiety because of Trump’s refusal to deal with the pandemic in a scientific manner. He’s making it worse by both his actions and inaction. How do I cope with this anxiety?”

Over Memorial Day weekend, we approached the mark of 100,000 casualties, not by an external enemy but by bioterrorism of our own government.

We have a president who went golfing after stating: “I don’t take any responsibility at all.”

Leaving people helpless, unable to discuss the overarching problem in properly rigorous terms, let alone prevent it, worsens trauma.

How this cultural trend came about is an important story that has been reported elsewhere.

Two hundred and fifty years of scientific enlightenment vanished in an instant to descend us into a medieval-level plague when a president did not wish to apply knowledge. Similarly, 25 years of mental health awareness went up in smoke to descend on us a dark age of ignorance and stigma when a psychiatric establishment wished to shroud knowledge.

It does not have to be this way.

In democracy, people have a right to expertise and, alongside the free press, a right to access the best available knowledge.

Honest information empowers people against oppression and autocracy and, in this case, also is the best medicine.

 

May 27, 2020