Stress during a pandemic can elicit fear and worry about health, it can disrupt sleep patterns, make concentration difficult, worsen chronic health conditions and mental health conditions, and lead to increased usage of tobacco, alcohol and other substances, according to the Centers for Disease Control and Prevention. This means utilizing healthy mechanisms to cope with stress during a pandemic could make individuals and their communities stronger.
Soon after the coronavirus pandemic was declared in March, the National Alliance on Mental Illness (NAMI), the country’s largest grassroots mental health organization, released a guide to answer frequently asked questions regarding COVID-19 and its effects on people with mental illness.
Chris Bouneff, executive director of NAMI in Oregon, stated that for a long time we, as a society, haven’t bothered to provide care for mental health issues — especially in this country. According to Bouneff, it has often been challenging for patients to navigate the system in order to access resources. Additionally, there hasn’t been a strong focus on the quality of care that patients with mental health issues receive.
“The pandemic made everything worse,” he said, “as it laid bare the vast deficiencies and gaps in our health care system as it relates to services for mental health issues and substance use disorders. Everything we were dealing with before, we are now dealing with exponentially.”
However, there is a silver lining, he noted. “The COVID-19 pandemic forced the behavioral health sector to transition to telehealth. While technology doesn’t work for everyone, it has shown an unexpected benefit. With telehealth as a ready option, more people are likely to show up for appointments and engage in care. Before the pandemic, the show rates were 60 to 70%. Now, show rates for patients with mental health needs are 90 to 95%, which is a positive sign.” Bouneff said the key, as the pandemic continues, is to figure out how we will continue to deploy technology.
As COVID-19 vaccines are administered, Bouneff said we should take a multifaceted approach to address the needs of those with mental health issues. Washington State Department of Health is doing a great job of forecasting the needs of the community, he said, by sharing resources on their website .
Bouneff is concerned that, as a nation, we are not ready for what is about to come. “The hope is that we can walk and chew gum at the same time,” he said.
Leslie Adams, assistant professor in the Department of Mental Health at Johns Hopkins Bloomberg School of Public Health, said stress induced by the pandemic is just another hurdle impacting the mental health of Black Americans, a focus of her research.
“We know many biological causes of mental health. However, even the social environments that Black Americans have to navigate on a daily basis impact their mental health,” Adams said. “Before the pandemic, approximately 7 million Black Americans were affected by mental health issues. In fact, about two-thirds of them don’t receive adequate medical care for their conditions. These are unmet needs that are exacerbated during the pandemic.”
While she also acknowledged that telehealth has been beneficial in providing access to mental health resources to patients, she said stigma and inequalities still exist. She outlined these disparities in a report she co-authored for World Medical and Health Policy in August.
“This pandemic will be a marathon, not a sprint,” she said. “The vaccine will only be a small part of the solution to a large issue. It won’t be a quick fix.”
Some of the challenges, she said, are that the vaccine distribution plans are primarily state-mandated and not nationwide. Therefore, it will take some time to implement and fully vaccinate all Americans. Notably, most Americans won’t receive the vaccines until health care providers, essential workers and those at high-risk of severe complications from COVID-19 receive their dosage, so the alleviation of stress associated with the pandemic will be gradual, not rapid.
In discussing the long-term impacts of the pandemic on mental health, Adams stated that there may be prolonged negative effects throughout the population. “Psychological distress in the U.S. may match the economic challenges we are experiencing as a result of the pandemic, such as job loss and small business closures,” she said.
To cope with the challenges of the pandemic, resilience will be especially critical, she noted. How people adapt to the ongoing and upcoming changes will be key to addressing the long-term effects of COVID-19 on mental health. In thinking of resilience, Black Americans and ethnically diverse communities are generally more resilient because they have had to deal with challenges related to racism in the U.S. However, the resilience found in diverse communities is no reason to limit equitable care and support to those who are disproportionately impacted by the economic, physical and psychological consequences of COVID-19.
In order to get through this pandemic, she recommends that people maintain social connections with family and friends, whether it’s through phone calls, online conversations or physically distanced visits.
One organization, Active Minds , has been working with students and young adults to promote mental health awareness.
Amy Gatto, senior campus program manager, said before the pandemic, mental health was a priority for some institutions, but it was just another issue for many others. Some institutions are more proactive because their students are outspoken and they realize that mental health is directly related to performance. Now, during the pandemic, every institution is considering the mental health needs of their students.
“Undoubtedly, the COVID-19 pandemic has brought to the forefront mental health issues. Therefore, campuses that weren’t prioritizing it before are now taking it seriously,” Gatto said. “Results from surveys disseminated among about 2,000 students showed that approximately 80% of college students said that the pandemic has negatively impacted their mental health. Out of those, 20% also said that their mental health has significantly worsened.
“The beginning of the pandemic was particularly difficult for the students as they struggled with routines and self-care. This directly impacted their ability to focus on their studies and perform well,” Gatto continued.
Gatto said universities are recognizing that coping during the pandemic has been tough for their students. They are now focusing on students as a whole, rather than just the academics. That is a positive shift, as universities have adapted to and are encouraging coaching and support groups. After all, it is about building communities within peers that will enable us to begin these much-needed conversations.
Despite the hardships the pandemic has wrought on every segment of society, there is no evidence that suicide rates have increased worldwide, according to Michael Phillips, executive director of the World Health Organization Collaborating Center for Research and Training in Suicide Prevention and director of the Suicide Research and Prevention Center at Shanghai Mental Health Center. With that said, there are concerns that the negative effects of the pandemic and its economic aftermath on mental health could result in increased suicidal behavior, so it is essential to closely monitor the rates and demographic profile of suicides.
According to Phillips, real time data for suicide is difficult to obtain as there are usually delays in reporting official suicide rates because in many locations the cause of death must be confirmed by an autopsy and formal investigation.
“What can be done during the pandemic is active monitoring of suicide attempts and deaths,” Phillips said. Additionally, he stated that it would be important to monitor changes in the prevalence of factors associated with suicide such as drug and alcohol use and social isolation during the pandemic.
Phillips is part of an international group of suicide researchers, the International COVID-19 Suicide Prevention Research Collaboration that was launched in response to the pandemic in collaboration with the International Association for Suicide Prevention . The goal of this new group is to enhance the quality of research on the prevention and management of suicide and suicidal behaviors due to the COVID-19 pandemic.
As we inch closer to the end of the coronavirus pandemic, mental illness remains of strong concern. As a society, we must accept that only if mental health needs are addressed, will our communities flourish at large.
Rupal Ramesh Shah examines the intersection of public health and social justice in this periodic column. Shah has bachelor’s degrees in biology and chemistry from Southern Wesleyan University, a master’s degree in microbiology from Clemson University and a master’s degree in public health from Boston University. She has extensive experiences in the field of infectious diseases through her prior work at Harvard University’s School of Public Health in the Department of Immunology and Infectious Diseases and Partners in Health. She serves as the executive director of Konbit Sante, an organization that supports the development of health systems in Haiti. Street Roots is an award-winning weekly publication focusing on economic, environmental and social justice issues. The newspaper is sold in Portland, Oregon, by people experiencing homelessness and/or extreme poverty as means of earning an income with dignity. Street Roots newspaper operates independently of Street Roots advocacy and is a part of the Street Roots organization. Learn more about Street Roots . Support your community newspaper by making a one-time or recurring gift today .
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