Mental Health an Emerging Crisis of COVID Pandemic

Another recent report, released Friday from 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 fears about the virus.

A recent poll of more than 3,100 WebMD readers found that 26% said they felt a sense of trauma from COVID-19.

Koenen, who has studied other major disasters, sees problematic differences this time, including how long-lasting the pandemic may become and how it has affected the whole world.

“We know that social support is so important to buffer the effects of disasters, to help pull people out of disasters, and here, we see that because of physical distancing … we’re sort of robbed of some of that social support, so that’s extra-challenging.

“In terms of this specific situation, we’re really treading new ground.”

Mental Health’s First Responders

At the nation’s crisis and suicide hotlines, counselors are seeing the first waves of emotional distress. Callers have flooded the phone lines to talk about health fears, job losses, relationship strains, and lonely days spent in isolation.

Calls to the Sacramento crisis line increased 40% from February to March, according to Porteus, the CEO of WellSpace Health, which operates the hotline. In a year-to-year comparison, April’s call volume was 58% greater than in April 2019, he said.

Lauren Ochs, MA, a counselor who takes crisis calls in St. Louis, MO, has also talked to many more people since the pandemic started, averaging 25-35 calls during her 8-hour shifts, she said. “About 80% to 85% at least mention COVID. That might not be their primary problem, but some way, somehow, they’re affected by it.”

Calls also have risen significantly at the San Diego Access and Crisis Line in California, said Program Manager Heather Aston.

“We’ve seen an increase in more anxiety-driven calls,” Aston said. Some people are worried about COVID-like symptoms. “They want to know where can they go to get safely tested.” Others are concerned about family members. One woman called for advice on how to help a sister who had stopped eating and drinking and was having paranoid thoughts about COVID-19, Aston said.

Long-Term Effects

In a recent opinion piece published in the Journal of the American Medical Association, Sandro Galea, MD, MPH, DrPH, a professor at the Boston University School of Public Health, warned of an upcoming wave of mental disorders because of coronavirus.

He noted that “large-scale disasters, whether traumatic (the World Trade Center attacks or mass shootings), natural (hurricanes), or environmental (Deepwater Horizon oil spill), are almost always accompanied by increases in depression, posttraumatic stress disorder (PTSD), substance use disorder, a broad range of other mental and behavioral disorders, domestic violence, and child abuse."

The COVID-19 pandemic would likely produce a similar “overflow of mental illness,” he said.

He cited examples:

• 5% of people affected by Hurricane Ike in 2008 met the criteria for major depressive disorder in the month after the hurricane.
• 1 in 10 adults in New York City showed signs of major depressive disorder in the month following the 9/11 attacks.
• Nearly 25% of New Yorkers reported using more alcohol after the attacks.
• Communities affected by the Deepwater Horizon oil spill showed signs of depression and anxiety.
• The earlier SARS epidemic was linked with increases in PTSD, stress, and psychological distress in patients and health care workers.

The mental health effects can happen immediately and last over time, he wrote.

The pandemic also comes at a time when people already struggled to get mental health care, often due to cost, lack of access, and a shortage of providers. As people who had been getting help before stay-at-home orders found their care interrupted, some providers have begun to offer telehealth services.

Charles Jones, the CEO of MDLive, a large telehealth provider, told MedCity News that his company has seen increased demand for behavioral health services from patients who are stressed out about health or work issues. Cigna, one of the largest providers of mental health services, launched a toll-free, 24-hour help line for the public to speak to behavioral health specialists.

Profound Effects

From isolation to anxiety to excess drinking, coronavirus has touched almost every area of life, said Lan Nguyen, a suicide and crisis services program manager for the hotline in Santa Clara County in Northern California.

For many callers, community shutdowns have bred a deep sense of isolation, he said. “People complain that they are stuck in the house all day. They don’t know what to do.”

On the home front, relationships can be strained, Porteus said. “Families are kind of a tinderbox, especially in confined areas.” Children may now face a greater risk of abuse, especially since they can no longer find respite at school. “There are a lot of family dynamics that are not healthy, and now kids have to be in them full-time,” he said.

The same goes for victims of domestic violence, according to Porteus. “People can’t get out of their homes, so they’re more enmeshed with the perpetrators than ever before.”