May 6, 2020

Opinion: Surge of Mental Illness Will Emerge from COVID-19 Crisis

Dr. Derald Walker and Dr. Jeffrey Eisen, Cascadia Behavioral Healthcare

This Op-Ed was published in the Portland Business Journal May 5, 2020, 9:51am PDT. Submitted by Dr. Derald Walker, Ph.D., President & CEO, and Dr. Jeffrey Eisen, MD, MBA, Chief Medical Officer of Cascadia Behavioral Healthcare, pictured.

The COVID-19 pandemic and resulting economic downturn have already had a profound impact on our community’s mental health and created new challenges for those already suffering from mental illness and substance use disorders. Beyond the fear of getting sick from COVID-19, people are facing widespread job loss, economic instability, social isolation and fear for the health and safety of family and loved ones, leading to a surge of mental illness that will inevitably emerge from this pandemic.

In a recent poll, 45 percent of adults in the U.S. reported that their mental health has been negatively impacted due to worry and stress over the virus. The threat of untreated mental health conditions — including anxiety, depression, PTSD, substance use, loneliness, and domestic violence— may present another pandemic of its own. A daunting reality of this virus is its ability to affect the mental health of everyone, regardless of age, health status or other factors. Consequentially, this leaves everyone in our community vulnerable to the physical and mental health challenges that can come with the experience of living through a global pandemic. Individuals who have previously been diagnosed with a mental illness may find their condition resurface or worsen, while others could develop a mental health challenge as a result of the crisis. Risk is especially high for health care workers providing frontline services, marginalized groups like immigrants and refugees, as well as people who have lost loved ones or jobs due to the disease.

Fortunately, there are steps we can take to ensure we are effectively identifying and treating those who face mental illness amid the COVID-19 pandemic. In order to improve the health and wellbeing of our communities, it’s crucial we take action sooner rather than later.

As we move forward in this new reality, we’ll undergo continuous change to ensure we’re reaching vulnerable community members as effectively as we can, while also facing immense, unprecedented limitations. First and foremost, doing outreach in our community, especially among vulnerable individuals, is crucial. Engaging in regular contact with individuals who are at high-risk, including the elderly, marginalized groups, and those with existing mental health challenges, will be a key piece to ensuring we can manage our community’s health needs. We know based on existing COVID-19 data that individuals with co-occurring physical and mental health concerns are at great risk, specifically those with hypertension, diabetes and asthma. This makes the delivery of integrated care more
important than ever, since these conditions lead individuals to have a greater risk of poor outcomes from COVID-19. As a community, we can continue to provide support and funding for Certified Community Behavioral Health Clinics, which can help improve access for those with complex health needs.

Continued innovation in our healthcare landscape will be necessary to deliver quality care. Health organizations across the country must continue to adapt to offer telehealth options where possible, including primary care, mental health, and crisis services. Fortunately, there are state and federal-level changes being made to allow for expanded delivery of telehealth services. Medicare and many insurances have even expanded coverage to cover telehealth services, including virtual visits with psychologists and social workers, allowing more people in need to access essential services in a safe way.

However, many individuals in our communities don’t have the technology available to connect with others for care and don’t have a safe home to call their own, making innovation is especially crucial during this time. We need effective methods for outreach and care that will reach all members of our society, including marginalized communities which are especially vulnerable.

Despite innovations in delivery of care, an unfortunate reality of the mental healthcare space is a limited workforce. Having enough mental health professionals was a challenge pre-pandemic, so a surge of mental health concerns will only exacerbate this issue. Ensuring we have a robust workforce of mental health professionals to manage our community’s healthcare needs, including physiatrists, nurses, doctors, counselors, and peers, should be a top priority, both during and after this pandemic. We must also consider the challenges of working on the frontlines during a pandemic, recognize the strength and resiliency of healthcare workers, and ensure they have the support and resources they need to continue doing their jobs safely and effectively.

Finally, more than ever, we must prioritize connection in any way we can. Many individuals who struggle with mental health challenges rely on therapy groups, classes and workshops, and community activities in their daily lives to stay well. While many of these offerings are on hold amid the national Stay at Home directive, we’ll need to find safe, sustainable ways to continue facilitating these important elements of mental health treatment. To that point, social connection should remain a top priority, as well. Although we can’t physically be together, we can encourage social connection through online and telephonic activities, including exercise, worship, and skills building.

The pandemic is likely to have both long- and short-term implications on our community’s mental health. Additionally, it highlights both existing and new barriers to accessing mental health services, including social stigma and lack of access. As our local, state, and national governments continue to discuss further actions to curb the public health and economic impacts of the COVID-19 pandemic, it’s crucial we make mental health a part of the conversation.

When new cases and fatalities due to COVID-19 decrease, we know that we’ll continue to see an increased need for mental health services. As we continue to fight against the virus, we must also continue to monitor its growing effect on the mental health of our community and find innovative, effective ways to deliver care to those in need. Although we face incredible challenges, with foresight, preparation, and determination, we can take action and ensure the health and wellbeing of our