As the world comes to terms with the reality of COVID-19, tens of millions of Americans now face an uncertain future: A global pandemic the likes of which we’ve never seen. The federal government’s glacial response. Pending economic collapse. Massive layoffs. A healthcare system that’s woefully unprepared. Grocery stores picked clean.
Even the most mentally strong among us would have to admit that these are trying times. The fear of the unknown. The loneliness that comes from social distancing. The despair that comes from feeling powerless.
Just imagine how this crisis will affect the nation’s mentally ill.
The Mentally Ill Are at Grave Risk
According to the National Institute of Mental Health (NIMH) and The Centers for Disease Control (CDC), mental illness affects 1 out of every 5 adults in the United States and 1 out of every 6 children. That’s more than 68 million people, the vast majority of whom struggle with anxiety or depression. For context, that number is equivalent to every man, woman, and child in both California and Texas combined.
68 million people in this country suffer from anxiety and depression, and that was before even a hint of a global pandemic, civil unrest, or economic disaster.
As of this writing, approximately 9,000 people worldwide have died from COVID-19. That’s a scary number. But it pales in comparison to the number of people who die every year from mental illness and drug addiction, which are often the same thing. Consider:
- Worldwide, 800,000 people die from suicide each year. That number includes about 47,000 Americans, the vast majority of whom had been diagnosed with major depressive disorder.
- Another 168,000 Americans die every year from drugs and alcohol. This includes overdoses, disease, and accidental deaths.
- Worldwide, 8 million people die from mental illness every year.
My point here is that COVID-19 isn’t the only epidemic that America is facing. It’s just the only one we seem to care about.
And regarding the 68 million in this country who suffer from mental illness? What’s going to happen when they start getting sick, or when the economy starts to collapse, or when they don’t have ready access to psychotropic medication, or when they lose people they know and love, or when social services and community supports dry up and die?
Does anyone really think the number of mentally ill in America won’t grow much, much larger?
The Mental Health Field Is Totally Unprepared for COVID-19
I see news reports all the time about how there are not enough masks, not enough respirators, not enough bottles of hand sanitizers, not enough hospital beds. And yes, those things are important. But those things are only used to treat the body. Why is nobody talking about the resources we’ll need to treat the traumatized minds and the battered souls that will invariably be the result of so much uncertainty and chaos?
The field of mental health has never been taken very seriously in America. Sure, there’s no shortage of inspirational memes on Facebook that you can share with your family and friends. Sometimes we even wear ribbons. And of course, there’s no shortage of gurus out there writing articles about the importance of therapy and self-care. For all the good it does.
But when push comes to shove, the support is nothing but an illusion. As a nation, we’re investing less in mental health services than we were 30 years ago. Hell, we’ve even refused to give mental health professionals a pay raise in more than 25 years (adjusted for inflation, my counterpart in 1995 made more than I do in 2020). And as a result, outcomes have suffered. Suicide rates are getting worse, not better. Depression is more prevalent, not less. Drug addiction is still rampant. Access to services is scarce. The courts are still the primary mode of “treatment” for many.
And we’re about to get clobbered by a global pandemic.
It’s not like our mental health infrastructure was ever rock solid. Mental health professionals, social workers, therapists, and psychologists are already woefully and insultingly underpaid, understaffed, and overworked. We’re already having serious conversations about shutting down community mental health agencies and private practices in response to COVID-19, and we’re just as likely to get sick as anyone else. We also have children who are out of school, our own families and friends to care for, and our own precarious financial positions.
There’s a very real scenario about to unfold where access to outpatient mental health and substance abuse treatment simply collapses under the weight of all that is happening. Case in point — the lion’s share of addiction treatment is done at the group level. It’s not unusual to have 18–20 people in one group. But of course, we’re not allowed to gather in groups of more than 10 anymore, so many facilities are just suspending their services. It’s not like they have tons of extra staff to pick up the slack. They’re always undermanned.
And if you’re not actively involved in the mental health field, you might be unaware of the scale of this problem. I’m not just talking about the sheer number of people that will be affected. I’m also talking about the many different types of services we offer to the public that have already been suspended or are heading in that direction.
Forget what you’ve learned from movies and TV. Therapists who sit on couches and talk about people’s dreams represent just one small slice of a gigantic mental health pie. We are first responders. We are in the schools and embedded with DSS and in hospitals and in homes and out in the community. We’re working with gang members and drug addicts and the intellectually-disabled. We treat victims of sexual abuse and human trafficking. We are grief counselors working with hospice and in foster homes monitoring the safety and welfare of our nation’s most vulnerable youth. We prevent suicides and mitigate domestic violence. We advocate and teach and mentor.
Of course, there’s all sorts of professionals involved in the fight against COVID-19. There are doctors and nurses and police officers and paramedics. And all of their contributions are at least as important as anyone else’s.
The difference is that we’re already talking about those professions. It’s on the news 24/7. There’s not a person left in America who doesn’t know that nurses and doctors and other first responders are on the front line of this thing.
But nobody’s talking about the other first responders, the counselors and therapists and social workers and clinicians who are responsible for the treatment and care of those 68 million, plus all the others who will need access to services in the weeks and months to come.
What You Can Do
I work at a psychiatric hospital and see clients in private practice. For my part, I’ll keep showing up for work until I run a fever that gets me barred from entry at the hospital and I’ll keep seeing my clients until the government forces us to switch to video conferencing and other forms of telehealth. And I have no doubt that my colleagues throughout the nation will continue to provide services as well.
But I still encourage anyone reading this to email, phone, or tweet their Congressman to inquire about mental health services in your area. Because when the Coronavirus hits your area — and it will — you’ll want every available resource at your disposal. We will all need professional supports to get through this crisis. Let’s make sure that they still exist when the time comes.