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Second COVID-19 Wave Is Already Here: It’s Our Mental Health Crisis

Summary

The pandemic unleashed high levels of anxiety and despair. Here’s how we can help turn the tide with compassion and hope.

Guiding our members to mental health care

By Viwek Bisen, MD, Senior Medical Director

The coronavirus pandemic is already bringing a second wave. Not of viral infections, but mental health problems.

Depression and anxiety have started rolling through wide parts of our nation. And unless people can access needed mental health services and certain conditions such as unemployment change, growing rates of substance use disorder and suicide may follow.

Nearly half of Americans report the pandemic has been harmful to their mental health, according to a Kaiser Family Foundation poll. And a federal emergency hotline for people in emotional distress crisis received about 20,000 texts in April compared with 1,790 during the same time last year.

Even more troubling were the results of new research that projected 75,000 people may die from drug or alcohol misuse or suicide as a result of the pandemic. According to the study, these so-called “deaths of despair” would be the result of three factors: unprecedented economic failure paired with large-scale unemployment, required social isolation possibly leading to ongoing isolation for years, and uncertainty caused by the sudden appearance of the virus itself.

These projections are only estimates right now, hopefully they will never come to pass. But history has taught us what happens to our collective mental health following major events like wars or natural disasters. A recent article on the COVID-19 pandemic discussed the mental health impact of previous disasters on individuals:

About 11 percent of people have minimal impairment or mental health issues.
About 50 percent had moderate levels of emotional and psychological distress.
About 21 percent have significant distress.
About 18 percent develop a psychological illness.

Several variables increase the risk of a person falling into one of the more severe categories, including fewer social supports, a history of trauma or mental illness (including substance use), and ongoing stresses such as losing a job.

What can we take away from these historical models? One, everyone reacts to traumatic events differently, and there is no single variable that predicts how people will respond. Two, the health care system will need to be prepared to deal with the rising number of mental health crises just as it had to brace for the virus itself.

Coping with the new normal

Now that the initial shock of the pandemic is gone, people are reacting in individual ways. As restrictions lift, some are starting to venture out and return to their old lives while some are still frightened of the uncertainty and retreating further into isolation.

While there is no true “normal” way to act in this “new normal,” it’s important to recognize the signs of distress in yourself and your friends or family and learn ways to ward off feelings of anxiety or depression.

For one, it’s understandable to feel stressed and frustrated during these times. But, other behaviors can signal a deeper level of distress: getting easily distracted doing everyday tasks, showing low frustration tolerance, becoming easily irritable, snapping at family and friends over small issues, and catastrophizing, which is thinking only about the worst possible outcome to a situation.

We should also be aware of the signs that could precede a more serious clinical situation. Symptoms of underlying mental illness could worsen and include abrupt changes in behavior, like waking up much earlier and going to bed much later than normal or not taking pleasure in activities that are usually enjoyed, like spending time with family. If left unaddressed, these symptoms can lead to people thinking they don’t want to live or feeling the world is a better place without them. If you notice these behaviors in others, it’s important to talk with them and encourage them to seek professional help.

The best way of dealing with ongoing stress and uncertainty is to be willfully engaged in positive self-care. For example, talking with friends, exercising, and avoiding substance use will not only make you feel better in the short-term but have also been proven to lead to better long-term outcomes.

Stepping up to meet the challenge

Meeting a person’s immediate needs can reduce the lasting mental health effects of trauma. But it’s unclear if the health care system has enough “supply” to meet the coming demand for mental health services.

Only about half of people with mental illness in this country receive treatment – and that was before the pandemic. Many people, especially those in rural areas or without jobs, may be facing a shortage of qualified health care professionals who can offer therapy, support or medications.

It’s going to take innovative approaches to address this society-wide problem. We’ve already begun to see some promising steps. A national coalition of more than 250 mental-health groups recently announced it was leading a coordinated mental health and suicide prevention response effort to the pandemic.

Here at Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ), we’ve been making it easier for our members to access the mental health care they need. Out-of-pocket expenses for telemedicine visits for members enrolled in a fully insured plan will be waived through the public health emergency and State of Emergency declared by the Governor in Executive Order 103 of 2020. For the long-term, Horizon BCBSNJ has partnered with in-state physician groups and virtual care providers that offer support for a range of mental health problems, including substance use disorder.

Just as we all took necessary measures to flatten the curve of COVID-19 infections, we can all do our part to reach out to those in despair and connect them with the care they need. So remember, despite all of our challenges, there is hope.