Is the US in a Nation-Wide Mental Health Crisis?

When the governor of Illinois first ordered the shelter-in-place order in March 2020 due to COVID-19, Stenzel saw a significant drop in clients for the first two weeks afterward. It seemed that people hunkered down and prepared to stay home for what, I imagine, most thought would be a few weeks at most. I know I did. Stenzel adapted quickly and in partnership with our Electronic Medical Record Platform, we were able to offer telehealth sessions to 100% of our clients.

A few weeks after the shelter-in-place order, Stenzel started seeing an increase in the number of clients being seen. As the summer months progress and as we enter fall, the numbers continue to increase at a rapid pace. Stenzel is seeing at least 100+ per week more than we were before COVID-19. Personally, I noticed an increase in the levels of anxiety, stress, and family issues with my clients. I had a feeling this was not unique to my clients or Stenzel as a whole. I wondered what impact COVID-19 has had on our nation. How are people responding to the restrictions being placed on them by government officials? I set out on a data-gathering mission. Unfortunately, my suspicion was correct. I have included the links to the articles and studies where you can also read about this information.

Kaiser Family Foundation (KFF), a non-profit organization focused on gathering nationwide health care information, gathered data on COVID-19’s impact on mental health and substance abuse nationwide. Here is what they found:

1. “More than one in three adults in the U.S. have reported symptoms of anxiety or depressive disorder during the pandemic (weekly average for May: 34.5%; weekly average for June: 36.5%; weekly average for July: 40.1%).” KFF’s research showed that prior to the COVID-19 Pandemic, only 1 in 5 American reported having a mental health illness in the past year.
2. “In a KFF Tracking Poll conducted in mid-July, 53%of adults in the United States reported that their mental health has been negatively impacted due to worry and stress over the coronavirus. This is significantly higher than the 32% reported in March, the first time this question was included in KFF polling.”
3. “Many adults are also reporting specific negative impacts on their mental health and wellbeing, such as difficulty sleeping (36%) or eating (32%), increases in alcohol consumption or substance use (12%), and worsening chronic conditions (12%), due to worry and stress over the coronavirus.”
4. “The KFF Tracking Poll conducted in mid-April found that 64% of households with a health care worker said worry and stress over the coronavirus caused them to experience at least one adverse effect, such as difficulty sleeping or eating, increases in alcohol consumption or substance use, and worsening chronic conditions, on their mental health and wellbeing, compared to 56% of the total population.” 
5. “Data from the mid-July KFF Tracking Poll found that if schools do not reopen, 67% of parents with children ages 5-17 are worried their children will fall behind socially and emotionally.”

US News and World Report explored some data from the Centers for Disease Control and Prevention (CDC) that is quite worrisome. This study looked at the rates and risk of suicide amongst health care professionals and young adults.  

1. “The most recent Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention revealed that 41% of respondents have faced mental health challenges related to COVID-19 and steps taken to combat the pandemic, including social distancing and stay-at-home orders.”
2. “Younger adults, racial/ethnic minorities, essential workers and unpaid adult caregivers reported having experienced disproportionately worse mental health outcomes, increased substance use, and elevated suicidal ideation.”
3. “About 22% of essential workers and 31% of unpaid caregivers also reported seriously considering suicide in the 30 days prior to the survey.”
4. “Respondents 18 to 24 years old were most likely to suffer mentally from the pandemic, with 75% of the age group saying they had at least one adverse mental or behavioral health symptom. About half, or 52%, of people aged 25 to 44 years old said the same.”

The last study we will learn from was initially published by the Journal of the American Academy of Child and Adolescent Psychiatry. This study explores the connection between COVID-19 and the isolation that children, teenagers, and young adults are feeling as a result of the cancelation of schools, sports, and other social activities. An analysis of this study was written by Alison Knopf at Brown University.

1. “The duration of loneliness is a predictor of future mental health problems, the researchers found, noting that this is particularly relevant during COVID-19 with countries considering how long schools should be closed, and how to implement social distancing in schools.”
2. “The strongest association between loneliness related to isolation and mental illness was depression, a finding that was consistent across studies of children, adolescents, and young adults. Loneliness was more strongly associated with elevated depression symptoms in girls and with elevated social anxiety in boys.”
3. “…children who had experienced isolation or quarantine were five times more likely to require mental health services and higher levels of post-traumatic stress.”

How to manage during a mental health crisis

I recognize that this could be scary new information for some. Perhaps for others, there was already an awareness of the impact COVID-19 has been having on people’s emotional wellbeing. As a professional in this field, some of this information is worrisome for me as well. We were not created to live in isolation for any period of time, let alone for months on end. The question then becomes, “What do we do with this information and what practical steps do we take moving forward?” As we move into fall and winter, when there are shorter days, colder weather, and less sunshine, it is more important than ever to be mindful of your emotional wellbeing.

One of the core principles in managing a crisis or emergency is to focus on the basics. For instance, when I was taking flying lessons in high school, my flight instructor always talked about “going back to basics”. In a flying emergency, it is crucial for the pilot to focus on the basics of flight:  the direction the airplane is flying, the speed of the aircraft, and where you are compared to the ground. If you lose focus of the basics, there is a much higher chance of not getting to the ground safely. The same principles of this lesson can be applied to people and their emotional wellbeing. When someone is in an emotional crisis, focusing on the basics of life is key to how one navigates through it. Here are four tips that can help you navigate through a mental health crisis.

TIP 1 –

Gain insight into your own emotional wellbeing. Learn about your stress level and what warning signs your body might be giving you indicating you are headed towards higher levels of anxiety, stress, or depression. US is generally a fast-paced culture, remember to slow-down. Focus on the present moment. Do not allow your brain to jump too far into the future or focus on mistakes from the past. If you struggle with staying in the present moment, teach yourself a few mindfulness skills focusing on being emotionally present in the moment.  

Tip 2 –

Engage in physical activity and build a routine. You do not have to be a bodybuilder and go to the gym three hours a day, seven days a week. It can be something simple, such as going for a 20-minute walk several times a week. Take advantage of the cooler weather and explore some local forest preserves in the area. With some of my student clients, I encourage them to do sit-ups or push-ups between their virtual classes to give their body an opportunity to be active. If you can include other family members or friends into a new routine, it can make it more enjoyable. To build a new routine, one must be intentional about it.

Tip 3 –

Focus on healthy eating and sleeping well.  Having a healthy diet and a good bedtime routine are crucial. Perhaps this is the most difficult step for people to focus on. Building a new healthy routine does not always feel natural and enjoyable at the beginning. Set an accurate expectation that this might be tough for you. Seek support from others who can help hold you accountable in developing this new healthy standard.  

TIP 4 –

Seek help before you are in an emotional crisis. Talking to a therapist before you are in crisis can often help lower the chances of entering a mental health crisis where your functionality is impacted to the point of not being able to complete necessary and daily tasks. You can meet with a therapist in-person or virtually. Remember, you can also seek support from family and friends. Set up weekly “catch-up” sessions either through Zoom, Facetime, Google, or practice social distancing and meet in-person.  

Links to data found in this article:

https://www.bcbs.com/coronavirus-updates/stories/some-the-covid-19-crisis-also-mental-health-crisis

https://www.usnews.com/news/health-news/articles/2020-08-13/coronavirus-pandemic-causing-anxiety-depression-in-americans-cdc-finds

https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/

https://onlinelibrary.wiley.com/doi/epdf/10.1002/cpu.30511