The coronavirus brought swift public health and economic damages, but the mental toll from thousands of deaths, millions on unemployment and isolation could have lasting effects on mental health.
While the volume of West Michigan residents initiating behavioral treatment hasn’t necessarily increased, the severity of callers’ anxiety, stress and depression has, experts say. Without early treatment to identify the symptoms, longer term mental health disorders may settle in.
“The people who are calling seem to have much more severe symptoms to what we’ve experienced pre-COVID-19,” said Kristin Spykerman, chief clinical officer for Network180, Kent County’s community mental health authority. “We definitely are thinking these will have long-term impacts.”
Behavioral health experts say the warning signs of long-term mental health issues are already evident in increased alcohol sales, for example, and rising unemployment, which grew from less than 4 percent to more than 20 percent in Michigan over a matter of weeks.
The ongoing uncertainty over the economy and forced isolation contribute to anxiety and depression, culminating in increased risk for post traumatic stress disorder or suicide, particularly for front-line health and other essential workers, as well as those who have lost loved ones but weren’t able to see them.
Evonne Edwards, outpatient clinical director for Pine Rest Christian Mental Health Services in Grand Rapids, says while crisis hotline calls have increased in Michigan and nationwide, “We’re not seeing that same increase in people coming to initiate services. There’s a mismatch, and it might mean people don’t think we’re open for business.”
She added that seeking help and intervening early is key.
“Managing stress early on might treat it while it’s still mild symptoms and prevent you from a long-term anxiety disorder,” Edwards said. “It doesn’t have to be a crisis level to seek help.”
Still, Edwards remains concerned about long-term effects on health based on research following other pandemics, such as SARS in the early 2000s. She is “particularly worried” about an increase in substance use disorders, or using alcohol and drugs to cope with the surrounding health crisis.
“I’m seeing on Facebook things like ‘quarantinis’ — that’s clearly being used to cope,” Edwards said. “When you use it that way, it puts you at increased risk of substance use disorder.”
Other concerns for Edwards include a spike in domestic violence incidents, child abuse and neglect and increased suicide rates.
“So many of the known predictors of suicide and worsening mental health are increasing,” she said. “Unemployment is predictive of anxiety, depression and suicide. … Some of the mental health outcomes will reverberate longer than some of the economic ones.”
Services expand, move online
A national poll released last month by the American Psychiatric Association showed more than a third of Americans say COVID-19 is having a serious effect on their mental health.
One possible silver lining to the mental health implications of COVID-19: It’s never been easier to get treatment. Phone-based treatment and telehealth, or seeking therapy virtually, is now commonplace and likely will be in the future.
Network180, Pine Rest and Forest View Hospital — a private psychiatric facility in Kent County — this month launched the “Don’t Go Out, Reach Out” campaign encouraging residents to contact local mental health agencies instead of going to emergency rooms. The organizations and others around the state and country run 24/7 hotlines.
“It’s never been easier to reach out for mental health help than right now,” Spykerman said.
The reach-out campaign is meant to avoid straining emergency departments treating COVID-19 patients. According to Spykerman, Kent County sees more than 15,000 ER visits a year related to behavioral health.
The Whitmer administration has also focused on mental health during televised COVID-19 updates and has issued multiple orders making it easier for residents to seek treatment.
Earlier this month, a statewide “warmline” was opened to offer phone services to people who need to speak to someone but aren’t suicidal. The Michigan Cares program aimed at educators and families with school children offers free digital lessons involving mental health. On April 17, the state also launched the “Stay Home, Stay Mindful” website that includes in-home meditations and exercises free of charge.
“Michiganders have faced an unprecedented crisis over the past month, and in these uncertain times having access to mental health resources is crucial,” Gov. Gretchen Whitmer said in a statement announcing the website. “This virus has taken a toll on Michiganders’ physical and mental health. While we all stay home and stay safe, it is so important (to) take the time to check in and take care (of) yourself. Michiganders are tough, but having access to tools like this one will help us all get through this together.”
Michigan has also received federal funding to improve mental health services. On April 21, the U.S. Department of Health and Human Services issued $2.3 million in grants for the state, including $2 million for community mental health programs.
How employers can help
For people who have been working from home, employers can play a key role in monitoring the mental health of employees. Spykerman encourages employers — while it varies based on industry — to remain in contact with staff and reach out “far more frequently” than before. This includes “more all-staff meetings and encouraging supervisors to connect if not daily then several times a week to ask staff how they’re doing — not just work-related, but emotionally.”
Edwards said employers can ensure health insurance plans cover telehealth and should convey to workers “the importance of using those resources.”
She agrees with Spykerman that regular check-ins with employees are crucial, as is making the work environment as safe as possible for those companies remaining open.
“Feeling emotionally safe and physically safe at this point makes a very big difference,” Edwards said. “If they’re feeling unprotected by employers or put at a greater risk than needed, that can exacerbate any symptoms that are there.”