Future of public health: Mental health is key to healthy individuals and communities

Madison, Wis. — From greater incidence of problematic drinking and opioid use disorder, to increased rates of depression and anxiety, COVID-19 further exposed a dramatic need in the United States – mental health care.

A growing body of evidence shows that mental health declined during the pandemic. In June 2020, adults reported levels of adverse mental health conditions, substance use and suicidal thoughts at considerably higher rates than the same point in 2019, according to a study in the Centers for Disease Control and Prevention’s Monthly Morbidity and Mortality Report.

About 25% of adult respondents reported symptoms of an anxiety disorder, compared to 8.1% in the second quarter of 2019. The increase in depressive disorders was even greater: 24.3% in June 2020 compared to 6.5% in 2019. The study showed that communities of color were disproportionally impacted.

Experts attribute this to stressors like fear of job loss, economic stress, social isolation, unstable housing, concerns about getting sick, domestic violence and others, according to Dr. Beth Lonergan, director, Behavioral Health Services, UW Health.

Understandably, demand for mental health services also increased during the pandemic, according to a report from the U.S. Government Accountability Office.

The COVID-19 pandemic has exposed and exacerbated longstanding mental health trends, while also moving it to the forefront of public health, and the public health system must grow to meet these challenges, Lonergan said.

“Impacts on mental health treatment like access challenges, workforce shortage, concerns regarding untreated behavioral health issues and lack of focus on prevention – including building resilience in people – have been years in the making,” Lonergan said. “Now that more people are seeking care, the health care system must respond.”

A rise in cases of substance use disorder also became apparent as people struggled to cope during the pandemic, particularly alcohol and opioid addiction and deaths due to overdose. And, for those already addicted, their social structure in many cases was taken away or disrupted by the social isolation the pandemic created, she said.

Addressing the mental health implications of this “twin-demic” – rise in substance abuse coupled with COVID-19 – will need to be a major focus in public health as well, Lonergan said.

While it will take time to build up access capacity in the health care arena, telehealth could play a key role in increasing access to care and early intervention.

“For patients in rural areas where transportation is a barrier, telehealth and virtual visits will be a valuable tool,” Lonergan said.

A greater support for clinical access is important, but there are two themes that will also be crucial to combat as society emerges from the pandemic: building resilience and early intervention to safeguard mental wellbeing particularly when people and populations navigate times of intense stress, strain or trauma.

“Making our society better equipped to cope with challenges when they arise, like the trauma of isolation in a pandemic, or the shock of a natural disaster or mass shooting, will be a future facet of public health,” Lonergan said. “And, early intervention when needed can spare the public health system cost and access, but more importantly, reduce the suffering of those impacted.”