COVID-19 has added fuel to the mental health crisis in the U.S., which has been in the making for decades.
Since 2014, around one in five Americans has a mental illness, with one in 10 suffering from major depression and one in 25 from a serious mental illness. Suicide has become the 10th leading cause of death in the U.S. with over 47,000 annually.
Psychiatric Services reported in 2017 that around 3.4% of Americans (8 million) suffered from a serious psychological distress. Roughly eight years before, the number was less than 3%.
Groundbreaking research in 2018 studied over 5,000 individuals and discovered that over 56% of Americans are struggling to get mental health services for themselves or a loved one.
U.S. Health and Human Services reports that less than 20% of children who suffer from a mental health issue are receiving appropriate treatment. That is a huge disparity.
Some of this is linked to a lack of awareness of resources because of the lack of funding for community centers, which would have provided the education or even set up appointments.
In 2020, the CDC reported that 40% of Americans were wrestling with mild depression due to the pandemic, which has increased mental health related emergency room visits.
Because of the projected long-term impact of the novel coronavirus, experts are anticipating a mental health nightmare on the horizon.
“Over the past year, our world has been rocked by the COVID-19 pandemic, isolation, economic uncertainty, racial injustice, political strife, violence and more,” Daniel H. Gillison, CEO of the National Alliance on Mental Illness (NAMI), said in March 2021. “It is no surprise that this atmosphere has led to the epidemic within the pandemic: a mental health crisis.”
Prior to COVID-19, mental health services were limited – either there were not enough services or patients lacked insurance. This means we are ill-prepared for the increased needs and challenges that are coming.
The United States has simply not set aside the resources to ensure we have enough inpatient mental health beds and community resources to meet the growing need.
The largest need is access to community-based services, which keep patients connected to providers and engaged in their treatment plans. Unfortunately, these community-based programs are poorly funded or not available.
As a result, individuals suffer needlessly without support (and some, tragically, take their own lives), or treatment is pushed to more expensive settings like hospitals.
The constant reduction in mental health spending in the U.S. since 1955 has directly impacted services.
For example, roughly 35,000 state psychiatric beds are currently available. That is about 11 beds per 100,000 people – the lowest rate since the 1850s. Experts recommend that 40 to 50 beds per 100,000 people are appropriate.
Similar cuts have impacted community-based facilities and treatment centers, resulting in long wait lists and patients being placed in the wrong type of treatment program.
The Biden administration has approved record funding for mental health in the CARES Act and The American Rescue Plan, but this is all accomplished via a limited amount of grant money.
Another need is to improve insurance coverage for mental health.
Many assume that since the passage of the 2010 Affordable Care Act that everyone has mental health insurance. Unfortunately, 42% of Americans cite poor insurance coverage as a top reason for not being able to access mental health services.
In addition, 25% report that they had to choose between mental health treatment and daily necessities, while 17% feel forced to decide between treating a physical illness or a mental health condition.
Limited resources and a lack of adequate insurance have created barriers to care. Lack of appropriate, affordable mental health services potentially leads to more costly health conditions like substance abuse disorder, liver problems, heart disease, high blood pressure and potentially suicide.
The U.S. is facing an unnecessary crisis in health care.
We know that the number of mental health patients has been on the rise for decades and that we are facing a dramatic increase due to the trauma of COVID-19. We also know that we need to focus upon preventative treatment.
Rather than wait until a person requires an acute hospital admission, lands in jail or worse, we need to implement compassionate and cost-effective mechanisms for getting people treatment earlier and in appropriate and supportive community environments.
Rethinking how the government invests in health care is a first step.
A second is to begin treating mental illness as seriously as we do heart disease, chronic obstructive pulmonary disease or even cancer by advocating for targeted funding of community-based mental health clinics.
Editor’s note: This article is the first in a series this week for Mental Health Awareness Month (May).
Senior Staff Chaplain and Clinical Ethicist at the Baptist Health Medical Center in Little Rock, Arkansas.
