Cases of anxiety and depression increased dramatically during the pandemic.
Researchers with the U.S. Government Accountability Office released a report on April 30 that confirmed what previous studies had revealed: Cases of, and emergency department visits for, overdoes and suicide attempts skyrocketed, increasing by 36% and 26%, respectively.
None of this is new. We have seen a rise in mental health cases with almost every pandemic.
We saw it with the Russian Flu of 1889, which is now believed to have been a corona-style virus. For many, the disease was associated with lethargy and depression, which lingered long after the pandemic. Parallels can be seen with today’s COVID-19 long haulers.
In like manner, the flu pandemic of 1918 saw a huge spike in mental health related issues. Years after the 2003 SARS CoV-1 scare, affected populations are still wrestling with substance abuse disorders.
Some experts explain this phenomenon as societal post-traumatic stress disorder; others link it to the viral disease process.
How epidemics and mental health are linked is still speculative, but it is well documented that there is a correlation.
Because we are again witnessing an increase in epidemic-related mental health cases, one would expect clinics to be doing more to combat the problem. Unfortunately, we are seeing the opposite.
The National Council for Behavioral Health surveyed its member organizations and estimated that during the pandemic 27% of member organizations had laid off staff and 45% had shut down programs.
The scaling back of services has resulted in the rise in mental health emergency department visits.
Some of this was understandable during the early days of the pandemic because the professionals did not know what was safe.
Yet, even as knowledge about COVID-19 increased, and even with a majority of the country now vaccinated, we are still not seeing increased mental health services.
For decades, mental health services have fought to gain funding from the government and insurance companies.
The Mental Health Parity and Addiction Equity Act of 2008 and the Patient Protection and Affordable Care Act of 2010 required that institutions and insurers had to provide for mental health and substance abuse treatment.
Today, only pre-ACA insurance policies and health care cost-sharing ministries are exempt from the mental health parity rules, but that does not mean the problem is solved.
Mental health and substance abuse treatment has historically had low reimbursement rates, and those rates have steadily been dropping.
Since 2001, Medicare reimbursement rates for mental health have dropped almost 20%. In 2013, the American Psychological Association reported that 26% of psychologists had left the Medicare program due to low reimbursement rates.
As a result, mental health clinics are being forced to refuse Medicare patients because they do not get reimbursed enough to keep the lights on and the doors open. This trend is extremely troubling because over 25% of Medicare recipients have some kind of mental health concern.
It also contributes to the economic disparities in this country. Economically challenged households deserve access to mental health services.
Two factors are making matters worse.
First, mental health and substance abuse cases related to the COVID-19 pandemic are flooding the system.
Experts have been talking about this for almost a year. The surge in cases is joined by the influx of substance abuse patients linked to the opioid crisis.
Both surges will not end soon, and we are not sure when they will even crest. The nation does not have enough mental health professionals to handle the current caseload let alone what is coming.
Second, Medicare is being flooded with new members as the baby boomer generation ages.
The Centers for Disease Control and Prevention estimates that 20% of people over 55 years of age have some kind of mental health concern, ranging from anxiety and depression to cognitive impairments like Alzheimer’s.
Because professionals already cannot handle the number of mental health cases filling our emergency departments and hospitals, the baby boomer generation will be left with nowhere to go for help.
The lack of focus on mental health services for senior citizens is abhorrent as 80% of the time these patients are easily treated in outpatient settings.
In addition, it is known that the failure to treat these conditions increases patient mortality and radically escalates the cost of care.
This continued failure to address mental health disparities is neither compassionate nor cost effective. We are leaving countless vulnerable people to suffer needlessly.
As more and more cuts are made to Medicare, and as insurance reimbursement rates continue to decline, we will witness an increase in the crisis.
Therefore, it is time for us to look to a paradigm that focuses upon holistic care.
Our definition of health care needs to adequately address the connection between physical health, mental health and social well-being.
We need to do so before the system is swamped, and we can never recover.
Editor’s note: This article is part of a series this week for Mental Health Awareness Month (May). The previous articles in the series are:
A Survival Guide for Tired Clergy After COVID-19 | Elizabeth Denham Thompson
Don’t Stigmatize Others Seeking Mental Health Services | Autumn Lockett
5 Tips Toward Good Mental Health During Pandemic | Michael Chancellor
9 Ways to Overcome Pandemic’s Shadowy Grip | Gillian Drader
Limited Access, Funding Plague Mental Health Care | Monty Self
Senior Staff Chaplain and Clinical Ethicist at the Baptist Health Medical Center in Little Rock, Arkansas.
