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Americans’ Mental Health Is Declining, and Experts Say to Brace for Worse

Mental health and substance abuse experts told legislators there needs to be a more robust public health infrastructure, more telehealth programs and less stigma for getting help.

WASHINGTON (CN) — Around half of American adults say the Covid-19 pandemic has impacted their mental wellbeing, and one-third of those adults have said there was a time in this past year that they did not get the mental health care they needed — most often because they couldn’t afford it or couldn’t find it. 

A year of isolation, stress and trauma has only worsened the United States’ long standing mental health crisis, and experts told lawmakers on Wednesday that it’s not going away anytime soon: we need to prepare for further decline.

“We have to address the unseen scars of trauma, depression, addiction and other mental health issues,” said Democratic Senator Patty Murray of Washington at a hearing Wednesday of the Senate Health, Education, Labor and Pensions Committee, which she chairs. “The reality is healing those scars will not be quick or easy. It will take years and we need to act accordingly.”

Andy Keller, president of Meadow Mental Health Policy Institute in Texas, told senators that the indicators of depression increased four-fold and the number of people considering suicide doubled in the past year. 

What’s more, 81,000 people died from drug overdoses in the U.S. in a 12-month period ending in May 2020, the highest number of overdose deaths ever recorded in the span of a year. 

And while Covid has generally spared the physical health of young people, it has taken a huge toll on their mental health as family stress, school closures and isolation occur simultaneously at a pivotal time in development. The number of mental health-related emergency room visits per 100,000 visits increased by 24% for 5 to 11-year-olds and 31% for 12 to 17-year-olds, as compared to a year earlier. 

“I believe that the most important action we can take to help people is to reopen as much of the country as quickly and safely as possible,” said GOP Senator Richard Burr of North Carolina, ranking member of the committee. “Bring back hope to the American people, let neighbors celebrate birthdays and milestones, and let students see and interact with their peers.”

Keller made a number of suggestions to the legislators, including reinforcing primary care as the backbone of the health care system in order to have a robust public health infrastructure in place. 

“The hallmark of a public health approach is we have to detect illness early and we have to do everything we can to prevent it,” Keller said. “Primary care is the best part of our health system to detect. Furthermore, including that public health framework with our schools, and targeting and providing selective service to students at risk.” 

Witnesses told legislators of the need to continue using telehealth services even after the pandemic is over, as it eliminates transportation time and costs, decreases the number of no-shows and reduces the embarrassment and stigma around seeking mental health treatment. 

“That is the dynamic which leads telehealth to be so successful, it’s the lack of stigma,” said Keller. “Research shows that telehealth works — in many cases, better — because of anonymity. It’s easier to tell the truth.”

Telehealth will also be important for health care providers, who often don’t seek mental health services because of the stigma associated with it, and because their long hours sometimes don't allow it.

“We need to eliminate the repercussions of reporting mental health conditions,” said Tami Benton, psychiatrist-in-chief of the Children’s Hospital of Philadelphia. “Many physicians are afraid to report a mental health concern, particularly if there was a substance use concern, for fear of losing their license.”

Keller said the mental health of health care providers may worsen after the pandemic is over. 

“Prepare for me. We didn’t see PTSD rates go up during the war, it was when they came home,” Keller said. “We have to normalize the experience that people are going to suffer from post-traumatic stress and its rates are going to go up after the pandemic recedes.”

Expert witnesses and committee members also touched on loan forgiveness programs so that people who are entering the medical field can afford to go into mental health treatment, expanding access to educational programs and the need to continue to innovate new models of care. 

“This pandemic is a painful reminder that our work remains far from finished,” said Murray.

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