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Failure to address coronavirus mental health issues will prolong impact
Increased levels of fear and anxiety are just the tip of the iceberg when it comes to the possible mental health implications of the coronavirus pandemic. It's often the underlying factors we don't see right away that can have the most severe long-term consequences, if not adequately addressed.
There are several things the federal government and state and local leaders can prioritize in their coordinated responses to ensure the health and well-being of Americans long after headlines about coronavirus have dissipated.
First and foremost, transparent, science-based communications -free from political jargon - are essential. Conflicting or confusing information will exacerbate panic, which could put a strain on our health care system and leave those who require treatment for acute respiratory distress and other life-threatening conditions in a dangerous predicament.
People need actionable information about when, where, why, and how to seek care. And communication tactics cannot be one-size-fits-all. Message points must be culturally informed, targeted based on regional demographics, and vetted by professionals.
It is also critical for officials to publicly counter any efforts to blame already marginalized groups for coronavirus. The toxic mix of scientific ignorance and paranoia often resulting from misinformation has a long history across the globe, including in recent decades during the HIV/AIDS pandemic and outbreaks of SARS and Ebola. Coronavirus communications must correct this type of misinformation head-on.
Second, our leaders must acknowledge that psychological trauma from coronavirus will happen and take specific steps to address it proactively. In a survey of Hong Kong residents about SARS, nearly two-thirds of respondents expressed helplessness, with nearly half saying their mental health had severely or moderately deteriorated because of the epidemic. Sixteen percent demonstrated posttraumatic stress symptoms. Similar mental health implications should be anticipated in the U.S.
When trauma goes unaddressed, symptoms can appear and worsen over time. In this case, unaddressed trauma from quarantines and social isolation, feeling one's own life is in danger, illness, or the loss of a loved one to coronavirus could have public health repercussions that reverberate for years.
Research has shown that traumatic events can trigger emotional and even physical reactions that can make people more prone to health conditions such as heart attack, stroke, obesity, diabetes, and cancer. Trauma can also impact a person's ability to cope daily. So, if someone has a predisposition toward anxiety, that anxiety might escalate to debilitating levels. Many who have experienced trauma also end up self-medicating uncomfortable feelings with drugs and/or alcohol.
Given that we are already struggling to address a mental health crisis in this country - with overdose rates at historical levels and suicide, the fourth leading cause of death for adults between 18-65 - the importance of efforts to lessen the impact of trauma and other mental health implications cannot be overemphasized.
A government taskforce on coronavirus-based trauma should be assembled to advise on best practices and monitor nationwide trends. If needed, extra resources should be made available immediately in areas of concern.
Third, we must use technology (i.e., telehealth) to treat more people remotely. If significant portions of the population end up quarantined or isolated, mental health and addiction treatment services must still be available online through secure, video conference-based options such as telehealth.
Telehealth can accommodate psychological assessments, therapy (individual, group, or family therapy), patient education, and medication management. Research shows it is equivalent to in-person care in diagnostic accuracy, treatment effectiveness, quality of care, and patient satisfaction. It is a powerful tool for extending provider reach.
The federal government should urgently remove barriers to telehealth in Medicaid and Medicare, which collectively cover over 120 million people, and instruct commercial insurers to ensure telehealth services are available to all members. Employers can also follow up with their health plan administrators to inquire about telehealth options and communication strategies for staff.
In summary, although no response is going to be perfect when navigating a public health crisis of this magnitude, there are essential steps we can take to prepare and lessen the impact. Our leaders must act now to structure a thorough response to coronavirus that goes beyond testing and containment protocols. If we fail to take into account the mental health implications of this crisis, we will undermine our ability to fight and recover from it. As a nation, we have a unique opportunity to set a new precedent: mental health is essential health.
Dr. David Satcher is the founder and senior advisor of the Satcher Health Leadership Institute at Morehouse School of Medicine. He was the 16th U.S. Surgeon General, and former Director of the Centers for Disease Control and Prevention (1993-1998). Former U.S. Rep. Patrick J. Kennedy is the founder of The Kennedy Forum, co-founder of the Kennedy-Satcher Center for Mental Health Equity in the Satcher Health Leadership Institute at Morehouse School of Medicine, and co-chair of Mental Health for U.S. Arthur C. Evans Jr., Ph.D. is CEO of the American Psychological Association.